Breast Augmentation

Breast Augmentation is a very personal decision. What we think of ourselves is impacted to an extent by the way we look. You may be surprised to know that according to the American Society of Aesthetic Plastic Surgery in 2004 there were over 334,000 women that had breast enlargements. The better informed that you are about the procedures like Breast Augmentation, Breast Lifts and Breast Reductions the better equipped you will be to make an intelligent decision.

This website is built to help you make an educated, intelligent decision and is not designed to replace speaking with your doctor.

Find out why South Florida breast augmentation specialist, Dr Mendieta, has been named one of the top surgeons in the US for 4 years in a row since 2002 and why he was chosen by Harvard University.

Breast Implants & Augmentation Specialists offer a wide selection of breast augmentations procedures tailored to meet the desires of any individual, while reducing the size and the visibility of scars.

The correct breast augmentation technique still depends on the individual anatomy as well as the sagginess of the breast. For the BEST breast augmentation choice for YOU, please contact us or email us your photos.

For general information on breast augmentation please click here.

I. Breast augmentation procedures:

(a) Areola, transaxilary, inframmamary breast augmentations.

(b) Scarless breast augmentations (TUBA).

(c) Expansion breast augmentations.

(d) Circumareolar (minimal scar) breast augmentations with lift.

(e) Vertical scar breast augmentations with lift.

(f) Traditional t-shaped scar breast augmentations with lift.

Please click below for general information on breast augmentations procedures.

• Who is having breast augmentations.
• Who is a candidate for breast Augmentation.
• Risk and Complications after Breast Augmentation.
• Planning your Breast Augmentations / Who should your surgeon be?
• Preparing for Breast Augmentation.
• The surgery.
• Recovering after your Breast Augmentation surgery.
• Your new look.

Who is having Breast Augmentations.

Breast augmentation surgery has been performed for over 25 years on well over 2.5 million women. This massive clinical experience attests to the safety of the procedure and its effectiveness in improving self-image and the quality of life for those patients who have had augmentation.

Many women today seek breast augmentation for a variety of reasons:

• Improve self image and self esteem
• To have better body proportions and contour, so they feel and look better in clothes and bikinis
• To regain a more youthful shape to their breast.

Whatever the individual reasons may be, breast augmentation is quickly becoming the most requested plastic surgery procedure in the United States today. Currently it is only second to liposuction.

Who is a candidate for Breast Augmentation.

What many patients fail to realize is that the final results after an augmentation will depend greatly on what the anatomy is prior to the operation. While it is true that nearly every woman has the opportunity to increase and or improve the shape of her breast. There are several anatomic factors that need to be taken into consideration so as to determine what the best options are for your particular case. Many patients will bring photographs of someone else and desire that persons breast shape or inquire after the operation as to why their breast don't look like her friends. This is never possible since no two individuals are the same. It is important to have realistic expectations, and not expect perfection. Even within our own self we don't have symmetry. If you notice one side of your body is very different from the other (One side is longer, shorter or fuller than the other.)

When deciding on an augmentation, several factors have to be taken into consideration. The quality of the skin, the amount of breast tissue present, and most importantly, whether a breast lift is needed. What I tell my patients is that if nothing else is done but an augmentation, then at 6 months after surgery you will have the exact same breast you had before the operation but only fuller and larger.

Many women, have nice, round, and perky breast and they are just seeking to augment what is already naturally pretty. In this straightforward scenario, since you have started with a breast that has good to excellent shape, you should end up with similarly attractive breast but larger. The incision of choice does not really matter since we are only addressing the size of the breast and not the shape. The incision locations will become a mere formality in the discussion between you and your surgeon as to what is more appealing to you.

In other cases perhaps, the breast may have a less than ideal shape. It is in these cases that the incision location, implant type and the placement of the implant (whether it is partially under or over the muscle), may make a difference in the end result. It is in this particular area that you will find many plastic surgeons, depending on there philosophies, experience and training, offering different opinions as to what is best for you. This is why it is important to seek different consultations, this way you may become comfortable with the surgeon you choose and familiar with the options available in your case.

Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.

Risk and Complications after Breast Augmentation.

