(603) 775-7444
137 Portsmouth Avenue Stratham, NH 03885
(603) 775-7444

Plastic & Cosmetic Surgery Skin & Laser Center

Breast Augmentation

Breast augmentation has steadily increased in popularity over the past 50 years and is now regarded as an extremely safe procedure offering excellent, natural-looking results. While breast augmentation surgery was controversial nearly 20 years ago, the safety of breast implants is now well-established. Patients interested in breast augmentation surgery with implants can contact our practice today to schedule a private consultation with our plastic surgeon, Dr. Richard Zeff. His goal is to remove the mysteries surrounding the procedure, so you can make your decision with a much better understanding of your choices.

What Is Breast Augmentation?

Breast augmentation, or enlargement, is a cosmetic procedure designed to increase the size and restore the youthfulness of the breasts. Year after year this plastic surgery procedure remains the most popular enhancement option across the nation, and one can choose between silicone and saline implants in a wide array of sizes to achieve a natural-looking result that suits your body and your goals.

What Benefits Does Breast Augmentation Offer?

Designed primarily to enhance the size of the breasts, breast augmentation can also:

  • Improve breast fullness, especially the upper breast
  • Enhance breast shape
  • Address symmetry (the similarity of the breasts)

Additionally, many women find that their confidence increases with their new breast size, so they feel more comfortable in their own skin. Some women find that their clothing fits better, giving them a more feminine silhouette overall.

Is Breast Augmentation Right for Me?

Ideal candidates for breast augmentation will want to improve their appearance by enlarging their breasts. One should also have reasonable expectations for the result and be in good general health. Our experienced medical team will review all the details of your treatment plan, so you are well-informed about what to expect and what can be accomplished. Dr. Zeff is committed to patient safety and care, and he will complete a thorough evaluation and discuss your preferences to develop a customized program with your anatomical needs, cosmetic goals, and personal preferences in mind.

Do I Need a Breast Lift with My Augmentation?

Breast implants provide increase in size as well as a very minor lift of the breast, but in some cases the breast tissue hangs too low for implants to provide complete correction. In those cases, patients may require a breast lift—which is also referred to as a mastopexy.  Not all surgeons will perform lift and augmentation at the same time. Dr. Zeff can evaluate your individual needs and explain the pros and cons of augmentation, lift, or both.

What Types of Breast Implants Are Available?

With the many advances in the design of breast implants over the years, patients have almost too many options when it comes to type and size. We offer both silicone gel and saline implants, and we personalize each breast augmentation consultation to help you determine the right choice for your specific needs and goals.

Our surgeon uses the most advanced augmentation methods so that patients can benefit from the most natural-looking results possible after breast surgery. An important influence on just how natural the results of breast augmentation will be is a phenomenon known as “capsular contracture.” It’s normal for the body to form a delicate fabric of scar tissue around breast implants. It’s much like the film of tissue one finds just inside an eggshell. However, in rare cases, this scar shrinks, making the breast augmentation more obvious. For some women this can be a desirable side effect, simulating the “wonderbra” lift.

Breast Implant Materials

Two types of breast implant materials are available: silicone and saline. Silicone breast implants have a silicone shell filled with a cohesive silicone gel. Saline implants also have a silicone shell, but they are filled with saline—a harmless saltwater substance. Although uncommon, wrinkling or rippling is a risk of breast implant surgery. Silicone gel-filled implants have a lower risk of rippling. The right choice for you will depend on many factors, particularly personal preference.

Breast Implant Sizes

Breast implant size does not, as many people may think, correspond with cup sizes in bras. That said, we can help you determine how large your breast implants should be to achieve the look you’re after. It can also help to “stuff” a bra with a bag of rice to see how a certain size will look on you. Dr. Zeff feels that the absolute best way to determine the size you want is by trying on a wide variety of implant sizers, so you can have a more realistic visual of how each size will look on you. This is done at a preoperative appointment. The ultimate shape of your result is far more related to the inherent shape of your breast, enhanced from behind by the implant. We will provide additional details at your initial consultation.

What Is Breast Augmentation Surgery Like?

During the breast augmentation procedure, Dr. Zeff will make small incisions and insert either a saline implant or silicone gel implant into the desired location. While there are several possible incisions through which breast implants can be inserted, Dr. Zeff prefers the inframammary crease (beneath the breast). These incisions are very small and relatively subtle.

