If your breasts are not the desired shape or size that you would like, you are not alone; many other women feel the same way. Dr. Phillip Dahan performs hundreds of breast surgeries a year to help his patients achieve the results they were always looking for. Whether your breasts are too small, asymmetrical, or have lost volume from pregnancy and breast feeding, breast enhancement surgery can help address these common issues.
What is Breast Augmentation?
Breast augmentation, also known as breast enlargement, is Dr. Phillip Dahan’s most popular procedure that he performs at Advanced Aesthetic Plastic Surgery in Reno, NV. The goal of surgery is to increase the size of the breasts, improve symmetry, or increase volume and fullness. This can be achieved with silicone or saline breast implants, which will be discussed during your consultation. Once the implant and size is chosen, you will take the next steps in scheduling your surgery.
Dr. Phillip Dahan has performed over 1,000 breast implant procedures on patients from all over the world. With his expertise and guidance, he will provide a recommendation for where the incision is made, type of implant, size, and placement, to ensure you get the breasts you’ve always wanted.
Who Is a Good Candidate for Breast Augmentation?
The question of whether augmentation is right for you is completely personal. If you’ve never been happy with the size or shape of your breasts, it can change that. If your breasts are uneven, it can correct that. Or if you’d simply like to have larger breasts, this surgery will accomplish that. But the decision has to be 100 percent for you. This has to be something you want, not made at the behest of a husband or partner.
If you have noticeable sagging of your breasts, whether due to prior gain and loss of a good deal of weight or from repeated pregnancies with or without nursing, you may want to consider a breast lift along with your implants. This will remove excess, sagging skin at the same time as placing the implants to achieve the best aesthetic result.
Benefits of Breast Augmentation
The benefits of surgery may seem obvious, but there’s more to augmenting your breasts than simply making them bigger. This procedure can change the way you feel about your figure, or even your entire body image. Here are a few of the most common benefits patients experience:
- Improved breast size, shape, projection and symmetry
- More feminine appearance
- Improved confidence and self-esteem
- Balanced body proportion
- Improved clothing fit and options
- Improved intimacy
How Dr. Phillip Dahan Performs Breast Augmentation
Breast augmentation is an outpatient surgery performed under general anesthesia and takes 45 minutes to 1 hour to complete. For saline breast implants, a one-inch incision is made for placement, and a 1.5-2 inch incision is made for silicone implants. Silicone implants are already filled prior to placement, whereas saline implants are filled after placement, resulting in a smaller incision size.
Dr. Dahan has extensive experience placing all sizes of breast implants and adheres to strict scientifically proven surgical techniques to limit bleeding. The breast pocket is made with care to avoid injuring the nipple and the milk ducts while being irrigated with antibiotic solutions to help prevent infection and capsular contracture.
To check symmetry and implant positioning, Dr. Dahan will sit the patient up during surgery. He is very meticulous and checks the implanted breasts from every angle prior to closing the incisions with tiny sutures that minimize scarring. Unlike many plastic surgeons, he will not allow an assistant to perform any part of the surgery aside from holding retractors and cutting the excess sutures when tied. Dr. Dahan performs the entire operation and only he handles the sterile breast implants which is likely why his capsular contracture rate is so low. Dr. Dahan even applies the final dressing after the incisions are sutured closed.
Types of Breast Implants
There are three types of implants offered at Advanced Aesthetic Plastic Surgery. We offer silicone gel implants, saline implants, and Gummy Bear implants.
- Silicone gel implants – Silicone gel implants consist of a silicone outer shell filled with medical-grade silicone gel. The gel is “cohesive” meaning it stays together and within the shell more if the implant develops a leak. Silicone gel breast implants are considered safe and superior to saline breast implants. Most people believe silicone implants feel more like natural breast tissue when compared with saline implants. Silicone implants are more commonly used and desired by patients and plastic surgeons as they exhibit less rippling, look and feel more natural, and last longer than saline implants.
- Saline implants – Saline implants consist of a silicone outer shell filled with a sterile saline solution. Unlike silicone implants, which are filled at the factory, saline implants are placed into the breast pocket empty and are then filled in place. This allows these implants to be placed through smaller incisions. It also allows some flexibility with size. However, saline implants exhibit more rippling, feel and look less natural, and do not last as long as silicone implants.
- Gummy bear implants – Although technically silicone, gummy bear implants are different and deserve their own description. Gummy bear implants are made with “highly cohesive” silicone gel; think of the consistency of a gummy bear. This gel is much thicker than the gel used in other silicone implants. If a gummy bear implant is cut in half, the gel will remain within the shell and not leak out. Gummy bear implants are also created in a teardrop shape, which is closer to the shape of the natural breast. However, women who prefer more upper breast fullness and more cleavage will benefit from round silicone implants and not shaped implants.
