Breast Augmentation at Duggal Plastic Surgery

Breast augmentation refers to surgical enhancement of a woman’s breasts through the insertion of saline or silicone implants, or in some cases injection of your own fat. There are many options beyond just “what size” to consider when thinking about breast augmentation.

  • a woman who wants to increase the size of her breasts
  • a woman who wants to improve the shape of her breasts
  • a woman who has lost weight or lost volume in her breasts after pregnancy
  • a woman with asymmetry breasts

At Duggal Plastic Sugery, 3-D imaging with the Vectra Photography System allows a woman who is considering breast augmentation to see a realistic view of what they would look like after breast augmentation.

Both saline and silicone implants have a silicone shell, or outer coating, but are filled with different substances.

Saline implants are filled with sterile salt water. Many women find saline implants do not feel as natural as silicone, but have the advantage of obviously deflating if ruptured.

Silicone implants are filled with a thick sticky silicone gel. Many women find this to be more natural feeling. The silicone gel inside the implants is now more “cohesive”, or sticky, and stays together even if the implant shell ruptures. Silicone has been extensively studied by the FDA through multiple clinical trials and has shown to have no links to cancer, reproductive or connective tissue diseases.

Highly cohesive silicone gel implants, also known as “gummy bear” or “form stable” implants are made of a thicker and more cross-linked silicone gel. This enables them to maintain a more anatomic shape than traditional round gel implants. They were approved by the FDA in the United States in 2012 but have been used throughout much of the world since 1992. Gummy bear implants can provide a more natural look for women who prefer that.

At Duggal Plastic Surgery, pre-operative 3-D imaging with the Vectra photography system allows women to see the differences in their own breasts between traditional round implants and the newer more anatomically shaped form stable implants.

This refers to Dr. Duggal performing liposuction an area or areas of your body, including abdomen, thighs or flanks. The fat is collected and processed and then transferred, or re-injected, into your breasts. This is a less common method of breast augmentation and can be done alone for modest 1 or 1 ½ cup size increases in breast size, or combined with an implant to improve breast shape.

The two major choices for implant position are subglandular (above the pectoralis or chest muscle, and below the breast tissue) or subpectoral (behind the pectoralis muscle). Placing the implants below the pectoralis muscle has the advantage of less rippling on the top or middle area of your breast, and a lower chance of firm scar tissue forming around the implant that might distort the shape of your breast. The choice of where to place the implant ultimately depends on your own anatomy and individual situation, and is something to be discussed with Dr. Duggal during your consultation.

There are several options for placing the incision (scar) for breast augmentation including

  • inframammary fold incision in the crease below the breast
  • periareolar incision around the bottom of the nipple
  • more distant incision including in the armpit or bellybutton

The most common option is in the crease below the breasts, which has the advantage of a low chance of implant malposition (the implant being in the wrong position) and a lower chance of firm scar tissue forming around the implant. The decision of where to place the incision will ultimately depend on your own anatomy and individual situation, and is something to be discussed with Dr. Duggal during your consultation.

There are risks to every surgical procedure. Breast augmentation surgery is the second most frequently performed aesthetic surgery in the country last year,

With breast augmentation surgery, there is small chance of:

  • infection
  • malposition of the implant
  • change in sensation in the breast or of the nipple
  • fluid or blood around the implant
  • capsular contracture (firm scar tissue around the implant)
  • implant rupture

Breast implants are not designed to last forever. You will need to return to see Dr. Duggal for follow-up examinations, and may need to change the implants if they leak or rupture. You will need to continue with national recommendations for mammograms depending on your age, and you may need an MRI to further image your breast tissue or to evaluate your implants.

If your breasts have lost volume and the nipples are lower than you would like, there is a chance you would be a better candidate for a breast lift, or a breast lift with an implant.

When you arrive in the office, a medical history will be taken to find out about any medical problems or allergies you have and what medications you are on. If you are over 40, we would recommend a baseline mammogram within a year before scheduling any breast surgery.

During the consultation, Dr. Duggal will discuss with you your current breast size and what your desires for breast augmentation are. She will answer any questions you have about the procedure and the recovery. Dr. Duggal will then measure your breasts and chest wall to determine which range of implant shapes and sizes would be best for your anatomy. It is our goal at Duggal Plastic Surgery to pick an implant which fits your body and your natural breast tissue in order to not stretch the tissue too much and create long lasting problems with your skin and breast tissue. We will focus on achieving your immediate goals of breast enhancement while ensuring long lasting beautiful results.


After the examination, you will have your picture taken by the 3-D Vectra photography session. You and Dr. Duggal will then be able to sit and look at a three dimensional representation of yourself and your breasts, and you will be able to see how you would look with the range of types and sizes of implants appropriate for your body.

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From preoperative Vectra 3D imaging giving a woman a true picture of what she will look like after surgery to the new anatomically shaped breast implants, the results we can get after surgery are more beautiful and natural than ever.

-Claire Duggal, MD