Breast Augmentation Surgery in Boston & Sudbury

Serving Wellesley & Sudbury Patients

• Why Pursue Breast Augmentation Surgery
• Breast Augmentation Candidacy
• Types of Breast Implants
• Placement Options for Your Breast Implants
• Incision Patterns
• Day of Breast Augmentation Surgery
• Recovering From Breast Augmentation
• What Breast Augmentation Surgery Costs
• Achieving Your Dream Breasts

Why Pursue Breast Augmentation Surgery?

Most women would agree that their breasts are a symbol of femininity and youthful vitality. For women with full, well-shaped breasts, they are often a source of self-confidence. It is no surprise, then, that many women who are unhappy with the appearance of their breasts seek breast augmentation surgery with saline or silicone breast implants. This procedure can be performed to improve the appearance of small, deflated-looking or asymmetrical breasts.

If you can relate to these sentiments, you have come to the right place. At Accurate Aesthetics, Dr. William E. LoVerme and his team are proud to provide breast augmentation procedures that help women in Boston, Wellesley and Sudbury love the look of their breasts and enhance their quality of life.

Dr. LoVerme and his supportive staff are committed to providing beautiful yet natural-looking results from breast implant surgery, in a compassionate, comfortable environment.

Breast Augmentation Candidacy

Only a highly experienced, board-certified plastic surgeon such as Dr. LoVerme is qualified to determine whether you are a candidate for breast augmentation surgery. However, generally speaking, appropriate candidates for the procedure include women who:

• Desire fuller or larger breasts
• Would like a more cleavage or a greater degree of outward projection of the breasts from the chest wall
• Desire a subtle lift
• Are in good overall health, both mentally and physically
• Have reasonable expectations for what breast augmentation surgery can accomplish
• Are seeking aesthetic improvement, not necessarily perfection
• Have made the choice to pursue breast augmentation of their own volition
• Are not currently nursing (Women who are breastfeeding should wait  at least 12 weeks after they have finished nursing to undergo breast surgery, as this is how long it typically takes for their true breast size and shape to be restored.)

The team at Accurate Aesthetics encourages you to schedule a personal consultation with our Harvard-trained breast augmentation specialist to establish whether you would benefit from breast implant surgery or perhaps another procedure, such as breast lift surgery or combination breast lift surgery with implants.

Breast Implant Information

Undergoing breast augmentation surgery in Boston under the care of Dr. William E. LoVerme can be a positive, life-changing experience. Boston, Wellesley, Sudbury and MetroWest patients who have had the procedure often remark that they love their new figure and have greater self-confidence.

Nonetheless, the decision to undergo breast enhancement should not be taken lightly, as it is a serious surgical procedure and the results of the procedure are extremely long lasting.

• History of Breast Implants
• Saline vs. Silicone Breast Implants
• Breast Implant Size
• Other Breast Implant Choices

There are several important decisions that must be made during the breast augmentation process, including what type, size, shape, texture and profile of breast implants to choose. To help you make an informed decision about which breast implants to choose, the team at Accurate Aesthetics offers the following information about your breast implant options.

History of Breast Implants

Breast implants have been used since the mid-1960s. Initially, the implants used were most often comprised of silicone gel. In the 1980s and ’90s, citizens started raising concerns about the safety of silicone breast implants, asserting that they cause autoimmune disease. In 1992, after much debate about whether silicone implants were safe (including the implementation of a voluntary moratorium on the distribution of silicone implants proposed by the FDA and agreed to by implant manufacturers), the FDA placed a moratorium on the use of silicone breast implants, except for women undergoing breast reconstruction surgery or for those who already had silicone implants and needed to replace them. Saline implants were still available on the market.

However, in 2006, after reviewing the findings of many clinical studies conducted to prove the safety of silicone breast implants and concluding that they do not cause autoimmune disease, the FDA lifted the ban on silicone breast implants, allowing them to be used in breast augmentation procedures for patients who are at least 22 years old. The FDA also approved the use of a newer style of silicone breast implants: highly cohesive, form-stable silicone implants, often referred to as “gummy bear” implants, due to the gummy-like consistency of the filling material.

