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Breast Augmentation

Breast augmentation is the single most popular cosmetic surgery performed today, both in the United States and all over the world. Symmetrical, well-proportioned breasts can instill a sense of confidence in any woman. At our plastic surgery center in South Carolina, we offer breast augmentation to give individuals the opportunity to achieve a desirable sense of proportion and feel more attractive. We believe every woman deserves to feel beautiful and love her body. With breast implants, our patients can experience the sensation of self-confidence and improved balance between breasts.

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Dr. Craig Rowin and Dr. Ram Kalus, two leading plastic surgeons in the Charleston area, have helped numerous women achieve the look and feel they desire through breast augmentation surgery. Breast augmentation is a highly personal choice with the potential to significantly enhance self-image and confidence for a more proportionate and feminine figure, allowing patients to feel sexier and more attractive.

What is Breast Augmentation?

If you feel your breasts are disproportionately small for your frame or body type and wish to improve the contours of your breasts for a more aesthetic shape, breast augmentation can be a powerful solution to achieve your desired silhouette. Breast augmentation is a cosmetic surgery designed to impact both the size and shape of a woman’s breasts through the insertion of breast implants. Depending on your concerns, this enhancement can address breast asymmetry; restore lost breast volume (especially to the “upper pole” of the breast); and/or simply attain the breast size, shape, and fullness you have always wanted. With a broad range of implant types, sizes, and shapes to choose from, the procedure is personalized according to each patient’s cosmetic goals for a final outcome tailored to an individual’s ideal aesthetic. As one of the most popular cosmetic surgeries performed today, breast augmentation can yield incredibly natural-looking results that enhance your figure and body contour, not to mention improve your overall self-esteem and self-confidence.

What Can a Breast Augmentation Do For Me?

Depending on your specific needs as well as your unique aesthetic goals and desires, breast augmentation can be custom-tailored to help:

  • Improve the size and/or shape of the breasts, including mild sagging or drooping
  • Restore lost breast volume caused by pregnancy, weight loss, aging, and/or genetics
  • Enhance the symmetry of the breasts
  • Make the breasts appear more proportionate to your figure
  • Rejuvenate the overall appearance of the breasts, making them more youthful

Am I a Good Candidate For Breast Augmentation?

The U.S. Food and Drug Administration (FDA) requires that for relatively healthy women with small breasts, breast augmentation patients receiving saline implants be at least 18 years of age, and those receiving silicone implants be at least 22 years old. These stipulations, however, are purely guidelines, and it is ultimately up to your plastic surgeon to devise a treatment plan that is best for you, regardless of age. Adolescent girls who have developed an unusual breast shape or asymmetry may be candidates for plastic surgery on their breasts— this can even occasionally be considered “medically necessary” by third-party insurance companies.
To be considered a good candidate for breast augmentation, you must be in good overall health with no underlying medical conditions that may inhibit proper healing. You should refrain from using any tobacco products for a minimum of four weeks prior to surgery (ideally with no intention of continuing after treatment). It’s also important to have relatively good skin elasticity to provide ample support for the breast implants, the quality of which can be determined during your consultation.
It is important to note that anyone interested in addressing breast sagging simultaneous to enhancing the shape/volume of the breasts may be better suited for an augmentation combined with a breast lift. This is due to the fact that implants on their own cannot correct moderate to significant breast drooping, medically referred to as “ptosis.”

What are My Breast Implant Options?

Today there are more breast implant options than ever before. Implants can be textured or smooth, round or anatomic-shaped, or saline filled or silicone gel-filled; they are also available in all sizes, shapes, degrees of softness or firmness, and degrees of projection to accommodate each woman’s unique anatomy, needs, and desires for enhancement. A smooth round implant is the most popular choice for women since it will move slightly with a patient’s breast, more accurately resembling natural breast tissue.

