The talented cosmetic surgeons at Sarasota Plastic Surgery perform countless breast augmentation procedures each year. Breast augmentation enhances the size and shape of the breasts. If your breasts are naturally small, unequal in size, have become visibly smaller after pregnancy, or sag as a result of aging, you could benefit from cosmetic breast surgery. Using silicone or saline breast implants, or in some cases, a fat transfer, enhancement surgery can improve your self confidence and allow you to wear the clothes you have always wanted. During a thorough consultation, your aesthetic goals will be discussed, and all of the various options presented so that the best treatment plan can be implemented. Breast augmentation surgery produces gorgeous, natural looking, lasting results for our Sarasota patients.
Breast Augmentation Reviews
"Dr. Engel was very welcoming and made me feel comfortable through out each and every visit. He is very funny. He educated me on the different types of implants, sizes and profiles. He was able to answer every question I had before I even asked it. If you're thinking about getting a BA, I RECOMMEND HIM!!!! No questions asked. I will go back to Dr. Engel every time for any and all other BA surgeries needed. He gave me a natural look that I didn't think I was going to like at first because I thought they would be too small (but after the drop & fluff...which is still happening) they look more full on the bottom so I understand why he recommended I not go any bigger...My goal was to proportion my body because I am a little more bottom heavy. So I thought big big big to even it out, but he exceeded my expectations and I could not be happier with my results. I have so much more confidence because of him. Thank you SO much Dr. Engel."- B. / Vitals / Aug 06, 2014
"Dr Mobley is the best of the best, I am so 100% happy & satisfied with his great work and excellent advice."- N.O. / Yelp / Nov 14, 2015
"Life Changing! Breast Augmentation with Periareolar Lift - Sarasota, FL - I'll start off this review by saying if you have ever considered having a breast augmentation, wait for the Doctor who you are 100% confident in and with. Now I'll share my story. I'm 24 years old and went through a pretty big weight loss a few years ago. I lost around 80 pounds, all of which i was completely convinced was any appealing breast tissue i ever had. I was left with loose skin and my boobs did this super attractive cookie monster thing. Being an 18-23 year old took a toll on my self confidence. It took a bit until I realized I am not defined by my breast size or how they look, I became confident in myself as a woman and thats when I knew I was ready to pursue the surgery. Coming from a family who is completely against plastic surgery, friends who pressured me to get it or not get it, listen, EVERYONE will have an opinion. But what matters is you. This is your body and your life. People will think you are the smartest person or the dumbest. They will love your results or hate them. Again, this is you that will live with the results of either having a breast augmentation or not. It is a very personal decision and you make it confidentially. The ones who love and support you either way will be there. It took a lot of consultations, before i found hands down, the best and most honest Doctor I've ever encountered. I went to consultations where I felt rushed, like my questions were silly or a burden, I had a lot of questions with having some extra skin and wanting my breasts to be even(no more cookie monster) etc.. and please, if that ever happens, you leave. This is a major surgery and you are looking for someone to completely trust, it is a life changing surgery. It took about 5m of talking with Dr. Brian Derby of knowing he was going to be my doctor. He has changed my life. He has given me results above and beyond anything I have ever dreamed of. From the first consultation he sat and answered any and every question I had, he put me at ease and explained everything so thoroughly. He explained along with a breast augmentation I would also need a periareolar lift, he thoroughly went through implant sizes and I was able to show him what I wanted, my end goal was to be a D-DD, he went over after care and everything in between. I felt 100% trust with him. His staff is so thorough and follow up with you very often. So I booked my surgery and my final consultation before I brought my boyfriend who would be taking care of me after, Dr. Derby explained everything to him, made him completely at ease. We talked about everything, joked around, showed my boyfriend the final implant size, I left feeling very excited and confident.The day of surgery I wasn't that nervous and I owe that to my supportive man and the staff and Dr. Derby, we all joked around that morning, very early morning, talked about going under, they answered my question of "will I wake up half way during surgery?" as silly as it was, that was my only fear. We all laughed at that one. Everything went amazing. They called my boyfriend multiple times during surgery to let him know I was good, which meant a lot to him and put his mind at ease, the next thing i know I woke up with boobs! Best day ever! Recovery wasn't bad at all. I slept most of the first day, and went back the next morning for my follow up. I got to see them for the first time and even with them being 12 hours old I was amazed. I went home and just stared at them and cried because I was so over whelmed with happiness. That has been my every day reaction since. I had this mental picture, combined of all the boobs I looked at prior to surgery, which was ALOT, alot, of boobs..and my results don't even compare. I never imagined I would and could look like this. The after care and follow up and how personable Dr. Derby has been, what he has done for me, how he has changed my life, I could never say thank you enough. I waited for this surgery and I thank God every day I waited until I felt that trust, because how beyond happy and in love with my results, I wouldn't trade for anything. I went from about a 32B to a 32DD. No more cookie monster thing, just perfection in my eyes. I'm about 1.5 months post OP and my scars have almost completely diminished. I will and always go with Dr. Derby. I get compliments daily and can't help but be so excited to tell people where to go and who to see, because every single woman who wants and is pursuing a breast augmentation deserves the happiness, trust, comfort and excitement and falling in love with YOUR body and how you look, what I live with now and after having an incredible experience, was worth the wait, was worth everything.Thank you Dr. Derby for impacting my life in such an amazing way! You truly are gifted in what you do!"- L. / RealSelf / Jun 24, 2016
