Breast Augmentation
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WHAT IS BREAST AUGMENTATION?
Breast augmentation is a popular cosmetic surgery procedure performed to increase the size of the breasts using breast implants or fat grafts. This treatment can help people enhance their breast volume or restore a natural-looking breast shape to their figures.
WHO IS A CANDIDATE FOR BREAST IMPLANT SURGERY?
Breast augmentations remain one of the most popular cosmetic surgeries from year to year. People in and around Portland, Oregon consider this procedure for a variety of reasons, such as:
- You feel that your breasts are too small for your body type
- You feel uncomfortable wearing a swimsuit or low-cut tops because of your breast size
- You have small or deflated breasts due to weight loss
- You have asymmetrical breasts
If you experience one or more of the above concerns, you may be able to benefit from breast augmentation or a related procedure, such as a breast lift. Breast augmentation patients need to be in generally good health and have reasonable expectations and motivations for wanting to increase their breast size. Dr. Fichadia will also tell patients to stop smoking before the plastic surgery procedure, as this limits the body’s ability to heal.
At the end of the day, an in-office consultation with board-certified plastic surgeon Dr. Hetal Fichadia is the best way to determine if you’re a good candidate to be a breast augmentation candidate.
Before & After

Breast Augmentation Case 9

Breast Augmentation Case 1

Breast Augmentation Case 2


BREAST AUGMENTATION CONSIDERATIONS
Breast augmentation comes with a few different choices that will determine the path of your surgery and the outcome of your results. These include your breast implant type, your incision, and the implant’s placement.
BREAST IMPLANTS
The broader classifications of breast implants are silicone gel implants and saline breast implants (both types are generally made with a silicone shell). Both saline and silicone implants Dr. Fichadia uses are FDA-approved, and breast implants, in general, are some of the most widely studied and documented medical devices in history.
Saline implants are filled with a sterile saltwater solution after placement inside the breasts, and the advantage of these implants is that it requires a smaller incision that is easy to conceal within the breast’s natural folds and pigmentation. The downside is that it is liable to deflate the breast if it ruptures, but this makes it easy to detect.
The other types of breast implants are filled with silicone gel. Their advantage is that they are softer and give a more natural look and feel compared to saline implants. Since they do not deflate with a rupture, however, this type can require an MRI scan to detect any weak areas or tears. “Gummy bear” implants are silicone implants but are filled with a more cohesive silicone gel, which is more like a solid than liquid, giving it a “gummy bear” consistency that feels very similar to natural breast tissue.
Additionally, both saline and silicone breast implants come in many different shapes and sizes, meaning Dr. Fichadia can assist you with selecting the ideal implant for your exact results. Some factors include projection, profile, shape (round or teardrop-shaped), and texture, all of which will produce different results. It’s important for a woman to know exactly how they would like their results to appear so that choosing the type of implant becomes easier.
INCISIONS
There are also a number of incision patterns that can be used for breast surgery. Dr. Fichadia offers breast augmentation techniques using these incision options:
- Inframammary incision, which follows the curve of the natural breast fold.
- Periareolar incision, which follows the pigmentation of the areolae.
Each of these incisions offers different benefits, depending on your implant choice and intended results. Both offer effective concealment for scarring, but you can speak with Dr. Fichadia about your options if your skin is especially prone to scarring.
IMPLANT PLACEMENT
Implants can be placed in one of two ways during a breast augmentation procedure: underneath the pectoral muscle or above it. The former procedure is called a submuscular placement and the latter is called subglandular. In either case, a small pocket is formed within the breast tissue to accommodate the breast implant.
Each placement type offers different benefits and will provide a different feel, comfort, and projection. For example, implants placed underneath the muscle will have a more natural feel and look, but will not project as much. Implants placed on top of the muscle will provide greater size and projection but are more prone to rippling.
During your consultation, Dr. Fichadia will discuss your best options for all the various breast augmentation procedures, including implant size, shape, and placement.
THE RAPID RECOVERY PROCEDURE
Dr. Fichadia prefers to practice a set of techniques called rapid recovery breast augmentation, which leads to excellent results without the extended recovery period of traditional breast augmentation Portland. This surgical breast implant procedure includes taking care at every step of the procedure to avoid tissue aggravation and rough handling, both of which contribute to swelling and the risk of complications like capsular contracture. In practice, here is what rapid recovery breast augmentation looks like.
PRE-OPERATIVE STEPS
This process starts at your consultation with the precise and complete measurement of the treatment area, implants, and incisions. Although this is done at any breast augmentation consultation, the rapid recovery technique does it with the intent of reducing as much trauma and manipulation to the surrounding tissues as possible. When Dr. Fichadia has exact measurements and can precisely plan her technique, she can avoid these things that commonly contribute to extended recovery periods.