Types of Breast Implants

Breast implants are divided into two basic categories depending on the type of shell surface (smooth versus textured) and the inner fill of the implant (saline or salt water versus silicone gel). The outer shell of all breast implants, regardless of the type, is composed of silicone—a compound whose chemical term is silicone dioxide, or consisting of silicon and oxygen. Silicone is a material that is used in every aspect of our lives, with the compound found in our kitchens, bathrooms, cars, and hospitals. It is used in syringes, IV tubing, kitchen utensils, lipstick, hair conditioner, body and face creams, and is even present in natural drinking water from a brook or stream.

When it comes to understanding the different types of breast implants, most patients and plastic surgeons agree that the feel of a silicone gel-filled implant more accurately mimics the feel of a woman’s breast when compared to a saline-filled implant. That said, the larger a woman’s breast (which consists of breast tissue and normal body fat), the less relevant the feel of the implant becomes since the main purpose is to make the breasts look larger. Conversely, in a very small-breasted woman who is seeking augmentation, or in a patient who is undergoing breast reconstruction after mastectomy, the feel of the implant may play a more important role.

Implant Updates

Recently, concerns have arisen regarding the late onset of a rare type of cancer known as BIA-ALCL, which is short for Breast Implant-Associated Anaplastic Large Cell Lymphoma. This rare disease has only been associated with one type of textured-surface breast implant, mostly the polyurethane textured implants or another aggressive texture associated mainly with Allergan® implants. At our own practice, these implants have rarely been used, and for thirty years we have primarily been using smooth-surfaced implants which have not been associated with this condition.

The recent increasing awareness of the risk of BIA-ALCL and its link to textured implants has led to the decision of most plastic surgeons to only offer smooth-surface implants. The once popular teardrop-shaped (“gummy bear”) implants were only available in the textured surface, and therefore have largely fallen out of favor with most plastic surgeons and patients due to the concerns of late onset BIA-ALCL. As of July 2019, Allergan® issued a voluntary recall of BioCell® textured breast implants, which are the types of implants most commonly associated with the recent cases of BIA-ALCL. Dr. Rowin and Dr. Kalus use MENTOR® smooth-surfaced implants at Plastic Surgery of the Carolinas, so our breast augmentation patients are not affected by this recall. With that said, it’s important to note that if you have already had implants placed and are not experiencing any symptoms or issues (pain, swelling, or tightness around the implant), no further steps need to be taken regardless of whether you have smooth or textured breast implants. If you are unsure which implants you have, refer to the Identification Card provided at the time of surgery. Please don’t hesitate to call our practice to speak to a member of our team if you have any concerns.

Learn more about breast implants.

Choosing the Right Implant Size

The most common reason for dissatisfaction after breast augmentation is size—either a patient feels she is not big enough, or she feels her size is larger than she had hoped. Thankfully, in our South Carolina breast surgery center, this is rarely a problem for our patients who are almost uniformly happy with their results. Generating a clear understanding of the type of results envisioned is critical to choosing the right breast implants.

At Plastic Surgery of the Carolinas, Dr. Rowin and Dr. Kalus take a visual approach to helping women select the proper implants. This involves having patients present pictures of individuals who have results similar to what they desire—a request made easy with our unique online resource (What Size Should I Be?®) that provides access to height, weight, pre-/post-operative bra size, implant type, and various other details when viewing before-and-after photos in our patient gallery. With this clear visual conception of your desired final results, it is truly rare in our practice that there are any surprises, or that patients are disappointed with their final outcome.

In addition, as part of your consultation, we will have you try on specially created breast implant sizers shaped like a breast and made to fit over your own breast within an unpadded bra. This way, when standing in front of a mirror, you can see what you would look like after your breast enhancement when wearing a bra, bathing suit, favorite T-shirt, or other form of clothing. This can help you gauge the final outcome if, say, a 250 cc breast implant was utilized versus a 450 cc implant or 300 cc implant. We also use this method to predict which implant variations are required to correct asymmetry.