Smooth Versus Textured Implants
Most women and plastic surgeons in America prefer smooth round silicone breast implants. Round implants come in more sizes and projections then shaped implants. They come in smooth or textured surfaces. Smooth implants are more popular since they can be massaged to improve position and symmetry. Smooth implants may also be massaged to reduce capsular contracture (hardening).
Textured implants have the disadvantage of being fixed in position like Velcro and should not be massaged. Textured implants have a higher incidence of spontaneous seroma (fluid collection around the implant) and there is an association with Anaplastic Large Cell Lymphoma (ALCL) of the breast. Dr. Dahan only recommends textured implants if you prefer to have shaped implants. Shaped implants are nearly twice the price of round implants and do not offer the patient as much fullness in the upper breast or cleavage.
How to Choose the Right Implant Size for Breast Surgery
Some women assume implants are sized similar to bra cup sizes. Actually, they are not. Implants are sized based on the amount of silicone gel or saline filling the implant. This volume is measured in cubic centimeters (cc), also known as milliliters (mL). For instance, a 250 cc or 300 cc implant may represent an increase of one cup size, an A cup to a B cup, in most women. Smaller women may require less volume to achieve one larger breast cup size, whereas larger women may require more volume to achieve one larger breast cup size.
The implant volume needed to make larger cup sizes may also vary based on individual physical characteristics of the breasts. Dr. Dahan has an implant sizing system that allows you to very accurately visualize how different implant sizes will look on your figure. Dr. Dahan is well-known for his accuracy in determining his patients’ desired implant and breast size, which is why the overwhelming majority of his breast implant patients are so happy with their results.
How Are Breast Implants Placed?
Dr. Dahan recommends that both silicone and saline breast implants be placed in the partial submuscular position (dual plane technique).
This has been demonstrated to offer the best results.* These patients experience fewer irregularities such as rippling, unnatural implant shape, capsular contracture (hardening) and less sagging. Some patients, however, may be good candidates for placement of the implants above the muscle and under the breast tissue or subglandular.
Types of Breast Augmentation Incisions
You will choose where you want Dr. Dahan to make the incisions to place your implants. He places implants through three incision locations: periareolar, inframammary, or transaxillary.
- Periareolar incisions — These incisions are made just outside the dark skin of the areola on the lower side. These incisions become almost invisible after healing. The implants can be placed above or below the pectoral muscle, although Dr. Dahan recommends placing it below the muscle to limit the possibility of infection and lower the risk of capsular contracture. This incision type can limit the size of silicone implants. It may not be possible to place larger silicone implants through a small areola. There’s also evidence that there is a slightly higher risk of capsular contracture (hardening) with this incision, however, Dr. Dahan’s patients have only a 3% risk of capsular contracture compared to a 10% risk reported in the United States. In Dr. Dahan’s hands, breast augmentation using the periareolar incision does not affect nipple sensation in the overwhelming majority of his patients. In fact, it is very rare for his patients to experience loss of nipple sensation.
- Inframammary crease incisions — This incision is made at or above the crease on the underside of the breast. This allows it to usually be hidden by the crease, beneath a bra or bikini top. However, this incision results in a slightly larger scar. In most cases, the implants may be placed through this incision partially beneath the muscle (Dual-Plane technique) or above the muscle (Subglandular). This incision can handle any size of implant. Nipple sensation is rarely affected when Dr. Dahan uses the inframammary incision.
- Transaxillary incisions — These are made with a vertical incision in the armpit. Dr. Dahan may use an endoscope for better viewing of the breast pocket with this incision. This incision leaves no scarring on the breasts, and the line in the armpit will become virtually invisible with time. Saline or smaller silicone implants can easily be placed behind the chest muscle. Nipple sensation and later breastfeeding is usually unaffected by placement through transaxillary incisions. Recovery can be a little harder with this incision.
Breast Augmentation Testimonial
I am one week post op from a breast augmentation and am already very very happy with his work. I was going for more natural and elegant look. He gave me EXACTLY what I asked for and went above and beyond surgically to make sure that they turned out perfect (many other doctors may have not pointed out the need for it or wouldn’t have taken it into consideration which may have caused me problems in the future requiring extra work). I could not have asked for more from him. Dr. Dahan is very personable and compassionate. I highly recommend him! *
Why Choose Dr. Phillip Dahan
Will I Need to Have my Implants Replaced?