Aside from the concern regarding a correlation between silicone implants and autoimmune disease, there was also a concern that silicone implants caused capsular contracture (a potentially painful condition in which scar tissue hardens around the implant, causing the breasts to feel hard). To prevent capsular contracture in patients with silicone implants, plastic surgeons started instructing these patients to massage the treatment area to keep any scar tissue as supple as possible. This worked well and led plastic surgeons to the realization that by placing the implants under the pectoralis (chest) muscle, the implants would in essence get massaged every time the arm was moved. Indeed, this did help minimize the incidence of capsular contracture, and is still a recommended treatment protocol.

Saline vs. Silicone Breast Implants

With postoperative massage and especially with submuscular placement, the chance of capsular contracture with first-generation silicone implants is greatly reduced. Also, the newest-generation silicone implants do not necessarily need to be placed beneath the chest muscle to reduce the risk of capsular contracture, thanks to their highly cohesive, form-stable filling material. In addition, silicone implants have been proven to be safe for use in breast augmentation surgery. However, some breast augmentation patients still opt for saline breast implants. Ultimately, the choice between saline and silicone implants is a personal one. To help you make this decision, here are some of the advantages and disadvantages of each type of implant.

Saline Implants

Saline implants are filled with a sterile saltwater solution that the body naturally absorbs in case of an implant leak or rupture. They are also slightly less expensive than silicone implants. Finally, because saline implants are filled after they are inserted, Dr. LoVerme can make small adjustments to the size of the implants during the operation

However, saline implants are more prone to folding, rippling or wrinkling within the implant pocket, and may be visible underneath the skin’s surface. For this reason, they are not necessarily the best option for women with thin skin or an insufficient amount of body fat to cover and support the implants properly.

Traditional Silicone Implants

Traditional silicone implants are filled with silicone gel. They are slightly more expensive than saline implants, but they more closely resemble the look and feel of natural breasts. They are also less prone to rippling within the implant pocket and to being visible underneath the skin’s surface.

The safety of silicone implants is shown by the fact that the body cannot absorb the filling material in case of a leak or rupture. Instead, the filling material stays intact either within or close to the implant pocket. This may make it more difficult to detect if there is a problem with the implant. For this reason, the FDA recommends that patients with silicone implants undergo a breast imaging exam every three years, starting the third year after the initial augmentation procedure.

Highly Cohesive Silicone Implants

The newest-generation implants are also silicone, but they are comprised of a more cohesive silicone filling material. Due to the gummy-like consistency of the filling material, these implants are often referred to by the public as “gummy bear” implants. Thanks to the advanced filling material, these implants are very unlikely to fold or move around within the implant pocket. Also, the filling material is form stable, meaning that it will maintain its form when the patient is reclining or even when cut in half.

These implants feel slightly firmer than the other options. However, they come in a variety of shapes and profiles, often making them a good option for women with very small breasts, those wanting a specific shape and some patients needing revision breast surgery or breast reconstruction for cancer.

Breast Implant Size

During your consultation, Dr. LoVerme will collaborate with you to help you decide what size your breast implants should be. The first step in determining your proper breast implant size is to have you review a series of photographs to identify the look you desire. It is helpful if you bring to your consultation photographs of breasts that you think look particularly nice and have a size you would desire. Special sizers (not just breast implant samples) are used for you to try on, to help determine the size you like. Dr. LoVerme will then measure your chest cage to establish an appropriate implant diameter. This is one of the most important factors in determining the specific implant for you.

Once Dr. LoVerme has helped you determine a size estimate, he will ask you to go home and fill two 1-quart Ziploc plastic bags with the corresponding amount of dry rice, which you will put inside a loose sports bra or halter top. This will help you get a better idea of how a certain size of breast implants will look on your unique frame.