During your consultation, regardless of whether you are seen by Dr. Rowin or Dr. Kalus, our doctors will take chest and breast measurements and assess nipple position, skin sagging, and skin quality— all of which are taken into consideration to create a list of implant shapes, sizes, projections, and degrees of softness that can realistically achieve your goals.

Breast Augmentation Incisions

Breast implants can be inserted through a number of incisions, including:

  • Inframammary Incision


    Located within the breast fold. This is the most popular incision technique, due to its inconspicuous location and ability to accommodate many different implant sizes.

  • Periareolar Incision


    Around the borders of the areolas. This incision is placed in a circular fashion along the edges of the areolas, with the location best suited for smaller implants.

  • Transaxillary Incision


    Within a natural fold of the armpit. The transaxillary technique places the implant through an incision in the armpit. While this placement allows the breast to remain unscarred, it is only effective for saline implants.

Developing a Custom Breast Augmentation Plan

There are a multitude of reasons why women consider breast augmentation surgery. Most women are looking to restore breast volume from the effects of pregnancy, weight loss, aging, or simply genetics. Regardless of the reason, breast augmentation should be something you choose for yourself and not to fulfill someone else’s desires or ideal image. During your consultation, you and your breast surgeon will decide on the details of breast augmentation, including which implant size, type, and placement location is the most ideal, as well as where the incisions should be made.
Dr. Rowin or Dr. Kalus will thoroughly review the benefits and potential risks of complications during breast augmentation surgery with you before any treatment plan is developed. It is also at this point where combination procedures (such as a simultaneous breast lift, or other “Mommy Makeover” procedures, such as tummy tuck, injectables, etc.) may be suggested to maximize your anticipated results. Your surgeon will address all of your questions and concerns to ensure that you make an informed decision that is right for you.
In summary, there is no substitute for a consultation, wherein your plastic surgeon listens to your concerns, takes a detailed medical history, and carefully examines you. Afterwards, he or she will review all of your options with you. The more informed you are before and after your consultation, the greater the likelihood you will end up totally satisfied with your decision and final result.

“Thank you so much for doing such a wonderful job on my breast augmentation. This is something that I thought about doing for a long time and I’m glad I finally did it!*”

*Individual Results May Vary

How is Breast Augmentation Performed?

Dr. Rowin and Dr. Kalus perform this breast surgery as an outpatient procedure utilizing a light general anesthesia, from which you will recover quickly and easily. There are several possible incisions that can be used to place your implant, with the most common incision made along the breast fold within the inframammary crease (breast crease). Your breast surgeon will help you determine the most beneficial choices according to the results you desire. Drs. Rowin and Kalus aim to make your incisions as discreet and inconspicuous as possible for a natural-looking outcome. A standard breast augmentation typically takes one hour or less to complete.

What is Breast Augmentation Recovery Like?

You will awaken from your surgery wearing a comfortable surgical bra, which will be provided. Minimal to moderate swelling and/or bruising may be present initially, but these symptoms should resolve with time. Any discomfort experienced is generally described as mild and can usually be controlled easily with pain medication. Most patients feel 75% recovered within 7-10 days, and 95% recovered within 4 weeks, at which time all restrictions on activities are lifted and one can resume unlimited sports or exercise. We ask our patients to wear their bra for the first four weeks—day and night—except when showering. Women should also avoid strenuous activity during this time period.

The majority of individuals feel well enough to return to school, office jobs, and non-strenuous daily activities, including driving, after about one week. That said, our plastic surgeons advise patients to avoid heavy lifting, vigorous exercise or strenuous physical activity of any kind for a minimum of four weeks in order to give the breasts ample time to heal as well as reduce the risk of implant malposition, extended swelling, and/or bleeding.

Most swelling should subside within four to six weeks, at which point a near final appearance of the breasts is often apparent. With proper care, the scar should fade over time, though it may take up to a year—if not longer—to fully mature and lose its pink color. This is typically resolved faster when the scar is massaged, which you will be clearly instructed on by Dr. Rowin, Dr. Kalus, or their nurses.

Will My Breast Augmentation Results Appear Natural?

