Breast Augmentation

Cosmetic Consultation

Breast augmentation consultations are scheduled with our Board Certified Plastic Surgeon, Dr. Alan Durkin. During your consultation you will talk to Dr. Durkin about your desired breast shape and size. Choosing bigger breast implants is not always the best choice for obtaining your desired cosmetic breast augmentation outcome. Sometimes the shape of the breast implant is just as important as the size of the implant. You can obtain a large bust size and still maintain a natural look. Dr. Durkin will also talk to you about the four types of breast augmentation approaches. Furthermore, breast augmentations can be tailored to fit your lifestyle. For example, Dr. Durkin has specialized approaches for women who are athletes, fitness competitors, and bikini models. Communication between the plastic surgeon and patient is a critical and often overlooked necessity to receiving the best possible breast augmentation outcome.

At Ocean Drive Plastic Surgery we pride ourselves on providing our patients an open environment that fosters questions and thoughtful discussions at anytime during your care. We don’t rush cosmetic surgery consultations and we don’t race people to the operating room.

Our approach to consultation is friendly, pressure-free, and information oriented. We share our knowledge and expertise with you through conversation, examination, virtual simulation, “implant tryouts”, and a comprehensive tour of our facility.

Our process for breast augmentation starts with a definitive discussion of your objectives. Dr. Durkin together with our Patient Care Coordinator consults with you in person. Bring any representative photographs of your desired result to your consultation. During this phase, Dr. Durkin discusses the critical topics of incision placement, implant placement above or below the muscle, type of implant used (shaped vs. round, saline vs. silicone), different implant profiles (high vs. ultrahigh vs. moderate), and different implant sizes. We have found that almost all of our patients seeking breast augmentation do have a personal “mind’s eye” picture of what they are looking for. Learning about your aesthetic goals is our priority.

Here is why we don’t use and never have used textured breast implants.

Physical Evaluation

Next, Dr. Durkin examines you. During this phase, Dr. Durkin talks about his surgical plan for achieving your desired result. During this time, Dr. Durkin takes measurements of your body and discusses breast shape with you. If you require a breast lift, then Dr. Durkin shows you why a lift is anatomically required, and a discusses different breast lift techniques such as, his proprietary “internal bra” technique, with you. Dr. Durkin also discusses the overall contributions of posture, bone structure, and breast position to breast symmetry. Dr. Durkin strives in giving you a comprehensive analysis of your anatomy. He correlates your specific anatomy with the best possible breast implant available to achieve your desired goal.

Which Breast Implant is Right for You?

When evaluating breast implants, the choice of implant is a key driver of patient satisfaction. The key again is good preoperative communication. At Ocean Drive Plastic Surgery, we meet with you more than once regarding breast implants in order to give and receive as much information as possible prior to surgery. The more everyone knows, the better everyone does.

Saline vs. Silicone Breast Augmentation

There is a great deal of misimformation regarding saline versus silicone breast implants. Many still are under the impression that silicone implants are unsafe, which is categorically false. Saline implants are supplied as an empty silicone shell with a fill valve. During surgery, the implant is placed into the breast pocket, and is then filled to the appropriate size based on preoperative evaluation and implant dimension. On the other hand, silicone implants come “pre filled”. Both types of implants have advantages and disadvantages. .

Advantages of Saline Implants

Advantage #1 – Smaller incision size. Since the implant is empty prior to your surgery, the incision can be less than 3cm in size, and any sized implant can placed through the same incision
Advantage #2 – Implant rupture detection. If a saline implant gets ruptured, you lose volume immediately, and over the course of hours to days, the diagnosis of a rupture becomes very evident. Removing the ruptured implant and replacing it is usually a simple operation.
Advantage #3 – Cost. This is the absolutely least important advantage. Breast augmentation is not an accessory. It is a lifestyle choice. If you are looking for the cheapest type, reconsider your reasons for having this done.

Disadvantages of Saline Implants

Disadvantage #1 – Rippling. Extremely common with saline implants. This is a design flaw in the implant, and absolutely nobody likes it. For athletic women, saline implants will always cause rippling.

Disadvantage #2 – Less natural feel. A saline implant is just that, an implant filled with saline solution. It will feel different than the feel of your breast. This is unavoidable.

Disadvantage #3 – Swimming. If you swim in cold water with a saline implant, the saline implant temperature balances with the water temperature, while your body remains warm. This can lead to a “turkey is done” effect, which can be socially awkward on the beach or at the poo

Advantage of Silicone Implants

Advantage #1 – Natural feel. No question about it. Silicone implants feel remarkably like the natural breast tissue. Because of this, we see 1-2 patients a week with saline implants requesting a change to silicone. Dr. Durkin has NEVER had anyone ask to go from silicone to saline because they like the “fake feel” better.

Advantage #2 – Safety. Silicone breast implants have been scrutinized like absolutely no other surgical device or prosthetic. The FDA recently completed a 10 year double-blinded clinical trial that clearly demonstrated the safety and efficacy of silicone implants. The cohesive gel implants (i.e., Gummi Bears) are safe.

Advantage #3 – Swimming. Silicone mimics the body tissue. You get less of the “turkey is done” effect.

Advantage #4 – MINIMAL RIPPLING. Almost never see or hear of it unless a very, very large implant is selected in a petite patient. Very common with saline.

Disadvantages of Silicone Implants

Disadvantage #1 – Rupture. If you have an implant rupture, your implant will not deflate. This is a good and a bad thing. With the new cohesive gel implants, the majority of ruptures are completely un-noticed and asymptomatic because the new implants have solid state silicone, not liquid. So, you can have a ruptured implant for years without any problems whatsoever. However, if you have concerns over rupture, you can only diagnose it with an MRI scan.

