Breast Augmentation

Breast augmentation with top quality implants can enhance the size, shape, and overall appearance of the breasts. In the hands of an experienced provider, the surgery can offer a highly customizable solution tailored to your individual goals.

Dr. Mark E. Richards is a world-renowned Bethesda plastic surgeon who serves patients from all over the country. Among the many services he offers are breast augmentation with implants and revision surgery for previously performed augmentations. If you are considering either of these procedures, please review the information below and contact our office to ask any questions you may have or to schedule a face-to-face consultation.

Breast Augmentation at a Glance

  • Sedation: General anesthesia
  • Potential Benefits: Increased breast volume, symmetry, and/or proportion; a more balanced and aesthetically pleasing physique
  • Potential Risks: Swelling, soreness, bruising; (less commonly) implant-related complications, adverse reactions to anesthesia
  • Procedure Length: Generally one to two hours
  • Recovery Time: Typically about one week before daily activities can be resumed and four to six weeks before high-impact exercise can be continued
  • Cost: Approximately $5,900 for the surgeon’s fee (facility, anesthesiologist, and implant costs are additional)

What Is Breast Augmentation?

Breast augmentation is a cosmetic procedure designed to increase the size, volume, and fullness of the breasts using implants. It is perhaps the best-known cosmetic surgery procedure; nevertheless, it is an operation requiring precise care and attention in order to achieve a natural, seamless look with minimal scarring. Dr. Richards has performed countless breast augmentation procedures for patients in DC, Maryland, and neighboring areas. This experience allows him to give expert advice and use leading techniques when working with patients who have chosen to obtain breast implants.

Who Is a Good Candidate for Breast Augmentation?

Aside from being in good general health and being a non-smoker (or able to stop smoking for several weeks before and after the procedure), the ideal candidate will be a woman who is dissatisfied with the size, shape, and/or symmetry of her breasts and would like to enlarge them. She should also have reasonable expectations for what the result will be. Dr. Richards and his experienced staff will go over this and more during the initial consultation. Additionally, patients will need to be able to take off the necessary time from work and other responsibilities (approximately a week) and follow certain activity modifications and restrictions in order to heal properly.

Breast Augmentation vs. Breast Lift

While breast augmentation and breast lift surgery both endeavor to alter the appearance of the breasts, the two procedures are meant to achieve different results. In particular, a breast augmentation primarily focuses on increasing the size and enhancing the shape of the breasts with implants. Meanwhile, a breast lift aims to combat sagging and drooping breasts by removing excess skin and tightening the surrounding tissue. This procedure cannot significantly change the size of the breasts; rather, it can lift and reshape them to a more youthful position. That said, many patients who want to both increase breast size and correct sagging choose to combine their breast augmentation with a breast lift.

Complementary Procedures to Breast Augmentation

Those who seek to improve their breasts with implants may wish to incorporate other procedures into their care. As noted above, breast lift surgery is commonly combined with breast augmentation for an improvement in both volume and positioning. Alternatively (or in addition), Dr. Richards may recommend you combine your breast augmentation with tummy tuck surgery (abdominoplasty), arm or leg lift surgery, or liposuction for a more dramatic final result. If you want to achieve a more youthful-looking figure following pregnancy, childbirth, or breastfeeding, multiple surgeries can be performed together in a personalized Mommy Makeover.

During your consultation with Dr. Mark Richards, you will have the opportunity to discuss your aesthetic goals and determine which procedure (or combination of procedures) can best help you achieve the effects you desire. Our passionate plastic surgeon is excited to help you obtain the body you’ve always dreamed of!

Which Type of Breast Implants Are Right for Me?

Dr. Richards has used a variety of types of breast implants over the past 30 years. Advancing beyond the standard saline and silicone breast implants, the innovative Mentor® MemoryShape® implants are now available. These are teardrop-shaped implants that are sometimes referred to as “gummy bear” implants due to the thick silicone gel’s ability to retain its shape. They have the remarkable ability to look, move, and feel natural when placed above the muscle. Placement above the muscle also reduces recovery and post-operative discomfort.

Dr. Richards will work with you on an individual basis to select the proper type, size, and shape of your new breast implants, as this decision is crucial to ensuring that you get a positive, satisfying result from your surgery. In guiding you to a conclusion, Dr. Richards will take into account your natural build and figure so that your final shape and appearance will be enhanced but not artificial. Given the array of options and the number of criteria by which they can be selected, you will benefit greatly from working with one of the finest cosmetic surgeons in the country as you choose your breast implants.

What Should I Expect From the Breast Augmentation Procedure?

Prior to your operation, you will determine with Dr. Richards the breast implant type, incision location, and placement. The procedure typically takes one to two hours, and patients return home the same day.