Unfortunately, breast implants have a lifespan. At some point, the implants will need to be replaced. Dr. Dahan only uses FDA-cleared breast implants and the manufacturers actually warranty their implants for life. The lifespan of your breast implants is quite variable. Most women should expect to have to replace their implants every 15-20 years or so, although they can last longer. Implant durability is increasing. Still, you should not expect that you will have only one set of implants during your life.
An obvious need for replacement is if the implant ruptures. If a silicone implant ruptures, silicone gel will leak into the breast pocket that was created to hold the implant. When this happens, the patient doesn’t usually know, as the implant usually retains its shape, and may develop a capsular contracture (hardening). The leak may show up on the regular mammograms and will more reliably be seen on breast MRIs necessary with silicone implants. The ruptured implant and any leaked gel will need to be removed and the implant replaced. If there is capsular contracture, the capsule should also be removed at the time of implant replacement. If a saline implant ruptures, the body simply absorbs the salt water and the implant will fully deflate, leaving the patient with one flattened breast. And, while the saline will be absorbed, the ruptured shell will still need to be surgically removed and replaced.
Recovery After Breast Enlargement Surgery
Recovery from breast enlargement surgery with Dr. Dahan is not that difficult. You’ll return home within a couple of hours after your surgery. You’ll have bandages on your breasts and an Ace wrap for comfort. You’ll need pain medication for 2-4 days, but the pain isn’t overwhelming.
You’ll return to our office one day after surgery, and Dr. Dahan will remove your dressing. At this point, he will demonstrate breast massage techniques that will relax the muscle and help the implants settle into their breast pockets. This type of postoperative massage has been proven to significantly reduce the risk of capsular contracture (where scar tissue contracts and hardens around the implant) and decrease discomfort. Most patients will be able to shower 2 to 3 days after surgery and thereafter, will wear a comfortable bra for support.
Most patients can return to work approximately 3-5 days after surgery. Your sutures will be removed after one week. You’ll wear a support bra 24 hours a day for 2-4 weeks after your surgery so as not to place any stress on your incisions. Normal activities can resume in 1-2 weeks, but any impact exercise will need to wait for 3-4 weeks. Upper body exercise, such as lifting weights, will need to wait for six weeks.
Will my Breasts Look Natural With Implants?
Implanted breasts by Dr. Dahan look completely natural, especially with the minimal scarring that occurs with the periareolar, inframammary or transaxillary incision locations and dual plane technique. The size and projection of implants you choose will dictate how natural or “showy” your augmented breasts will be.
Risks of Breast Augmentation Surgery
Beyond the general risks associated with any surgery, there are some risks specific to breast augmentation. These include:
- Capsular contracture
- Implant leakage or rupture
- Implant shifting
- Changes in nipple sensation
- Impaired ability to breastfeed
- Breast asymmetry
- Visible rippling of the implant
- Sagging (ptosis)
- Unsightly scar
Dr. Dahan will discuss all of the possible risks involved with surgery during your consultation.
Revision (Redo) Breast Implant Surgery
Unfortunately, since breast implants do not last forever, patients will require revision (redo) procedures. Most patients will not develop any significant complications and will have to exchange their silicone or saline breast implants in 15 to 20 years or more depending on the integrity of the implants and the patient’s desire to keep these implants. Some patients want larger or smaller breast implants or wish to switch from saline to silicone implants or vice versa.
Breast implant exchange surgery is relatively easy for the plastic surgeon and the patient, and may be performed under local anesthesia, local anesthesia with IV sedation (twilight) or general anesthesia as an outpatient. There is minimal discomfort and a rapid return to work, school, exercise and other activities.
Patients who develop sagging (ptosis) or malposition of the breast implants may require breast lift (mastopexy) and breast implant repositioning surgery. This can be performed using the same breast implants if they are not older than 10 years and are in good condition. Patients who wish to have a different type, shape, projection or size of implants will need to exchange the implants at the time of this surgery. This surgery is usually performed under general anesthesia as an outpatient and the recovery is also quite fast.
Approximately 40% of Dr. Dahan’s breast implant patients have had one or more breast implant operations from other plastic surgeons before coming to him for revision surgery. Dr. Dahan commonly performs breast implant exchanges, capsulectomies, mastopexies and other cosmetic breast procedures on patients previously operated on by other doctors. Dr. Dahan is considered one of Reno’s and Nevada’s experts at breast implant surgery and cosmetic surgery of the breasts.
Schedule A Consultation
For more information about breast augmentation surgery in Reno, Nevada, please contact Dr. Dahan’s office. To see if you are a good candidate, schedule a consultation by calling us at (775) 826-4477. Our practice serves Reno, Sparks, Lake Tahoe, Nevada, Northern California, and surrounding areas.
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*results may vary