"New Boobs! - Sarasota, FL - My interactions with him were awesome, he made sure I didn't go too big and also made sure I was comfortable! - - Dr. Engel is amazing! I had my breast augmentation done February 1st and he made everything so easy. I was extremely nervous to have the surgery and he made sure I was very comfortable as well as making sure the size that I choose was appropriate for my size, defiantly would go back or recommend him!"- C. / RealSelf / Jul 12, 2016
"30 Years Old, I Wanted to Add Lift and Fullness to my Breasts - Sarasota, FL - Dr. Derby was an amazing doctor to work with. I felt very comfortable around him and he listened to what my needs/wants were, and he delivered. He was very compassionate about his work and I could tell he put in the extra time and effort, he truly loves what he does. I even emailed him after my pre-op appointment to express what I wanted further and he called me promptly to ensure we were on the same page. My breast augmentation was the first surgery I've ever had and while I was nervous to be put under, I felt 100% at ease knowing I was in good hands. He followed up with me every day and my recovery process was easier than I could have ever imagined, I was out of the house the next day for my follow up appointment and I felt great. I have recommended him to all my friends & family for any procedures they were interested in. - - I wanted to be able to wear a sports bra and my breasts not have the "pancake" effect. I also wanted the option of not wearing a bar since there are so many cute clothes that have open backs, mainly dresses. I talked about having a breast augmentation for approximately 5 years and I wish I wouldn't have waited so long, I love the results."- J. / RealSelf / Aug 22, 2016
Saline vs Silicone vs Fat
Saline Breast Implants
Saline filled breast implants remain a good choice for patients under 22 years of age (silicone gel implants have not been released by the FDA in patients under 22 years of age unless approved by the doctor because of specific anatomic reasons, it is important to get a doctors opinion before deciding on the best implant type) and in patients who desire saline filled implants over silicone gel filled implants. Because these implants are filled with a sterile saltwater solution, any potential leakage is absorbed easily by the body. Saline implants also cost less than the silicone gel filled implants. Disadvantages of saline implants include rippling that can be seen or felt and a tendency for the implants to gradually shift lower in the pocket, causing thinning of the breast tissue under the implant. This is important to consider for women who are thin and have a small amount of breast tissue. Those who opt for this type of implant must be at least 18 years old.
Silicone Breast Implants
Silicone breast implants are very popular today and are highly recommended by surgeons for patients who are thin and desire a natural look and feel to their breasts. Since the FDA validated their safety and efficacy, safety concerns surrounding these implants are today essentially no different than that of saline. The silicone shell is prefilled with silicone gel and comes in different sizes, shapes and textures. Unlike saline implants in which leakage is absorbed by the body and implant volume appears visibly less or flat, it may be difficult to always detect when a silicone implant ruptures. An MRI may be required to detect or verify a suspected rupture. Patients considering silicone implants must be at least 22 years old.
For patients who desire fuller breasts but do not want an artificial implant to achieve this look, there is also an option known as a fat transfer. In this procedure, the doctor will harvest fat from donor sites of the patient, such as the flanks, abdomen and thighs via liposuction. The fat collected will undergo a process of refinement and purification, and then gradually reinjected into the breasts with smaller syringes so the shape is evenly distributed. Fat transfer may also be used to help improve results from breast augmentation using implants or during breast reconstruction surgery.
There are several manufacturers approved by the FDA.
- Natrelle by Allergen – silicone and saline-based implants
- Mentor – silicone and saline-based implants
- Sientra – silicone-based implants
Breast implants come in a variety of different profiles. The selection is based on how enhanced the breasts’ projection would be, as well as how wide the implant will be on the chest wall in relation to the base width. Since the silicone implants are already pre-filled, the standard profiles come in low, moderate, high and extra high. Saline implants, however are inserted then filled with saline solution up to the patient’s preferred profile. Choosing the right profile can sometimes be a difficult decision and it is up to a skilled surgeon to help guide the patient accordingly. At Sarasota Plastic Surgery Center we often use Vectra 3-D which allows the use of 3 dimensional images of the patient to show actual changes with different implants. This method is extremely helpful in making this all-important decision.