INTRAOPERATIVE STEPS
Most patients are surprised to learn that the rapid recovery method avoids using any deep anesthetic, intubation, or ventilation, and can be performed with a combination of lighter anesthetics. This greatly reduces any nausea or adjustment period after the surgery is complete, meaning many patients can be mobile after their procedure. The surgical techniques also focus on reducing bleeding, tissue trauma, and time spent in the operating room. Another factor that greatly reduces downtime is avoiding contact with the breast implant, which also greatly reduces the chance of infection.
POST-OPERATIVE STEPS
Unlike traditional breast augmentation recovery, which focuses on minimal movement or lifting, the rapid recovery method utilizes a long-lasting local anesthetic at the treatment area. This allows for light stretching and mobility soon after surgery, which can reduce the risk of capsular contracture. In fact, most rapid recovery plastic surgeons instruct their patients to regularly stretch and move around during the initial recovery.
Traditionally, the first few days after the procedure can be the most uncomfortable for a patient. The use of a long-lasting nerve blocker allows patients to recover comfortably, without the use of heavy pain medications.
RESULTS AND RECOVERY
You will receive detailed instructions for your rapid recovery during your consultation with Dr. Fichadia, but generally, you can expect to take two to three days off of work or school. After your breast augmentation surgery, you will be placed in a surgical bra to help minimize swelling and support your new breast size and shape as you heal.
Mild swelling, discoloration, tightness, and discomfort are expected. Excessive physical activity should be avoided for the first two weeks, though light walking is recommended. While most of the physical and emotional recovery occurs within 1-2 weeks after surgery, the recovery of the augmented breasts to their final appearance usually takes several months. Dr. Fichadia will schedule post-surgical appointments with you to help monitor your breast augmentation recovery.
BREAST AUGMENTATION IN PORTLAND, OREGON
If you want to boost your self-confidence by looking great in whatever you choose to wear, breast augmentation may be right for you. We know you have many breast augmentation choices and we’re ready to show you why Dr. Hetal Fichadia is the best choice for your plastic surgery. Please contact our office today by calling (503) 488-2344 or contact us online to schedule your consultation with Portland breast augmentation surgeon Dr. Fichadia.
BREAST AUGMENTATION FAQS
Are breast implants under warranty?
Yes. Most manufacturers cover their implants under warranty. They differ in their duration, coverage, and extra fees. Each of these manufacturers warranties is very strong. All of them provide a level of coverage and protection that is unusual in any product, particularly one that receives as much wear-and-tear as a breast implant. We do not recommend choosing an implant brand based on warranty alone. The breast implant brand used for your surgery should be discussed in detail with Dr. Fichadia and ought to be based on a variety of factors.
How long is breast augmentation recovery?
Dr. Fichadia uses innovative techniques to make breast augmentation a rapid recovery procedure. The patients should be able to go out the same evening. The soreness in the muscle feels more like it feels after an intense work out. Patients can expect to take up to three days off work or school. Any physical or strenuous activity should be avoided for two weeks post-op, at which point all activities can be resumed. The optimal results from breast augmentation will still not be apparent for a few months as the tissues heal.
What happens if you do not massage your breast implants?
Some patients have heard that massaging your breasts after breast augmentation is good for preventing capsular contracture, but this is unproven in the literature. In the initial healing period, massaging the breasts can do more harm than good. After surgery, you will be fitted with a surgical bra or compression garment to aid in healing and making sure the implants settle into the desired position. Once healing process is over, implant massage can be done, but there is no clear cut evidence that this helps prevent capsular contracture.
What causes breast implants to rupture?
All breast implants have a chance of rupturing. Over time, the risks of implant rupture increases. Most implant rupture is caused due to aging of the implant, but rarely, it can also be caused by trauma from accidents or impact to the breasts.
What is a gummy bear implant?
A gummy bear implant is one of the many implant options available for breast augmentation. these implants are silicone gel breast implants that contain a more form-stable material. They are called gummy bear implants because they are known to retain their shape better than other types of implants while still allowing breasts to still be naturally soft.
Do breasts sag after breast augmentation?
Breast implants can sag over time, especially if they are large. The augmentation surgery does not stop the skin from aging so the natural strength and skin elasticity of the breasts can change, to causing the implants to sag.
Can breast implants cause pain years later?
Yes. Breast implants can cause pain either due to capsular contracture (where the shell around the implant gets thickened and tight) or leakage (which may or may not always be painful).
Can breast implants last 30 years?
Yes, they can, but it is more an exception than the rule. Breast implants can have weakness in their outer shell 10-20 years after placement, causing leakage. It may not always be visually apparent through breast shape. For patients, it is important to understand that breast implants will likely need additional surgeries in the future for replacement or removal or revision.