Advances in breast augmentation techniques have made it possible to place breast implants through a few different entry points. The most commonly used incision location is just above the inframammary fold—above where the breast tissue meets the chest. This incision is inconspicuous, typically has the least effect on nipple shape and sensation, and can allow the most precise placement of implants. Other options include the periareolar incision, which creates a half-moon incision on the pigmented area around the nipple; the transaxillary approach, which is located in the armpit; and the transumbilical incision, which is located in the belly button. Not all implant types can be used with all incision options, and some incision options will be more appropriate for some patients than others. Dr. Richards will let you know which approach can provide the best outcome based on your treatment plan.

You will need to have a friend or family member drop you off and pick you up from the surgery center, as you will be placed under a short general anesthesia for the surgery. Our office will provide a detailed written overview of instructions to follow to enhance your recovery experience and optimize your outcome.

What Is Breast Augmentation Recovery Like?

After surgery, Dr. Richards and his staff at Ageless Impressions – Plastic Surgery Institute take every measure available to ensure that their patients recover from their breast augmentation with implants as smoothly as possible. The specific details of your recuperation from the procedure will be influenced in large part by the size and position you choose for your breast implants. In general, though, you will need to take at least a few days off from your work and several weeks off from any vigorous or high-impact exercise you regularly perform. Dr. Richards will direct you as to the best course of action for your individual case.

Swelling and some degree of discomfort are normal after cosmetic surgery, but that subsides several days after the breast augmentation. Dr. Richards will inject long-acting local anesthetic into the tissues before placing the implants in order to increase comfort. Please contact us today to discuss your goals and how we can help you fulfill them.

What Will My Breast Augmentation Scars Look Like?

Dr. Richards strives to make the least noticeable incisions possible, regardless of the technique used. In almost every case, the scar heals well over time, gradually becoming flatter, smoother, and more like the adjacent skin color. Silicone gel strips can be applied to the incision sites for six to eight weeks to fade the scars more quickly. Once fully healed, the mark is usually unnoticeable.

How Long Do Breast Implants Last?

The typical lifespan of both silicone and saline breast implants is approximately 10 to 20 years; however, this estimate is variable among patients. It is important to understand that, while breast implants are not designed to last permanently, many of today’s breast implant models are highly advanced and can last for decades.

With this in mind, there is still the possibility of complications (see section below) that can necessitate breast revision surgery. In such cases, patients may wish to either exchange the implants for new, upgraded models or remove them altogether, depending on their unique needs and wishes. It is very important for patients with any type of breast implants to follow the guidelines for follow-up breast examinations recommended by their breast surgeon and to be sure to consult with a physician if they notice any problems or changes in the breasts.

What Risks are Associated with Breast Augmentation?

As with any surgical procedure, breast augmentation carries certain risks that patients should be aware of before making a decision. While complications are generally rare when the augmentation is performed by a seasoned plastic surgeon, certain issues relating to the implants or the procedure itself are liable to occur, such as:

  • Abnormal reactions to anesthesia
  • Implant rippling that is visible (more common in saline implants)
  • Ruptures or leaks (which are often easier to identify in saline implants than silicone)
  • Capsular contracture (or excessive scar tissue formation around the implant)
  • Infection
  • Breast Implant Illness (BII), or systemic symptoms that may be linked to implants
  • Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL), an extremely rare cancer of the immune system*

Please note that the last two complications are extremely uncommon, and much research still has yet to be done into their relationship with breast implants. Nevertheless, Dr. Richards would be happy to provide more information about these concerns during your first-time appointment.

Moreover, all women with breast implants should be sure to undergo regular breast exams (both self- and professionally-administered). These evaluations are performed to ensure that the implants remain in good shape with no leaks, ruptures, or other concerns.

Can I Breastfeed with Breast Implants?

Breast implants should not affect one’s ability to breastfeed as long as the patient was able to breastfeed before the breast augmentation was performed. While many women are naturally able to breastfeed, others are not. Those who were already able to nurse infants should remain able to do so after breast augmentation; however, it is very important to communicate your concerns regarding future breastfeeding to Dr. Richards during the initial consultation.

How Much Does Breast Augmentation Cost?

Pricing for breast augmentation at our practice begins at $5,900. With this in mind, it is important to understand that this number reflects only the surgeon’s fee and does not include other expenses that will be ultimately assessed, including fees for anesthesia, use of the hospital facility, and the price of the implants chosen. The price of breast augmentation will vary from patient to patient to some degree, and this is due to differences in needs, goals, and treatment plan complexities. We will provide a comprehensive estimate of the total cost of your procedure during your initial consultation. We accept many payment types and work with reputable plastic surgery financing companies if you would like to consider that approach.

What Is Breast Augmentation Revision Surgery?

While cosmetic surgery in general and breast augmentation in particular have boomed in recent years, it is an unavoidable fact that these procedures are not and never will be unfailingly perfect. When performing his own first-time breast augmentation procedures, Dr. Richards seeks to minimize the risk of failure or dissatisfaction by utilizing impeccable surgical and safety practices in addition to pre-surgery planning. His excellent track record and extremely low rates of revisional surgery reflect this approach. Dr. Richards can also help patients who wish to make adjustments to their breast implants in order to modify their appearance.

