Breast Augmentation

CONVENIENTLY LOCATED TO SERVE NASHVILLE, BRENTWOOD, AND FRANKLIN

Who you choose to perform your Breast Augmentation is a very important decision. Double board certified plastic surgeon, Dr. Paul Warner Papillion performs hundreds of breast augmentations yearly and Breast augmentation happens to be one of his favorite procedures. His results are amazing, his patients love him, and a breast augmentation consultation with Dr. Papillion will be well worth your time. Below the quick facts, Dr Papillion has answered the key questions you need to know about breast augmentation. Keep reading to learn more!

Breast Augmentation Before & After Photos
Breast Augmentation Before & After Photos

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Quick Facts:

Breast Augmentation

Cost: 6000-7500
Downtime: 5-7 days
Pain Scale 1-10: 5
Cosmetic Ranking 2019: #1 – 299,715 augmentations performed.
Also known as: Boob Job, Breast Aug, Breast Enhancement

After deciding to start my journey with breast augmentation, I started researching surgeons in my area. I had already met with one doctor at a different office when I had my consultation with Dr. Papillion. He had rave reviews and I loved the results of his before and after shots. From the get go, everything was so easy. I was nervous for my first appointment, but right away, Dr. Papillion calmed my nerves. He walked me through what he could do for me during the procedure and what I could expect from my results. I knew quickly I was in the right hands and had found the best surgeon for me. I scheduled my surgery that same day. He answered all of my crazy questions before and after my procedure in detail and with quick responses. He was so easy to talk to, as well as all his staff and nurses. My recovery was a breeze and my pain was well managed. I will absolutely return to Dr. Papillion for any future procedures I decide to get. I have already referred him to a great friend of mine looking to get a breast augmentation. I could not love my results more! Thank you for making such a great impact on my life!

by K

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Am I an ideal candidate for breast augmentation?

Ideal candidates for breast augmentation are patients who are unhappy with their current breast size and would like to enlarge them with the help of implants.

If you are in good overall health, you are an excellent candidate. Non-smokers are ideal, since smoking increases the chance of complications and prolongs the breast augmentation recovery period. Smokers must quit at least two weeks before the date of the surgery, and they must continue to avoid smoking during the healing process after surgery.

Good candidates are not currently pregnant or breastfeeding and have realistic expectations for what the surgery can and cannot achieve.

Should I choose a Saline or Silicone (gel) breast implant: Making the best implant choice for your breast augmentation.

silicon implantWe use two basic types of implants, a saline breast implant and a silicone or gel breast implant. They both have a silicone shell; one is filled with saline during surgery, and the other comes pre-filled with silicone. Most plastic surgeons, including myself, and patients prefer the gel implant over the saline implant because the gel implants typically have a more natural “breast tissue” like feel and have lower rate of “rippling” or folding of the shell wall. In thin patients or smaller breasted patients, the feel and shell wall characteristics are more important because the less breast tissue you have covering the implant, the more you will feel and see the underlying features of the implant. If you start off with large breasts and choose a smaller implant, your own natural breast tissue will do a good job of masking any implant feel difference or rippling visibility and the differences between implants become less important.

The most common shape and surface of the breast implant used is a smooth round implant. This is the one I prefer and use the most.

When you come in for your consultation, you will be able to hold and feel the difference between breast implants. I will be able to perform an exam and give you my opinion about your breast tissue coverage and help you to decide which implant may be best for you.

Dr. Papillion’s Approach to Breast Augmentation

Dr. Papillion's Approach to Breast Augmentation

What is a gummy bear breast implant?

Gummy bear implants are a newer type of silicone implant that many patients find to be ideal. The difference between gummy bear implants and traditional silicone breast implants is the type of silicone used. Gummy bear breast implants are filled with a dense cohesive form-stable silicone gel. This allows them to retain their shape after a rupture.

These implants do not experience leaks when ruptures occur in the silicone implant shell. Because of this, gummy bear implants are very safe, and it also makes it much easier to remove them from the body when a rupture occurs.

What incision should I choose for my breast augmentation?

implant incisionsThere are 4 options for breast augmentation: Infra-mammary (most preferred and most common), Peri-Areolar, Trans axillary, Trans umbilical. I prefer and recommend the most commonly used: Infra-mammary incision “IMF”. I have and will perform any incision you prefer, but once most people hear the pros and cons of each incision, they end up preferring the IMF incision as well. The advantage of the trans axillary and trans umbilical incisions is that you simply have no scars on the breast. The disadvantage is that you have higher rates of Capsular Contracture and implant malposition. The periareolar incision was the second most popular, but also has a higher rate of capsular contracture, and if you don’t close the incision perfectly, you can get dimpling and retraction of the scar which does not look good. I have a revision case which demonstrations this. The IMF incision has the lowest rates of infection, capsular contracture and gives the best visualization to perform the surgery. I also place reinforcement sutures at the bottom of the incision to help support the implant long term. One of the long term risks of breast augmentation is that the implant can continue to migrate down after surgery, also known as bottoming out, see my revision case. Bottoming out occurs more often with the other incisions in my opinion.