There are several elements that factor into achieving natural-looking breast augmentation results. Three key components include choosing the right plastic surgeon, selecting the proper breast implants, and placing the implants in the ideal position based on a patient’s particular needs. For a more detailed explanation as to how each of these influences the final results of the procedure, check out our blog post on the best way to ensure a natural-looking breast augmentation.

How Much Does a Breast Augmentation Cost?

Statistics released in 2017 by the American Society for Aesthetic Plastic Surgery (ASAPS) reveal that the average surgical fee for breast augmentation is approximately $3,500, excluding fees for anesthesia, the surgical facility, and the cost of the breast implants themselves. The ultimate price is influenced by your geographic location and the expertise of your plastic surgeon, as well as the details of your treatment plan, including:

  • The type of implants utilized
  • The surgical technique used
  • Whether a breast lift was performed in conjunction with breast augmentation
  • The extent of concerns addressed
  • Whether the procedure was a breast augmentation revision

After your consultation, our office will provide you with a personalized quote based on your unique needs. Our practice accepts all major payment methods and works with several reputable healthcare lending companies that can allow patients the opportunity to pay for their treatment over time. Through one of them, CareCredit®, qualified applicants can make the price of breast augmentation more manageable by selecting the payment plan best suited to their budgetary needs. Many options include low- to no-interest rates and affordable monthly installments. Please contact our practice to learn more about the cost of breast augmentation.

How Long Do Breast Implants Last?

Long-established breast implant options like saline and silicone generally last 10 to 15 years before patients consider replacing or upgrading them. However, newer choices—such as cohesive gel “gummy bear” implants—are thought to remain in good condition for much longer than more traditional implant types. Most implants do not require replacement unless a complication occurs, such as rupture, rippling, or capsular contracture (scar tissue formation).

Will I Have Breast Augmentation Scars?

Scars from any type of surgery are inevitable, but Dr. Rowin and Dr. Kalus work to place incisions in the least visible locations possible. In many cases, scars are camouflaged within the natural lines and contours of the breast. The best example of this concealment is the peri-areolar incision, which blends into the change in pigmentation between the skin and the areola. Incisions made under the breast fold also hide well in their location within the breast crease. Our plastic surgeons will fully inform you of how visible your breast augmentation scars are likely to be, as well as what steps can be taken to help scars fade as the years go by.

Can I Still Breastfeed with Implants?

Breast implants are placed under the breast—not in the breast. Therefore, breast augmentation surgery should not impact your ability to breastfeed. That said, approximately one out of five women do not have luck successfully breastfeeding their baby (even if they never had surgery on their breasts), but this has no relation to breast augmentation.

Additional Breast Augmentation FAQs

  • Is breast augmentation safe?

    Breast augmentation is considered safe when using FDA-approved breast implants. The only way for breast implants to be approved is by passing extensive FDA testing. Some people may have heard about the 1992 FDA ban on silicone gel implants. This occurred because manufacturers were not providing the detailed information required to prove the safety and effectiveness of their silicone implants. After many in-depth clinical studies on silicone implants, the FDA lifted the ban in 2006. Since then, silicone breast implants have been deemed safe to use for breast reconstruction and breast augmentation.

    Our plastic surgeons are dedicated to providing the safest and best care possible for all our patients to minimize any risks that may be associated with breast augmentation. If you have any questions or concerns about the safety of breast augmentation, please do not hesitate to contact our office. Dr. Rowin and Dr. Kalus would be happy to provide you with more information.

  • What is the best age for a breast augmentation?

    There is not an exact age that is considered “best” for breast augmentation—everything is dependent upon the unique needs and goals of the individual. In fact, Dr. Rowin and Dr. Kalus have performed breast augmentation for patients ranging from their late teens to their late 50s and beyond. More important than age is a patient’s overall wellness and expectations for results that can realistically be achieved. It is obviously very different for a 23 year old who is small-breasted and fairly flat-chested but has never been pregnant, versus a 35 year old mother who may have nursed two or three children and feels that her pre-pregnancy C-cup is now barely a droopy A- or small B-cup.
  • How do I choose the best breast augmentation surgeon for me?