Like anything in life, risks always exist, and although it is a very straightforward procedure, the following complications may occur:

• Hematoma - This is a collection of blood within the breast implant pocket. This happens because of either internal bleeding or diffuse internal oozing from the breast pocket dissection. This is very rare, but if it does occurs it usually happens within the first 24-48 hours, (although there have been some rare reports of it occurring almost a week later). The symptoms are increased swelling on the affected breast along with moderate to severe pain on the side of the hematoma. When this occurs, it usually means a re-operation to explore the site to remove the collection and control any bleeding that may be present.
• Infection of the implant - There are several different ways to deal with an infection depending on the severity but almost always it means removing the implant, letting the body heal, and then placing a new implant 3 months later. If it were to occur it usually happens around the 8-10th day after surgery, although there have been rare reports of it occurring months down the road. (Some surgeons may choose to place a new implant back earlier or later than 3 months, but you need to wait until the infection is cleared up.)
• Capsular Contracture - The perhaps is the most common of problems. Whenever you undergo any surgical procedure scar tissue forms in the body. When an augmentation is done the scar forms around the implant, this scar is usually soft and the breast has normal feel to it. However, in a small percentage of patients this scar tissue hardens and tightens, depending on the degree of tightening, it can create a very firm felling breast that can even distort the breast shape. This can occur anywhere from a few months after your surgery to years down the road. It is also unpredictable and it can occur in one breast and not the other. When it does occur we have a few medicines that can help but often it means having to re-operate. Only in a few percentage of women does this problem keep recurring, and in these cases you may need to either accept the firmness or have the implants removed. For more information on capsular contracture click here.
• Implant rupture or leak - This is a very rare occurrence but if it were to happen the contents are just saline (salt water), so your body will absorb it. You would realize that a leak or rupture has occurred because your breast would seem smaller. When it does deflate it can happen all of a sudden or over time. The good news is that most implant companies offer a lifetime warranty on their products. For silicone gel implants it is a different problem since the body will not absorb the silicone and you would require an operation to remove the leaked contents. For more information on leaks please click here.
• Nipple, areolar or skin sensory changes - As is true with any breast surgery, after any operation you could loose sensation, however this is rare. In most cases if sensation is lost it is usually due to swelling, and it can take up to 3 months to return. In a few cases it can take up to one year but only in extremely rare cases is sensation permanently lost. What is seen more often is that the nipples become more sensitive, and this may require some special exercises to improve this hypersensitivity.
• Loss of Breast-feeding ability - Theoretically one could loose the ability to breast feed whenever any breast surgery is performed. However, most women are still able to breast feed after an augmentation. There is no evidence that implants affect pregnancy or fertility. For more information please click here.
• Stretch Marks May Develop - Any breast augmentation will obviously stretch the skin, and although it is extremely rare, in some patient when you augment the breast, stretch marks may develop. If they do develop some have advocated the use of laser but this is not mainstream and the results are very mixed, so to date there is no real treatment for stretch marks.
• Rippling and wrinkling - This is especially true with saline implants. If you have very little breast tissue then it is possible that you may either feel rippling or even see the wrinkles of the implant. If it occurs you may need to switch to silicone implants but even this does not guarantee results. For more information please click here.
• Synmastia - This occurs when the pocket that is created for the implant is made is to close to the sternum. The problem here is that both breast meet in the middle giving you the appearance as if you only had one breast. This is correctable but it requires a second operation. See Photo gallery.
• Bottoming out - This happens when the implant falls too far down on the chest cavity. This gives the appearance of the nipple not centered on the implant. What you will see is the nipple located very high on the chest area and the implant is low on the chest cavity. The nipple looks like it is in the wrong position (sunny side up look). This also can be corrected but it requires a second operation and perhaps going to a smaller implant.
• Double Bubble - This occurs when the implant is lower on the chest wall and the breast gland remains on top. You clearly see a distinction from the implant and the breast gland creating a double ridge or double bubble. See Photo gallery.
• Snoopy Deformity - This occurs when the breast tissue overhangs and slides on top of the implant. This may cause your nipples to point downward giving you an unsatisfactory shape. This can be corrected but usually requires a breast lift. See Photo Gallery.
• Bad Scarring - Hypertrophic, Keloid or wide scars can occur.
• Cancer - It does not cause breast cancer but it may obstruct the view on mammograms. Therefore it is important that you do self-breast exams and if you notice anything different report it to your physician. Also let the radiologist now that you have implants so they can take a special view of your breast. Many times they may add an Ultrasound examination to aid in evaluating the breast.