In summary, the IMF incision has the lowest complication rate, the best visibility for the surgeon, and provides the best long-term results.

Is it better to place the implant under the muscle or over?

silicon implant placement

Breast implants can be placed under the muscle or over the muscle. Most plastic surgeons including myself, prefer placing the implant under the muscle. There are two main reasons for this. One, the muscle offers more coverage at the top and middle side of the implant allowing for a smoother, more natural look. This is extremely important in a very thin patient. When the muscle is just under the skin, you can have a sharp edge to the implant and in some cases be at risk for ‘the round baseball’ look. The other reason is that it is proven that you have a lower chance to have capsular contracture. Capsular contracture is basically scar tissue that builds up around the implant that can cause a poor look and discomfort over time.

What size implant is best for me? : Choosing your optimal size.

Size of implantsYour starting body proportions and desired outcome preferences will make the size choice for you. Everyone has a different opinion of what look they want. The most common thing that patients say when asked about size is: I want to look natural. I want to look proportional. The way I like to determine your size is to first talk about your goals, perform an exam to see your dimensions, look at photos you may bring if you have any, and allow you to try on different sized implants so that we can get a visual of the look you like best. After combining this information, we have a pretty good idea of what implant size is going to be best for you. I rarely have patients unhappy about a size selection. Looking online at before and after photos which have the size listed can be helpful, but be careful because you really need to know the patient’s height and weight and their starting breast size needs to be similar to yours before you can get an idea of your potential outcome.

Remember that breast implants also come in different profiles. An implant’s profile refers to its projection from the chest wall. There are low profile, moderate profile, moderate plus profile, high profile, and extra-high profile breast implants. A low profile implant has the widest base and the least amount of projection, whereas an extra-high profile implant has a narrow base but a larger amount of projection. The ideal profile choice for you will depend on your aesthetic goals and the overall dimensions of your frame. Your options will be discussed during your informative consultation at our office.

What does the day of surgery look like?

breast implant surgeryTypically starting at midnight the night prior to your surgery, you will stop eating and drinking all food and liquids. You can brush your teeth the next morning, and take any approved medications with a sip of water, but that is it. You will arrive at the surgery center about 2 hours before your scheduled time. You will be checked in and prepped for surgery. I will see you before surgery, reviewing your procedure and size. After we confirm everything, you’re taken back to surgery. The breast augmentation surgery takes about an hour. After surgery you are taken to the recovery room where you fully awake over the course of 30-45 minutes. After this, you will get dressed and head home. You will have a small dressing under your breast covering your incision and a white band called a bando sitting high on your breast. The band holds pressure to the top of the implant to help the breast implant settle during the healing phase. The rest of the day is spent with minimal activity and pain control as needed.

What does recovery look like?

breast implant recoveryThe first few days you can expect swelling and discomfort. How much discomfort you have depends mainly on two things: How large of an implant you chose and how tight your breast tissues are prior to surgery. Most patients have a reasonable amount of discomfort controlled with the pain medication and a muscle relaxer that I give you. You can walk around as much as you like. Activities of daily living, such as eating, showering, making small meals are perfectly fine to do and encouraged. You do not need to drive while on pain medication. You will see me in the office about 5 days after surgery. At this visit we check everything and teach you how to massage the breast to help with the implant settling. After this visit, you can typically return to desk type work activity, driving, and small activities. At 3 weeks post op, I allow you to get your heart rate and blood pressure up. You can return to lower body workouts, fast walking, progression to jogging and other more physical activities. Your activities progress, as you feel better. The only restriction I have during the advancement of activities is that you do not do any focused chest workouts. No pushups, no Planks. At 3 months, you can return to planks, pushups, and have no restrictions.

View Breast Augmentation Post-Operative Instructions

Breast AugmentatioScheduling a Consultation for a Breast Augmentation in Nashville

These were some of the most common questions discussed during a consultation. A personalized consultation is best for hearing and learning about breast augmentation first hand. Dr. Papillion is truly amazing at his job and you won’t be disappointed in your decision to see him. Schedule your consultation today! We can’t wait to meet you!

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