Breast Augmentation

with Dr. Thomassen

What is A Breast Augmentation?

Breast Augmentation or augmentation mammaplasty is a procedure used to increase the size of breasts using either saline or silicone gel implants.   Fat grafting can also be used to increase breast size.  Implants are used to not only add volume, but also correct volume asymmetries between breasts, or correct excess droop or ptosis of breasts.

What implants are used in a breast augmentation?

What Size Implants Are Used in Breast Augmentation?

Implant sizes vary from around 100 ml or cc (cubic centimeters) to over 800 cc.  Silicone implants come in fixed sizes that vary by as little as 15 cc in certain ranges.  Saline implants are filled with sterile saline at the time of implantation and therefore can have more size variation than silicone.  This is useful in women that have breast asymmetry and may need a slightly bigger implant on one side than the other.  Some women may desire to have significantly larger implants and in these cases, several thousand cc's of saline can be placed in saline implant shells sized for 800 cc.

What are the different shapes of breast implants?

through what approaches are breast implants placed

The most common approaches for augmentation mammaplasty are using the periareolar incision and the inframammary fold incision.  There are also the transaxillary and transumbilical approaches that may require special endoscopic equipment.  The selection of the approach is dependent on the your anatomy after careful examination by Dr. Thomassen

Where are implant placed on the chest wall?

Who is a Good Candidate for a breast augmentation?

Good candidates for breast augmentation are women that desire a larger breast size, either because of a congenitally small size, or because of a loss of volume from involution due to aging.  Women must be at least 18 years of age for saline implants.  Women must be at least 22 years of for silicone gel implants.  However if used for breast reconstruction due to a congenital asymmetry, these age limits do not apply.

Preparing for your breast augmentation procedure

The key to a successful breast augmentation surgery lies in a thorough preoperative evaluation.  For your medical history, Dr. Thomassen will inquire about your medical conditions and medications taken.   Any conditions that may pose a risk for anesthesia or surgery will be addressed.


Any medications that may result in excess bleeding will need to be stopped 2 weeks before surgery.  These include anticoagulants like aspirin or non-steroidal anti-inflammatory drugs like Ibuprofen.  Tylenol is safe to take prior to surgery.  You need to provide us with a list of homeopathic medications taken as these could have an adverse effect on wound healing and bleeding.


A history of smoking is very important to report as this could adversely affect your wound healing as well.   In general it is safest to stop smoking for 2 weeks before and 2 weeks after surgery.

Mammogram and Ultrasound

In women over 40 years of age mammographic/ultrasonographic screening for breast cancer is recommended to be done yearly.  If planning a breast augmentation surgery, it is important to have a study done within 1 year of surgery.  If younger than 40, this is not required.  However, if you do have a strong family history of breast cancer, it may be recommended to obtain a study before surgery.

Physical Exam

Dr. Thomassen will examine you to determine how best to undergo the surgery.  Key information gathered in exam is your current breast cup, asymmetry, any axillary or breast masses, and the presence of breast ptosis or excess breast droop.

Breast ptosis is evaluated based on the relationship of the nipple-areola complex (NAC) to the inframammary fold.  For patients with a NAC located at or just slightly below the inframammary fold, a breast implant will provide a slight lift that will correct a mild sag.  For patients with more severe ptosis or significant asymmetry, a lift or mastopexy may be required for optimal results.

Choosing the Breast Implants

Dr. Thomassen will take measurements of your chest width, breast skin pinch thickness, and breast skin stretch. These measurements help narrow the options of implant sizes and shapes suitable for your body frame.

Dr. Thomassen will then use implants placed inside a thin bra to simulate your augmentation in the office so you can visualize your result.  When sizing for an implant, you should pay attention to the weight of the implant as well as the appearance over a fitted blouse to get an idea of which implant will give you the look you want.

Preoperative Clearance

Dr. Thomassen will recommend the appropriate preoperative workup required according to your medical history.  This workup usually involves an evaluation by a primary care doctor to ensure you are in an optimal state for surgery.  This includes laboratory evaluation.  If there are any abnormal findings from your workup, Dr. Thomassen will call you and discuss how to proceed.

Days before Surgery

  • Avoid strenuous exercise in the days leading up to your surgery.  You should be well rested leading up to your surgery date.  Also avoid excessive sun exposure.
  • Refrain from alcohol the week before surgery.
  • Pick up your prescriptions with plenty of time before your procedure.  Set up a comfortable recovery area at home and plan your meals including a light clear liquid meal for the first night.
  • Plan for someone to be with you for 24 hours after surgery.
  • You will receive a call from our Operating Room Nurse a few days before your procedure to go over the consent and any preoperative details and instructions to make sure you are ready for surgery.
  • You will recieve a call from our Anesthesia Provider the day before surgery to go over your medications and discuss details about your anesthesia.
  • Use antibacterial soap when showering the day before surgery.
  • Remove any piercings or jewelry you may have before coming in for the procedure.

What to expect the day of surgery

The day of surgery you will arrive at our office at the appointed time.  Wear something loose and comfortable that you can easily remove and put back on after the procedure.  A button down shirt and loose pajama bottoms are ideal.

You will meet the surgical team, including a preop nurse and anesthesia provider.  Dr. Thomassen will answer any final questions you may have regarding the procedure and do some markings.

What Anesthesia is Used for a Breast Augmentation Procedure?

Facelift procedures are performed with IV sedation and/or local anesthesia.  The IV sedation medications used will make you fall asleep but you will still be able to breathe on your own.  Local anesthesia will  ensure you are comfortable throughout the procedure.  When you wake up, you should feel comfortable, without the nausea that accompanies general anesthesia.

How long does the breast augmenation procedure take?

The procedure itself takes about 1 to 1 1/2 hours to perform.  When you wake up, you will have a bra and some gauze in place and should be comfortable. You will be able to go home after you meet criteria for discharge. Dr. Thomassen will call you the evening of the surgery to ensure you are doing well.  The pain medications prescribed will make you comfortable.   Dr. Thomassen may provide you with a muscle relaxant that will make you more comfortable if a tight soft tissue envelope results from the augmentation.

What is the Recovery like for a breast augmenation

Your first follow up with Dr. Thomassen will be in 1-2 days after surgery. You will have small steri strips or tapes along your incisions.  Dr. Thomassen will remove these on your second visit. Your breast size will be larger in the first few weeks due to swelling.

You should not undertake strenuous exercise for at least 4 weeks after surgery. Light walking is fine the first week and you can gradually increase excercise as you feel better.

You will be started on implant mobility excercises at 2-3 weeks after surgery. Implant mobility exercises are important for two reasons. First, they appear to be helpful in preventing capsular contracture. Second, as patients are able to stretch their tissues with the exercises, they are able to become comfortable more quickly.

Schedule Your Consultation Today!

If you’re considering plastic surgery, choosing the right plastic surgeon could not be more important. Dr. John Michael Thomassen has the training, experience, and caring to provide you with excellent care. We invite you to have a consultation about the procedure you need.