The volume (size) of breast implants is measured in cubic centimeters (cc). One ounce of dry rice equals approximately 30 cc. Thus, a 300-cc implant equals about 10 ounces of dry rice.

At home, if you decide that a certain size is too small or too large, please complete this process again, using a different amount of rice. However, make sure that you adjust the size by at least 2 ounces at a time.

In general, when deciding on a breast implant size, we recommend that you:

• Take your body type into consideration. Thin women may not have an adequate amount of skin and body fat to cover and support large implants. If there is not an adequate amount of skin, fat and breast glandular tissue to cover the implants, they may be noticeable beneath the skin’s surface. Also, patients with narrow body frames should not choose extremely large breast implants that have a wide base, or the results may look disproportionate with the rest of the body.
• Bring Photos With You to Your Consultation. To ensure that you and your surgeon share a similar vision of what your implant size and final look should be, it is helpful to bring in pictures of women who have similar breasts as the ones you desire. Note: Choose photos of women who have a similar physique as yours.
• Avoid Relying Exclusively on Bra Cup Size. Although referring to a bra cup size can be helpful as a starting point in choosing an implant size, avoid using bra cup sizes as your only reference point. This is because what a certain bra manufacturer refers to as a C cup may be referred to as a B cup by a different manufacturer.

Other Breast Implant Choices

Besides the type of breast implant, you will also need to choose the shape, texture and profile of your implants.

• Shape. Breast implants are available in a round or shaped form. Round breast implants provide added fullness and cleavage throughout the upper breast pole. Shaped implants may be more anatomically correct (They are larger on the bottom than on the top, like a natural breast). Also, because shaped implants come in a wide variety of options, there is an appropriate implant shape for every patient, even those who need implants with extra height, projection or width.
• Texture. Every type of breast implant has a silicone outer shell. The shell can be smooth or textured. Smooth implants may move around within the implant pocket while textured implants become affixed to the overlying tissue. Anatomic, or teardrop-shaped, implants are always textured, so they attach to the tissue, stay in place and do not flip around. If a teardrop-shaped implant flips, causing the larger portion to move up top, the effect would be a highly unnatural breast appearance. Some people assert that because the textured implants can attach themselves to the overlying tissue, they help lower the risk of capsular contracture. However, more evidence is needed to support this claim.
• Profile. The smooth, round implants are available in different profiles, or projections. Consider a 12-ounce glass of water. The glass will hold the same amount of water whether it’s tall and thin or wide and short. The height of the glass is similar to the projection of the implant. A lower-profile implant is wider on the chest wall and provides more roundness at the side of the chest. A higher-profile implant provides a greater degree of forward (outward) projection from the chest wall.

Let Us Help

At Accurate Aesthetics, we understand that there are many choices to make in regard to your breast implants. Among the three breast implant manufacturers in the United States — Mentor, Allergan and Sientra — there are several combinations of size, shape, texture and profile to choose from. We will use our extensive breast enhancement expertise to help you make informed decisions about your breast implants that you will confident about.

To schedule a private consultation with Dr. LoVerme and learn more about your breast implant choices, contact Accurate Aesthetics by calling (877) 603-7874 toll-free today.

Types of Breast Implants

We realize that pursuing breast augmentation surgery can seem like a daunting task, given the abundance of information about the procedure available on the Internet and the number of choices that must be made. Ultimately, however, it should be a positive, life-changing experience, and we strive to ensure that you feel comfortable, confident and happy about your decision to undergo the procedure. To this end, we offer the following preliminary information about the types of breast implants available, the decisions you will need to make and what to expect during surgery and the recovery period.

At Accurate Aesthetics, we offer saline, traditional silicone and the newest generation of form-stable silicone breast implants (often referred to as “gummy bear” implants).

All breast implants are comprised of a silicone outer shell and a filling material. Saline implants are filled with a sterile saltwater solution.