Planning your Breast Augmentations / Who should your surgeon be?

You have already taken the initial major step, and that is to inform and educate yourself of the procedure itself; its advantages, disadvantages, risk /complications and of what are reasonable expectations.

Your next major step is to find a surgeon that is qualified and has the training not only to perform the procedure itself but that also that has the experience and knowledge of taking care of the complications. Remember, although breast augmentation is relatively straightforward, complications can occur, even in the best of hands. Everything is smooth sailing in calm waters but when the rough seas approach you want someone that has the experience and training to deal with whatever may develop. You want to choose someone who has undergone the rigorous training of becoming a plastic surgeon.

What to look for:

In order to become a plastic surgeon one has to complete undergraduate college, medical school, and an approved surgery residency program of at least three years (it was traditionally 3 years of general surgery, or they have completed training in any surgical specialty, however most completed 5 years of general surgery) what then makes the difference is that they must be accepted and then complete an approved plastic surgery residency for an additional two to three.

It is these Physicians that have been trained in total body and face reconstruction and total face and body cosmetic surgery. It is these surgeons that are plastic/cosmetic surgeons. It is in this area that most patients become confused, because remember it is legal in most states for any physician who holds a medical license with or without surgical training, to advertise himself as a plastic or cosmetic surgeon. So what is important is to look for Board Certification in Plastic Surgery. This is obtained only after the candidate has been in plastic surgery practice for at least one year and has passed rigorous written and oral examinations administered by experienced plastic surgeons. This is another area which can become confusing and you must also be careful because, as the ASPS says, "Don't be confused by other official sounding boards and certifications." The American Board of Plastic surgery is the only Board recognized by the American Board of Medical Specialties (ABMS) to certify in plastic surgery of the entire body. There is no separate, ABMS recognized certifying for cosmetic surgery.

You must also be aware that some physicians will say that they are Board Certified, and they may be, but it could be in Dermatology, Gynecology, or any other field other than plastic surgery. So make sure your Doctor is Board Eligible or BOARD CERTIFIED IN PLASTIC SURGERY. Understanding certification is so important for the perspective patient. If there is any confusion about a surgeon's board certification you may consult the ABMS directory of certified medical specialist available on the ABMS web site, www.abms.org.

Your next step is to schedule a consultation. Every person's anatomy and goals are different, so it is not fare to standardize everyone into a certain procedure. When you consult with Dr. Constantino Mendieta he will take various measurements evaluate the shape of the breast, the amount of breast volume present, and if there is any degree of ptosis ( breast droopiness) which may require a breast lift . Recommendations will then be made so as to how best reach your desired goals.

If you are from out of town you can email photos and fill out the consultation form. Dr. Mendieta will then evaluate them and make recommendations.

After you have a consultation with Dr. Constantino Mendieta, you will receive an entire informational package that includes:

• How to prepare for you surgery
• what medications to avoid
• the operation
• what to expect as you heal
• the surgical risks and complications.

Preparing for your surgery.

Every plastic surgeon has his own ritual and recommendations. We have found it helpful for patients to do the following Things that you will need before your surgery:

• Ice packs or frozen peas (you will need these for the next 48 hours.)
• You will need to purchase a Sports bra, which you will wear for about 2 weeks for comfort.
• The night before your surgery you can take a Valium 10 mg this will make you sleep like a baby. Also the night before surgery we recommend taking a zantac 300 mg, this will sometimes help with preventing nausea after your surgery.
• Don't eat or drink anything after midnight (when you brush your teeth in the morning don't drink the water).
• The morning of surgery wear something very loose that is easy to take off and on, don't wear any jewelry, you can shower but done place any creams, lotions, deodorants or perfumes.

Arrange for someone to drop you off and pick you up after surgery. Arrange for someone to stay with you for a couple of nights.

You will have tape around your incision site, which will be removed when your sutures are removed at about day 5-7. Don't worry you will be able to shower the day following surgery; it is ok for the tape to get wet.

The following day you will come to the office for a follow up visit and massage.

Where your surgery will be performed.