The standard shape of a breast implant can either be rounded or tear-shaped. Each shape serves a different aesthetic function as it pertains to the patient’s goals. Rounded implants produce a shapelier curve on the top portion of the breast. The teardrop implants are shaped to simulate a more natural appearance with less fullness along the top of the breast. Both shapes give excellent results and the choice is based on the desires and goals of each individual patient.
Implants are made with either a smooth or a textured surface. In general, smooth implants cost less and are more commonly used for breast augmentation especially in younger patients and those who desire upper breast fullness. The textured implants were initially conceived out of the idea that it reduces the chances of capsular contracture (the constriction of scar tissue around the implant) . Most textured implant used today are teardrop shaped (Allergan Style 410 Natrelle Inspira Cohesive Gel or Sientra Tear Drop Shaped Cohesive Gel Implants)and the textured surface allows the surrounding tissue to attach to the implant and hold the shaped implant in the proper position. The textured implants are designed to give a more natural slope to the upper breast with less fullness.
The two most common placements are on top of the chest muscle or under it. When the implant is placed under the muscle, a pocket is created under the pectoralis major muscle. Many surgeons now prefer the submuscular approach (behind the muscle). Placing the implant behind the muscle also provides a natural look and provides the implant with the long-term support it needs to stay in position. Scientific studies also indicate there may be less chance of developing capsular contracture (hardening) of the implants in the submuscular position.
There are several standard incision approaches for breast implants. The most common is known as an inframammary incision, which is an incision near the breast fold. Second, is an incision made at the edge of the areola, which is known as a periareolar incision. A third option is to place the incision within the armpit, known as a transaxillary approach. There is also an incision approach that takes place around the belly button, but this approach is limited to the use of saline filled implants. It is up to the patient’s desires and surgeon recommendation as to what approach is best to take. Scarring is also discussed at this time with each method. At Sarasota Plastic Surgery we most commonly recommend the inframammary or perioareolar incision because both incisions heal with a nearly imperceptible line and both allow very precise positioning of the implants for the best overall results.
Plan Your Procedure
- Recovery Time
- 2 Weeks
- Average Procedure Time
- 1.5 Hours
- Post-op Follow-up
- Procedure Recovery Location
Breast augmentation is an outpatient procedure that lasts about an hour. It is performed using general anesthesia in our surgical facility. All activities must be limited within 48 hours after surgery. There will be mild bruising and swelling, support bra will also be worn to help in healing. It is normal to feel tightness around the chest area as the skin adjusts to the breast’s new shape. Most patients can resume normal activities within 7 days; exercise should be avoided for 3 weeks. It takes approximately 3 - 6 months for the breasts to look, feel and function normally in regards to softness, sensation and final implant position.
Breast Augmentation FAQs
Natural or Artificial?
The decision to undergo natural or artificial breast augmentation depends on the patient’s breast make up. Those who opt for implants may choose between saline or silicone as each has its own advantages. Most patients choose silicone gel filled implants because they look and feel more like a natural breast. At Sarasota Plastic Surgery Center, our surgeons believe they give patients an overall better result. Generally, patients who have a small amount of breast tissue or are thin will benefit especially from silicone implants. Fat transfer for breast enlargement is gradually becoming more accepted. The amount of volume increase is limited compared to implants and there can be some resorption of the fat (decrease in volume over time). More commonly fat-transfer is used to enhance the results from breast augmentation or reconstruction with implants.
Negative notions about silicone started back in the early 90s when there were cases of leakage and complications. With today’s advancements in engineering, the silicone-based shells are made durable and safe, and have been proven so by the FDA. Today, in fact, silicone is more preferred than saline since they last longer and feel more natural. The rates of reported complications have significantly decreased in the last decade.
Implant or Lift?
Breast augmentation is a cosmetic procedure designed to enlarge breasts while a breast lift is designed to tighten the loose skin of a droopy breast. Quite often these procedures are performed simultaneously when it is agreed that a breast lift with augmentation is necessary.
Today’s silicone implants are strong, durable and safe. Technical advancements have come so far, that even if a silicone implant does rupture, the shell of the implant will keep the silicone gel encased and protected from entering the body. In a rare case that a silicone implant does rupture, an MRI may be needed to detect the rupture. Because a rupture may be silent (causes no changes in how the breasts looks or feels) the FDA recommends that patients have an MRI scan 3 years after surgery and every 2 years succeeding the first MRI. This is less concerning with todays cohesive gel implants since the silicone gel stays within the breast pocket and doesn’t harm the patient in any way.
Implants may last up to 15 years or longer. As long as the implant shows no signs of damage or visible defects, such as breast rippling or a deformity, replacing them is not necessary. What’s necessary, however, is a periodic check of the implants to make sure that they are still intact.