The principal advantages of saline implants are that:

• The body safely absorbs the filling material in case the implant leaks or ruptures.
• They are the most cost-effective option.
• They can be adjusted during the operation to accommodate small differences in size.

The main disadvantages of saline implants are that:

• They do not resemble the look or feel of natural breasts as closely as silicone breast implants do.
• They are more likely to fold or wrinkle within the implant pocket.
• They might not be a suitable treatment option for women with thin skin or little body fat, as they may be visible underneath the skin’s surface.

Traditional silicone breast implants are filled with a silicone gel filling material. The main benefits of traditional silicone implants are that:

• The look and feel much like natural breasts.
• They are less prone to rippling or wrinkling within the implant pocket (making them a better choice for women with thin skin or little body fat).
• They may last longer than saline implants.
• With the use of a Keller Funnel, these implants may generally be placed through an incision that is about the same small size as the ones used for saline implants.

However, the potential drawbacks of silicone breast implants are that:

• In case the implant leaks or ruptures, the body cannot absorb the cohesive filling material, which stays intact either within or close to the implant pocket, often making it difficult to detect problems with the implants. Nonetheless, the body does not absorb the silicone gel, so there is little cause for alarm.
• Silicone implants are slightly more expensive than their saline counterparts.

The newest-generation silicone breast implants are referred to as highly cohesive, form-stable silicone breast implants. They are also sometimes called “gummy-bear” implants, thanks to the gummy-like texture of the highly cohesive silicone filling material. The main advantages of this type of implant are that:

• The filling material stays intact in case there is a problem with the implant. It will even stay intact if the implant is cut in half. This makes form-stable silicone implants extremely unlikely to fold or ripple within the implant pocket.
• Form-stable silicone implants are available in a wide range of shapes and sizes, including an anatomically correct teardrop shape, often making them a good choice for women undergoing breast reconstruction surgery following lumpectomy or mastectomy for the treatment of breast cancer.

The principal disadvantages of this type of implant are that it feels firmer than the other options, and that a longer incision may be needed for insertion. In addition, the surgeon must take more care in placing these implants to ensure they are lined up correctly before finishing the operation. Patients with form-stable silicone implants that are not correctly aligned during the initial procedure may need another operation to improve this.

In addition to choosing a type of breast implant, you will also need to decide which size you would like, as well as the shape, profile and shell texture of your breast implants. During your consultation, your plastic surgeon will measure your chest cage, review your aesthetic goals, explain the different treatment options and help you decide which type, size, shape and texture of breast implants is right for your aesthetic and anatomical needs. Specific anatomic sizers may be used to give you a good idea of what the implants will look like.

Placement Options for Your Breast Implants

There are several placement options for your breast implants. At Accurate Aesthetics, we offer:

• Subglandular placement (beneath the breast, or glandular, tissue but above the chest muscle)
• Submuscular placement (beneath the chest muscle)
• The most recent approach, subfascial placement, or the dual plane approach (beneath the fascia, or connective tissue, that covers the chest muscle but above the actual chest muscle). This is the option that Dr. LoVerme most frequently utilizes. He feels it provides all the benefits of submuscular placement without the possibility of abnormal motion of the implants any time the arms are flexed. It is also an easier operation to recover from than the submuscular approach.

Again, certain factors, including your aesthetic preferences, unique anatomy and the type of breast implant chosen, will help determine which placement approach is right for you.

For instance, patients with mild breast sagginess (ptosis) tend to benefit from subfascial placement, which provides a subtle lift throughout the breasts. For women with extremely petite breasts, thin skin and little body fat, submuscular placement may be better because it will provide better coverage and support for the implants. Women with small breasts who would like to minimize the degree of roundness throughout the upper breasts, for a more natural look, might benefit from a form-stable shaped implant with subfascial placement. During consultation, Dr. LoVerme reviews both the placement and implant type options with you in detail.

Incision Patterns

Accurate Aesthetics provides two main incision approaches for breast augmentation surgery.