    Research is important when finding the best breast augmentation surgeon for you. Here are a few factors to consider when making your decision:

    • Surgeon’s education, training, and credentials. Picking a board-certified plastic surgeon can ensure that your doctor has gone through an extensive amount of training and testing requirements to perform complex cosmetic procedures, like breast augmentation.
    • Online reviews. By reading patient reviews, you can gain insight on the experiences of previous patients. You can discover how they felt about their cosmetic treatment and what the positive/negative aspects were.
    • Before-and-after photos. Looking at before-and-after photos can give you a more visual and realistic example of what can be achieved by your surgeon.

    We also highly recommend scheduling an in-person consultation. During the appointment, you can determine if you are comfortable with your potential plastic surgeon and their team. This is also a great opportunity for you to ask any questions that you still have about the procedure. The right plastic surgeon should make you feel comfortable and confident under their care.

  • Will breast augmentation affect future mammograms?

    Sometimes breast augmentation can affect future mammograms. We often tell patients to make sure that whoever is performing the mammogram knows that they have breast implants. This allows the radiologist to use the proper techniques to get a more accurate screening of the breasts. If needed, the radiologist may choose to do an ultrasound or MRI instead to get a more accurate and comprehensive scan of the breasts.
  • Where should I place my breast implants?

    A breast implant can be placed either above or below the pectoral (chest) muscle depending on your aesthetic goals for the outcome, the amount of implant coverage your breast skin can provide, and the size of your implant. Insertion over the muscle generally allows a relatively faster recovery process compared to an under-the-muscle approach, although patients should have adequate skin quality to provide coverage for the breast implant. The advantages of placement under the muscle include better support for the implant and a reduced risk of rippling, which occurs when the edges of the implant are detectable through the breast skin. Dr. Rowin and Dr. Kalus will evaluate your anatomic indicators and suggest the best implant location for your needs.
  • Is breast augmentation painful?

    Our plastic surgeons try to make the surgery experience as pain-free as possible, but some patients do experience discomfort after breast augmentation. It is usually minimal and can be easily managed by taking over-the-counter pain medications, such as Advil® or TYLENOL®. Our team does our best to help minimize any discomfort by giving detailed post-operative instructions that can help the healing process go by more quickly and smoothly.
  • How can I reduce swelling after breast augmentation?

    Swelling is a normal response to breast augmentation and usually subsides four to six weeks after surgery. To facilitate in the healing process and reduce swelling, we often tell our patients to do the following:

    • Use cold compresses and ice packs (do not put any icy directly on an incision site or nipples)
    • Sit and sleep in an upright position as much as possible
    • Wear the surgical bra that your plastic surgeon gives you
    • Take light walks to improve blood circulation
    • Drink plenty of water
    • Have a healthy and nutritious diet
    • Avoid reaching or stretching your arms above your head before the incisions are fully healed
    • Don’t lift anything heavy before the incisions are fully healed
  • What type of bra should I wear after breast augmentation?

    Patients are instructed to wear the surgical bra provided by their surgeon after the procedure, or a comparable sports bra without underwires. This post-breast augmentation bra should be worn for approximately four weeks to help facilitate the healing process and support the new breast contours.
  • What should I avoid doing after breast augmentation?

    After surgery, you should avoid lifting your arms above the head, as well as carrying objects over approximately five pounds. While light walking around the house is encouraged to prevent blood clots, you shouldn’t exercise or engage in strenuous activity until at least four weeks after the procedure.
  • How do I sleep after breast augmentation?

    To ensure an optimal healing process and the best possible results, you will be instructed to sleep on your back for a few weeks after surgery. Sleeping on the sides or the stomach should be avoided.

Anyone interested in breast augmentation is welcome to contact our office to schedule a consultation with one of our doctors. Please email or call us today.