Disadvantage #2 – Incision size. Silicone implants come prefilled. Because of this, it is common to use a slightly larger incision to place the implant. As well, you cannot have this type of implant placed through the belly button.

Disadvantage #3 – Cost. Again, I shudder to mention this, because it is more of a difference than a disadvantage. A silicone implant is superior in quality, feel, and minimizes rippling. In the end, you are paying for a superior product.

Why we Don’t Use Textured Breast Implants

Not all silicone breast implants are created equal! The original silicone implants were introduced in the 1970’s, and used a liquid silicone fill. Due to health concerns related to leakage, they were taken off the market by the United States Food and Drug Administration (FDA). After an exhaustive study extending nearly twenty years, the FDA conclusively proved that silicone is a safe substance for breast augmentation. Since their re-introduction in 1994, the new cohesive gel “Gummy Bear” silicone breast implants have literally redefined breast augmentation. They offer a remarkably natural feel, greater longevity, and better patient satisfaction than their saline counterparts. The cohesive nature of the silicone also invalidates nearly all of the leakage concerns that were valid in the older liquid silicone implants.

The cohesive gel implants are often called, “Gummy Bear” implants because of their chemical structure, and because of how the gel actually feels like a gummy bear. The gel within your implant is a unique type of solid, in that it is soft and malleable, but it is not a liquid, and it retains its original shape after pressure is applied. While it can act clinically like a liquid, it is actually a soft but solid gel. This quantum leap forward in breast implant biomaterial has propelled breast augmentation into the 21st Century, and has allowed breast augmentation to surpass liposuction as the most popular plastic surgery procedure in the United States.

The driving force for the return of silicone implants was to improve the feel and longevity of breast augmentation procedures, and to eliminate the rippling seen so commonly with saline implants. These problems were definitively solved by 2004, and the public now knows it.

Gummy Bear Breast Implants

Not all silicone breast implants are created equal! The original silicone implants were introduced in the 1970’s, and used a liquid silicone fill. Due to health concerns related to leakage, they were taken off the market by the United States Food and Drug Administration (FDA). After an exhaustive study extending nearly twenty years, the FDA conclusively proved that silicone is a safe substance for breast augmentation. Since their re-introduction in 1994, the new cohesive gel “Gummy Bear” silicone breast implants have literally redefined breast augmentation. They offer a remarkably natural feel, greater longevity, and better patient satisfaction than their saline counterparts. The cohesive nature of the silicone also invalidates nearly all of the leakage concerns that were valid in the older liquid silicone implants.

The cohesive gel implants are often called, “Gummy Bear” implants because of their chemical structure, and because of how the gel actually feels like a gummy bear. The gel within your implant is a unique type of solid, in that it is soft and malleable, but it is not a liquid, and it retains its original shape after pressure is applied. While it can act clinically like a liquid, it is actually a soft but solid gel. This quantum leap forward in breast implant biomaterial has propelled breast augmentation into the 21^st Century, and has allowed breast augmentation to surpass liposuction as the most popular plastic surgery procedure in the United States.

The driving force for the return of silicone implants was to improve the feel and longevity of breast augmentation procedures, and to eliminate the rippling seen so commonly with saline implants. These problems were definitively solved by 2004, and the public now knows it. What the general public does not know about is that the NEXT quantum leap forward in silicone breast augmentation has now arrived: the Natrelle Inspira Cohesive Silicone Implant.

Smooth MemoryGel® Xtra Breast Implants

MENTOR’s Smooth MemoryGel® Xtra breast implants offer an exciting implant option for individuals seeking impressive results with a natural feel. MENTOR® implants from Johnson & Johnson are created to provide unparalleled projection, firmness, and fullness. However, what makes these implants truly unique is how natural and soft they feel. MENTOR® MemoryGel® Xtra breast implants are created with a shell that is firm and strong. Each implant is filled with a specific amount of the proprietary gel.

Try a Pair of Breast Implants On!

During the next phase of your consultation, you get to try on any of the breast implant styles that interest you. Dr. Durkin and our Patient Care Coordinator assists you with on trying on different types of implants with different types of bras and different styles of clothing. At this stage, we finalize together the pathway to your ultimate goal from surgery.

Ocean Drive Plastic Surgery is the ONLY aesthetic practice in Florida to offer our patients a full, on site sizing consignment of the Cohesive Gel Implants. We have the largest aesthetic experience in the state of Florida with these new implants, and we firmly hold the opinion that this implant is the next quantum leap forward in cosmetic breast augmentation. We have also seen beyond remarkable results with this implant in revisional breast augmentation, especially when combined with our Ocean Drive Internal Bra technique. Lastly, for our athlete patients, this implant is clearly superior, as rippling has yet to be reported by our fitness competitors, even when total body fat composition falls below 5%.

Breast Augmentation by Fat Grafting

A few words about fat grafting, or autologouos breast augmentation. We commonly employ fat grafting in facial cosmetic surgery, buttock augmentation, breast augmentation, and breast reconstruction. In regards to breast augmentation, fat grafting is most commonly used as an adjunct to implant placement rather than a primary augmentation approach. In other words, fat grafting is an outstanding add-on to breast implant augmentation, but it does not replace the need for an implant in women that want to increase their breast size more than 2-4 centimeters. Having said that, many women present wanting a limited volume augmenation, and in that case, stand-alone fat grafting can be employed with outstanding results

Before and After