Additional Frequently Asked Questions About Breast Augmentation

To help you make the best decision for your cosmetic goals and anatomic needs, Dr. Richards has answered some of the most common questions patients ask about breast augmentation. If you would like to learn more, please contact our practice to schedule a consultation.

How do I choose the right breast implants?

With so many options it can seem overwhelming to select your body’s most “ideal” type of breast implant. Together we will help guide your decision. For the most part, the style of implant you choose will come down to personal preference, but there are some factors you may wish to keep in mind. Round implants are often only a good choice for women with little but evenly distributed breast tissue and no sag who desire just a slight increase in size. Much more often, shaped, teardrop, or anatomic implants provide the most natural and attractive appearance. Saline implants were once considered by Dr. Richards to be preferable for many years, until the very cohesive “gummy bear” form-stable implants became available in the US. These implants have about the lowest complication rate and a very high patient satisfaction rate. Additionally, Dr. Richards most often places these particular implants above the muscle fibers so there is no deformation of the breast upon exercise or muscle movements. Furthermore, the risk of unsightly wrinkling and capsular contracture is lower than with saline implants.

What implant placement creates the most natural-looking results?

Broadly speaking, there are three locations for breast implant placement: above the muscle (subglandular), below the muscle (submuscular), and partially below the muscle (dual plane). Each placement offers unique benefits and drawbacks. There is no one right placement for all patients or all implants. Dr. Richards will review your anatomic characteristics and your desired outcome to determine the ideal implant positioning for you. We always strive to provide natural-looking outcomes, and Dr. Richards will work closely with you to achieve your goals to the best of his abilities.

How painful is breast augmentation?

The breast augmentation procedure itself is performed under general anesthesia, so you should not feel pain during the treatment. After the anesthesia wears off, some degree of pain and discomfort can be expected initially during the recovery process as the treatment areas heal. Medication is prescribed to minimize discomfort over the next several days. Each patient tends to have a somewhat different experience depending on the specific breast augmentation techniques utilized and their own anatomical response, which varies among individuals. By following the detailed post-operative guidelines and recommendations provided by Dr. Richards, patients significantly increase the chance that they will experience a safe and smooth recovery with only minimal discomfort.

How much do breast implants weigh?

While breast implants are designed to add volume to the breasts, it may be surprising to learn that the implants themselves do not weigh very much at all. Therefore, the breast implants should not ultimately affect overall body weight to a significant degree. Even in larger sizes, the solution inside the breast implants only adds about one to two pounds of extra weight (if that), and the outer shell is particularly light.

How long will it take to heal?

Everyone has their own unique rate of healing, and you should listen to your body as you recover to help determine when you’re ready to return to normal activities. Most patients take about one week to heal before resuming work, school, and their daily routine. We strongly encourage patients to avoid high-impact exercise for at least four to six weeks. Additional instructions, such as avoiding vigorous arm motions for the first few weeks, will be provided by Dr. Richards before your operation. Swelling, tenderness, and bruising are normal effects, and they should subside with time. Swelling will take six months to a year to 100% resolve, but the breasts usually look very nice and natural at one month. You will have several follow-up visits with us to check on your progress after surgery. You’re also welcome to contact our practice at any time for more information.

How should I sleep after breast augmentation?

Dr. Richards advises our patients to sleep on their backs for several weeks following the breast augmentation procedure. It is very important to avoid placing excessive pressure on the breasts for a certain period of time after surgery. You may need to make some adjustments in sleeping positions to allow the breasts to heal properly. Once your customized treatment plan has been developed, Dr. Richards can talk more with you about ideal sleeping positions and other things you can do to make sure your recovery goes as smoothly as possible.

What type of bra should I wear after breast augmentation?

The answer to this question is typically dependent on the unique needs of each patient. Some individuals may be prescribed a special type of support bra to aid healing in the weeks after the breast augmentation procedure; for others, it may be recommended that they avoid wearing a bra altogether during the recovery process. Dr. Richards can provide you with more specific advice once he has evaluated your needs. Additionally, a small elastic band worn around the upper chest helps keep implants “locked” into position for the first couple weeks of healing.

Can I change my mind about implants later?

Some women, after years of having breast implants, decide they want a change. Although uncommon in Dr. Richards’ practice, some women experience a condition called capsular contracture, where the scar tissue surrounding the implant tightens and thickens, causing pain and cosmetic issues. Regardless of the reason, in many cases breast revision or implant exchange surgery can be performed. Dr. Richards can exchange the implants for ones with the newer material in a different tissue plane, or he can remove them entirely. He can provide details specific to your needs and goals during your first consultation.

If you are considering breast augmentation or breast augmentation revision surgery, please contact Ageless Impressions – Plastic Surgery Institute as soon as possible to set up a consultation. If you are interested in any other procedures that are not listed on this site, please feel free to ask our office for more information on them.

Medical References* 

US Food & Drug Administration (FDA)