Breast Augmentation is a straightforward procedure that is relatively quick and safe. The procedure is most commonly performed in patients that are in good to excellent health, and therefore it can be done in either office based surgical centers, ambulatory surgical centers, or Hospitals. Most of our breast augmentations are in our own office based surgical center, this affords a very relaxed atmosphere with more patient privacy and comfort. The exceptions obviously would be if the patient has any major medical problems or the patient desire it to be done in the hospital.

Types of anesthesia.

The operation can be performed in various ways, either under local with IV sedation, nerve blocks with sedation or General anesthesia. It is Dr. Mendieta's preference to use General anesthesia since it is extremely safe and the operation is only about one hour.

Your surgery.

The amount of time the entire process takes depends on many factors, but on the average the usual time course is the following: The preparation before surgery takes about one hour, the surgery itself will also take about one hour, and the time in the recovery room is about one to two hours. You can therefore expect the entire process to last about 4-5 hours.

The decisions to be made prior to surgery will be the location of the incision, the location of the implant (above or below the muscle), the type of implant to be used, and whether a lift is needed or not.

The incision options are: Areola, Axillary (arm pit), Inframmamary (where the breast meets the chest), and Transumbilical (belly button). Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. Click here for more details on incision options.

The location of the implant: Since every person goals and body structure are different, then the location of the implant will depend on your surgeons philosophies combined with your special anatomic situation. It can be placed above the muscle, below muscle or a combination of both. Click here for philosophies on placement.

The type of implant used, will depend on your surgeons philosophies. The available types are round or anatomic, and they can be either smooth or textured. Click here for an overview of different philosophies.

Although the outer shell of all implants is made of silicone, the contents of the implant can be saline (Most commonly used today), silicone (restricted use by the FDA and you have to be part of a study) or soy implants (not really used in USA due to problems). Click here for an overview of silicone studies.

In patients that have had volume changes in their breast like after child birth, breast feeding or those that have lost a great deal of weight, may have some degree of droopiness to their breast (ptosis) and it may require a breast lift at the time of augmentation. Click here for breast lift with augmentation.



Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.



The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.



After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.

Recovery period after your breast augmentation surgery.

The first day of your augmentation you may feel groggy or sleepy, this is quite normal because of the anesthesia. This feeling will improve over the next few hours or day. We recommend that after your augmentation you only take liquids for the first day, since although rare, you may feel sick to your stomach and liquids as opposed to solids is much easier on your system. For the next 48 hours ice packs or Frozen peas are your best friends. We have found that cold is best for the first few days, and heat (saunas, Jacuzzi's, warm showers) is great after one week. As far as the infamous question about pain and getting back to normal:

Getting back to normal

Amazingly enough our recovery has been greatly enhanced through the unique use of certain exercises, ice packs and certain special medications that we give during and after surgery. Through this unique regimen most of our breast augmentation patients resume normal activities in about 3-4 days (brushing your hair, your teeth, driving, etc) and return to work in 4-5 days. It is very unusual for our patients to require any type of narcotic pain medication for more than 36-48 hours. It will take about one month before you feel completely normal, and what we mean by this is that you may feel some sensation changes and occasional discomfort in the breast. It is very normal for one breast to be more uncomfortable than the other. You may also find it difficult to sleep on your side, not because it is not recommended but rather because it may be uncomfortable for up to one month. The recuperation and these occasional discomforts are variable in everyone, some patients may take less time and others longer but the average is about one month for normalcy. Click here for more information.

The scars will be firm and pink for at least six weeks. They may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

We recommend for you to wait about one to one and half months before buying new bras. The breast is swollen in the beginning and you need to let the swelling subside before making wardrobe changes.

More specific instructions will be given to you during your consultation.

(See All surgery carries some uncertainty and risk.)

Your new look.

At first your breast may seem too big or too high, this occurs because your breast is swollen and it will take about 2-3 months for the breast to settle and take its nice natural shape. You may also notice that one breast is higher or larger than the other, this is quite normal since one side may swell more than the other, and also, if you notice your before pictures you will see that your breast were not symmetrical to begin with. It will take about 3 months for you to become accustomed to your new look and not notice the differences as much. Most patients are very happy immediately after their surgery. It is those patients that have unrealistic expectations and are not willing to wait for the healing process that become dissatisfied and anxious. Remember it takes about 3 months for all the swelling to go away and the breast to settle into their new position.