The first option is the periareolar incision pattern, which involves making a circular incision around the outer perimeter of the areola, or darkly pigmented skin surrounding the nipple. The main advantage of this approach is that the incision and ensuing scar is well-concealed within the darker areola skin. However, because the placement is so close to the nipple (which may secrete milk or bacteria even in a non-lactating woman), this approach increases the risk of capsular contracture and is rarely utilized by Dr. LoVerme.

The second option is the inframammary incision pattern, which involves making a horizontal incision below the natural breast crease. Although this incision pattern might be more visible, especially when raising the arms while wearing a bikini, it minimizes the risk of changes in nipple sensation and / or difficulty breastfeeding. Also, with time and proper care, scars should fade so that they closely match the color of surrounding skin and are nearly imperceptible.

A third approach is to go through the armpit. This incision may jeopardize future diagnosis options (sentinel node biopsy) in breast cancer patients and, for this reason, is rarely utilized by Dr. LoVerme.

Dr. LoVerme does not utilize the TUBA, or transumbilical belly button, approach, as it gives the least chance for proper placement of the implant and cannot be used with silicone implants.

Day of Breast Augmentation Surgery

Breast augmentation surgery is typically performed on an outpatient basis,   in our state-of-the-art, private operating suite. Anesthesia is provided only by board-certified anesthesiologists from award-winning Newton-Wellesley Hospital. Deep sedation anesthesia (total intravenous anesthesia) is utilized. You will not need general anesthesia. Local anesthesia is utilized at the same time, so that you wake up without pain. Breast augmentation takes one hour or more, depending on the complexity of the procedure, including whether an adjunct procedure such as breast lift is performed. Following surgery, you will be taken to a room where you can recover while the effects of the anesthesia wear off. You will then be released into the care of an authorized adult, so you can recuperate in the comfort of your own home.

Recovering From Breast Augmentation

You should expect to take about one week off from work or your usual routine to recover from breast augmentation surgery.

Although everyone recovers at different rates, the most intense phase of the recovery period generally occurs within the first four to five days following surgery. During this time, you should avoid strenuous activity, including heavy lifting, lifting your arms above shoulder height and exercising. (You should not raise your blood pressure or pulse for 10 days after surgery, to prevent bleeding and minimize bruising.) However, you should take short walks around the house periodically to encourage sound blood circulation and minimize the risk of developing blood clots, particularly in the lower extremities.

The treatment area may be tender, sore or numb. You may take oral pain relievers as prescribed by Dr. LoVerme to minimize any discomfort during the initial recovery phase. Any changes to nipple sensation are usually temporary, but, in rare cases, may be permanent. The treatment area may also be swollen, red or bruised, but these are normal symptoms that should subside over time.

Note: Breast implants may initially sit high on the chest wall, but they will settle into a more natural position over the course of a few weeks.

You will notice that a surgical bra has been placed over your surgical dressings. Be sure to keep the bra in place for several weeks to provide additional support to the tissues while they heal. Dr. LoVerme will tell you when it is safe to remove the surgical garment and to resume your normal activities, including your exercise routine, during one of your follow-up visits to Accurate Aesthetics.

What Breast Augmentation Surgery Costs

Typically breast augmentation prices at Accurate Aesthetics Plastic Surgery range from $6600 to $7970. This includes all facility and anesthesia fees as well as the implants. More specific and newer anatomic shaped implants may increase the fees. The surgery is generally performed at the certified surgery center within the office including the use of a board certified anesthesiologist. Surgery that needs to be performed at the hospital may cost more. You will receive a personalized quote at the time of your consultation. Consultation fee is deducted from the cost of surgery.

Achieving Your Dream Breasts

Achieving the breasts of your dreams starts with one simple step: contacting Accurate Aesthetics for more information. To schedule a consultation with Dr. LoVerme to learn more about breast augmentation surgery and your treatment options, please contact Accurate Aesthetics by calling (877) 603-7874 toll-free today.

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