The implant is placed most often beneath the pectoralis (chest) muscles. Our surgeon and the patient decide together which location will ensure optimal breast augmentation results. At our practice, we work with each patient to provide personalized treatment and exceptional care.

Breast Implant Incision Graphic

What Should I Expect During Breast Augmentation Recovery?

Breast augmentation is performed as an outpatient procedure. There is post-operative discomfort for several days, but we have developed a protocol that has greatly reduced pain and allows for a much faster return to normal activities. Depending on the demands of your job, we usually recommend a week off for recuperation, potentially longer if your breast implant surgery is combined with other cosmetic procedures, such as liposuction or a tummy tuck.

What Will My Breast Augmentation Scars Look Like?

While there are several options, Dr. Zeff feels that a small incision under the breast is best. Over time the scars are usually barely visible except on close examination. This also varies somewhat by individual.

How to Choose a Breast Augmentation Surgeon

When making the decision to undergo breast augmentation, choosing your surgeon is one of the most important keys to achieving a successful outcome. Dr. Zeff always recommends finding a board-certified plastic surgeon who is qualified and experienced in performing breast augmentation and other cosmetic breast surgeries. Memberships in prominent plastic surgery organizations, such as the American Society of Plastic Surgeons (ASPS) and The Aesthetic Society (formerly known as the American Society for Aesthetic Plastic Surgery, or ASAPS), can be further indicators of surgical excellence and elite professional standing. For many patients, the final stage of choosing a surgeon comes down to meeting face-to-face. Dr. Zeff encourages patients to get to know the surgeons they are considering by asking a lot of questions, paying attention to the surgeon’s approach and demeanor, looking at before-and-after images of other breast augmentation patients, and evaluating their own personal level of comfort with the practice as a whole.

Dr. Zeff is among the leading plastic surgeons in the region and offers decades of experience in breast augmentation. Every surgery is fully customized to the unique needs of each patient, using a variety of techniques and breast implant types to achieve optimal results. When you choose Dr. Zeff for your procedure, you can expect artistry combined with compassion, transparency, and skill—his goal is to ensure your safety, comfort, and satisfaction at every stage of the process.

How Much Does Breast Augmentation Cost?

The cost of saline breast enlargement (breast augmentation) with saline implants is $7,500 at our practice. The cost using silicone implants is between  $8,300 and $8,600 depending on the type of implant. These fees include surgeon, facility, anesthesia, and implant expenses. In unusual cases customization of the treatment plan may be necessary. Ptosis (droopiness of the breasts) for example, might require an entirely different procedure. Breast augmentation is a cosmetic procedure and therefore is not covered by insurance. If you would like to consider plastic surgery financing options, we work with several reputable agencies who offer appealing terms for qualified candidates.

*This number is only an estimate. The final price of your care is contingent upon a number of factors and will depend on your unique needs. We will determine the precise number during your consultation.

Breast Augmentation Frequently Asked Questions

We understand that you want to know as much as possible about a procedure before beginning. To help you in your research, Dr. Zeff has answered some of the most common questions about breast augmentation below. For additional details, please reach out to our office.