Can fat be transferred to breasts?
Yes!! Fat transfer is a great way for all-natural breast augmentation, with the added benefit of contouring a different area of your body. It is one of Dr Fichadias clinical interests as well.
Will Cigna cover breast augmentation?
Cosmetic breast augmentation is not covered by insurance.
Whats the safest breast implant?
All the currently available breast implants have undergone rigorous testing and found to be safe. That being said, it is important to understand that they are not meant to be lifetime devices, and will need replacement in the future. For silicone breast implants, FDA recommends screening for silent rupture by an MRI starting 5-6 years after placement and every 2-3 years thereafter.
What are gummy bear implant?
A gummy bear implant is one of the many implant options available for breast augmentation. these implants are silicone gel breast implants that contain a more form-stable material. They are called gummy bear implants because they are known to retain their shape better than other types of implants while still allowing breasts to still be naturally soft.
How long are breast augmentation incisions sore?
Breast augmentation incisions can be sore for upto 1-2 weeks. Most patients dont need any strong opioid-type pain medications after the surgery.
How do you know if you have capsular contracture?
If the breast starts to feel firm and/or tight, that may be a sign of early capsular contracture.
Can you breast feed after breast augmentation
Yes! You can breast feed after breast augmentation, especially if the incision is made in the breast fold at the bottom of the breast, which is what Dr Fichadia recommends. It is important to know that a certain percentage of women may have trouble with breastfeeding regardless of whether they have implants placed or not.
Can I move my arms after breast augmentation?
Yes! Dr Fichadia encourages arm movement after breast augmentation to promote speedy recovery. In fact, you will start doing arm stretches in the recovery area itself!
Does getting breast implants make you gain weight?
There is no clear scientific evidence linking breast implants with weight gain.
Do breast implants cause autoimmune disease?
At this point, there is no strong scientific evidence suggesting a direct link between breast implants and autoimmune diseases.
Do you have to replace breast implants every 10 years?
Breast implants are not meant to be lifetime devices and will likely need replacement in the future. This time is variable, but usually between 10-15 years. If your breasts look good, and imaging shows no rupture, there is no reason to replace the implants immediately. In general, the longer the implants have been in place, the more likely it is to find a rupture.
How do I know if my breast implant is leaking?
With saline filled breast implants, a leakage will result in visible loss of volume of the breasts. With silicone breast implants, there can be a rupture without any obvious visible changes to the breast. An MRI or high resolution ultrasound can be helpful to evaluate if the implant is ruptured.
Does insurance cover breast implants?
Insurance covers placement of breast implants only after a mastectomy (removal of breast tissue) for breast cancer treatment or prevention. Insurance does not cover cosmetic breast implant placement.
How dangerous is breast augmentation surgery?
A breast augmentation surgery is takes 1-1.5 hours under general anesthesia, and is extremely safe. It is an outpatient surgery with return to daily low impact activities within 2-3 days.
Is breast enlargement possible without surgery?
There is no way to enlarge breast tissue without surgery.
What are cohesive breast implants?
A cohesive breast implant has cross linked silicone which reduces the risk of rippling and implant rupture.
How painful is breast augmentation recovery?
Dr Fichadia uses rapid recovery technique for breast augmentation using breast implants. It is an outpatient surgery, and patients return to their daily activities within 2-3 days. Most patients dont require anything more than Tylenol and anti inflammatory pain medications. It is important to follow all the instructions and post surgery stretches to ensure smooth recovery.
Is there an alternative to breast implants?
Fat grafting is an alternative way to enhance the size and shape of the breast tissue. Dr Fichadia harvests unwanted fat from other areas through liposuction and injects it into the breast tissue for permanent breast enlargement.
Is getting a breast augmentation worth it?
Breast augmentation is one of the surgeries with a very high patient satisfaction rate.
What is the difference between a breast augmentation and breast implants?
A breast augmentation is an enlargement in breast size, most commonly done using breast implants. It can also be done using fat grafting to the breast.
What is the average cost of a breast augmentation?
Average cost of a breast augmentation (using silicone breast implants) with Dr Fichadia is $7200- $7900
What are Natrelle breast implants?
Natrelle is a line of breast implants made by Allergan
What can go wrong with breast implants?
Breast implants can rupture, go out of position, and develop tightness of surrounding scar tissue (capsular contracture)
how much does breast augmentation cost?
Average cost of a breast augmentation (using silicone breast implants) with Dr Fichadia is $7200- $7900
What is the most common breast implant size?
Dr Fichadia recommends a breast implant based on your chest measurements and size goals for bespoke results, therefore, there is no one size that fits most of our patients.