Breast Augmentation

General information about breast augmentation.

Breast enlargement (breast augmentation) is one of the most frequently performed procedures by Dr. Grigoryants, a board certified plastic surgeon. Our patients presenting for breast augmentation request to increase the size of the breasts, restore the breast volume lost following pregnancy or weight loss, or improve breast asymmetry. In some patients who developed breast sagging (ptosis), a breast lift may be required. Some of the typical results following breast augmentation are shown below. To view more photographs of our breast augmentation patients, visit our Before and After photo gallery.

What kind of breast implants do you use?

Dr. Grigoryants uses silicone and saline implants for breast augmentation. Both types of implants are FDA approved and considered to be safe. Saline implants are filled with salt water and silicone implants contain silicone gel.  The new generation silicone breast implants provide superior softness to the breast. Recent evidence shows that the new generation silicone implants (known as cohesive gel or memory gel implants) are less likely to leak than the saline breast implants.

Dr. Grigoryants offers Motiva Implants ®  which have a unique surface designed for enhanced biocompatibility to improve the body’s response to your implants.⁴ Compared to other implants*, Motiva implants were scientifically shown to have the least amount of inflammation⁴ and low bacterial attachment,⁵,⁶ helping the tissue around the implant to stay soft.⁴

Key Advantages of Motiva® Implants:

Lower risk of capsular contracture – With significantly less inflammation and fibrosis, the reported rate of capsular contracture is under 1%.

No reported cases of BIA-ALCL – Unlike some other implants, Motiva® implants have not been associated with breast implant–associated anaplastic large cell lymphoma (BIA-ALCL).

Placement above the muscle – Thanks to the low rate of capsular contracture, these implants can be placed over the muscle (either beneath the muscle fascia or under the breast tissue). This approach allows for:

-A narrower, more defined cleavage

-Less pain after surgery

– Lower risk of bleeding

– No animation deformity (visible implant movement with chest muscle contraction)

-Less dissection of the pocket laterally, preserving soft tissue and innervation to the nipple.

Traditionally, other brands of implants have been placed under the pectoralis muscle using a “dual plane” technique, which requires cutting the muscle. That method often leads to more postoperative pain, a higher chance of bleeding, and in some patients, visible implant movement when the muscle contracts. With Motiva® implants, these drawbacks can often be avoided.

How is breast augmentation performed?

Dr. Grigoryants emphasizes minimal scarring and therefore uses the shortest possible incisions for breast augmentation. Breast augmentation is performed through a small incision placed under the breast or around the areola (pigmented circle around the nipple). The choice of the incision will be discussed with you and will depend on your preference and your anatomy. Dr. Grigoryants also uses the Keller Funnel ® technique to place the implant. This no-touch method allows the implant to be introduced without direct contact with the skin, which helps reduce the risk of infection, lowers implant handling, and further minimizes the chance of capsular contracture.

Where will my surgery be performed?

To assure the highest safety for his patients, Dr. Grigoryants performs surgery primarily at Glendale Adventist Hospital affiliated surgery center. This state-of-the-art facility provides not only the safest possible environment but also caring and friendly staff. Your anesthesia will be performed by experienced anesthesiologists (doctors). In most patients, we use general anesthesia for breast augmentation. However, local analgesia and sedation can be used in some patients.

What is recovery like following breast augmentation?

Many patients do not require any pain medications following breast augmentation. However, pain medications will be provided to you for any possible discomfort. You will wear a support bra for several weeks. Dr. Grigoryants uses absorbable sutures that do not need to be removed. Most swelling will resolve within several weeks. You will be able to start performing more vigorous exercises with your arms in about 4 weeks after surgery. Within 1-2 months, the breasts will soften and improve in appearance. A surgical bra will be worn for the first 7-10 days, and a soft sports bra for another 3 weeks. A regular bra with underwires can be worn a month after surgery. The sutures (stitches) used in breast augmentation are absorbable and do not need to be removed.

Can I get mammograms after breast augmentation?

Just like women with no breast implants, women who underwent breast augmentation should obtain mammograms following general screening guidelines.

How is the size of breast implants determined?

During your consultation with Dr. Grigoryants, you will be able to estimate what volume of breast implants you like. We have silicone and saline implants of different sizes that you will try on. We will provide you with a special bra in which implants of different sizes will be placed. This will allow you to see the actual implants on you. Please bring with you a somewhat tightly fitting top to better see the outline of the implants on you. The final volume will be determined based on your desired size and your chest/body anatomy. Breast implants have different widths and amount of projection. We will discuss the different types of breast implants with you and choose the type that will produce the desired cosmetic result. Our goal is to create enhanced and naturally appearing breasts.

What is the aftercare following breast augmentation?

Dr. Grigoryants will discuss with you our postoperative instructions. You will be instructed to do capsule stretching exercises. The doctor will show you how to do these exercises during your postoperative visit. These exercises are done in order to minimize the chance of capsular contracture.

Dr. Grigoryants applies all known methods to minimize the incidence of capsular contracture, including washing the pockets with an antibiotic solution prior to implant placement, stopping any bleeding, and removing any remaining blood. Additionally, breast augmentation has to be performed under sterile conditions. Certain medications are sometimes used to treat and prevent capsular contracture. However, to date, there is no strong evidence that those medications work consistently.

Are silicone implants better than saline implants for breast enlargement?

Silicone implants are softer than saline implants. They are less likely to show visible rippling through the skin. Silicone implants are also less likely to break than saline implants. Silicone breast implants are filled with cohesive gel (or memory gel). The gel is sticky and stretches like a bubble. Many years ago, silicone used to be more liquid, and older implants were more likely to leak. Today, the risk of silicone implant leak is less than 1 % in 6 years. Most of our patients today prefer silicone implants over saline implants.

Do I need to do a mammogram before surgery?

Women who are 40 years of age and older should have a mammogram within 12 months prior to surgery. Mammograms are also recommended for younger women with a family history of breast/ovarian cancer in close relatives. This will be discussed with you further during your consultation.

Before

After

This patient underwent breast augmentation using 400 cc breast implants placed behind the muscle. Improved cleavage definition and fullness in the upper aspect of the breasts was acheived while preserving a natural look.

Before

After

This patient complained of having small and widely spaced breasts. Breast augmentaiton was perfomed using 370 cc breast implants placed behind the muscle. Improved cleavage and shape of the breasts was acheived. At the same time, liposuction of the sides of the chest and a tummy tuck was performed.

Before

After

In this patient, 280 cc breast implants were placed behind the muscle to increase the size of the breast and add fullness in the upper aspect of the breasts.