How long will I be out of work after breast augmentation surgery?
Most discomfort lasts only four to five days. You will be given a prescription for strong pain medication. However, many patients find it unnecessary after the first day or two. This is usually followed by another week of much milder discomfort. At least one week off work is recommended, but this can vary considerably depending on the physical demands of your job.
How safe are implants?
Since the implant controversy of the early 1990s, there have been numerous objective studies demonstrating the safety of breast implants. The patient satisfaction rate is extremely high and the safety record is exceptional.
How long do breast implants last? Will I eventually have to replace my breast implants?
Breast implants are designed and tested for longevity—and while most manufacturers estimate that implants can last for 10 years or more, many patients have kept the same implants without problems for over 20 years. Each patient’s body, their lifestyle, and other unpredictable factors, can contribute to the lengthening or shortening of a breast implant’s lifespan. When you undergo breast augmentation performed by Dr. Zeff, you can expect to receive only the highest-quality breast implants along with meticulous follow-up care. If at any point you are concerned about a potential problem with your breast implants, a prompt appointment can be made with Dr. Zeff to investigate any issues. There are a variety of reasons why women may choose to replace their breast implants. If it becomes necessary in the future, rest assured that Dr. Zeff is experienced in performing breast implant removal and replacement with exceptional results.
Are women able to breastfeed after a breast augmentation?
Yes, you should still be able to breastfeed after having breast enlargement surgery. In most cases the implants are placed behind the muscles, and therefore should not interfere with breastfeeding.
Does the price of breast enlargement increase if the size of the implants increase?
How long will the breast implants appear high and unnatural?
Implants may appear high for several weeks following surgery. You will be given instructions on breast massage exercises to help keep the implants soft and mobile. They will look more natural as your muscles continue to relax. The size of the implant and the degree of scar tissue formation will also influence the appearance. Interestingly, most women prefer a slightly “unnatural” appearance. That aspect of the result is not always something that the surgeon can control.
What do breast implants feel like?
Since breast implants are not a natural part of the body, they may take a bit of adjustment to get used to at first. With time, the majority of women adapt nicely to their implants and become accustomed to their different feel. Ideally, breasts augmented with modern breast implants and placement techniques should feel as natural as possible. Many women who desire larger breasts want to do so without achieving breasts that feel hard or reveal palpable features of the implants beneath the skin. To achieve this goal, Dr. Zeff often recommends silicone breast implants—for their softness, responsive texture, and more natural feel—placed below the chest muscle to conceal implant borders that might otherwise be noticeable. If a natural feel is one of your top breast augmentation priorities, it is important to discuss this with Dr. Zeff during your consultation.
What is capsular contracture and how can it be prevented?
Capsular contracture is a condition that occurs when the scar capsule that surrounds a breast implant becomes hard and shrinks around the implant. This can result in a breast that looks and feels unnatural, and may sometimes cause discomfort. The good news is that capsular contracture is often treatable and can be fixed with surgery. While capsular contracture cannot be entirely prevented, Dr. Zeff takes additional steps to help minimize the occurrence of capsular contracture for his breast augmentation patients. Patients must also closely follow post-operative care instructions following breast augmentation to help protect against capsular contracture.
What is breast implant illness (BII)?
Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA), and this approval means that breast implants have been rigorously researched and tested for safety. Although the FDA has established that breast implants are safe, a small percentage of women have experienced weakness, fatigue, aching muscles or joints, hair loss, cognitive dysfunction, and other health issues, and attribute these symptoms to the placement of their breast implants. Symptoms may become noticeable soon after placement or at some point after, perhaps years down the road. These types of symptoms, which are generally associated with autoimmune and connective tissue disorders, can fall under the umbrella term breast implant illness (BII), but it is important to understand that BII is not an official medical diagnosis. While patients’ concerns and physical challenges are real and must be handled with compassion, care, and appropriate treatment, the FDA does not have any evidence that breast implants cause specific autoimmune-related or connective tissue illnesses. It is also important to know that some women report relief of these symptoms upon removal of their implants. For those who believe their breast implants may be causing illness, Dr. Zeff offers comprehensive examinations and testing for implant complications, as well as the option for breast implant removal. He performs several types of breast implant removal procedures and the most appropriate treatment for each individual is chosen based on a thorough evaluation of their specific needs and goals.
What is BIA-ALCL and should I be worried about it?
In July of 2019, the FDA announced a link between breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)—a very rare, yet treatable health condition—and textured-surface breast implants. While this association may sound alarming, the likelihood of developing BIA-ALCL is very low—the FDA reports BIA-ALCL has occurred in less than 0.03% of patients with textured breast implants worldwide. Dr. Zeff believes that patients should be aware of all risks associated with breast implants before undergoing surgery. To alleviate concerns and protect patients, Dr. Zeff does all he can to prevent cases of BIA-ALCL from developing and advancing to problematic stages. These efforts include discontinuing the use of voluntarily recalled BIOCELL® textured surface breast implants, encouraging MRI screenings for patients with textured implants, and educating patients about the signs and symptoms associated with BIA-ALCL. Research has shown that when BIA-ALCL is detected early, it is highly curable. If you have any questions about BIA-ALCL for breast implant safety, we encourage you to discuss these concerns with Dr. Zeff.

Dr. Zeff’s Breast Augmentation RealSelf Responses

Dr. Zeff has performed plastic surgery, including breast augmentation, for over 30 years. He has performed well over a thousand breast implant surgeries. He uses his experience to help others better understand their options, and as part of that goal he routinely answers patient questions online at RealSelf.com. To see his responses about breast augmentation, follow the link below.


Contact Our Practice

We look forward to hearing from you. Feel free to contact our plastic surgery center today if you are interested in learning more about breast augmentation surgery with breast implants. Our New Hampshire practice serves residents throughout Maine, Vermont, and the entire New England region.

Stay Connected