Breast Augmentation

Why choose Wake Plastic Surgery?

There are many great surgeons that perform breast augmentation surgery. Most of them are safe, effective, and adhere to the principles of sterile technique. What sets us apart is the emphasis on communication and results. Understanding your wishes is a key component to ending up with satisfying results. But there is so much more than just getting what you think you want. Dr. Stoeckel will make certain that you truly understand the risks and benefits of the many options associated with breast implant surgery and help you make the best possible choices. And while nobody wants to deal with complications with any surgery, they certainly can happen. We pride ourselves in being able to effectively correct breast implant complications and to do so in a reasonable and patient friendly manner. Finally, Wake Plastic Surgery completes a high volume of breast implant surgeries, which is important. The before and after photos speak volumes. Please review them to see what natural but enhanced results should look like.

Where is the scar?

Breast implants can be placed using one of several incision locations, but the breast crease incision has the most benefits. Many women are concerned about visible breast scars, but when placed properly, the breast crease incision is very difficult to see. The risk for capsular contracture and implant malposition are significantly lower with this approach and is by far the preferred incision for Dr. Stoeckel.

That being said, we have a wide variety of treatments at the MedSpa at Wake Plastic Surgery that can help reduce the appearance of scars. We offer BBL laser, ProFractional laser, and Virtue RF as treatments that can aid in improving the appearance of stubborn scarring. All of Dr. Stoeckel’s surgical patients are eligible for a complimentary consultation at our MedSpa to discuss these aesthetic options and more.

Where is the implant placed?

Our doctors prefer, in most instances, to place breast implants under the pectoralis major muscle. Implants placed under the muscle or in a “dual plane” position are less likely to have long term complications including capsular contracture, implant malposition, and bottoming out. While there are still many surgeons that routinely place implants “over the muscle”, Dr. Stoeckel strongly believes that the benefits to avoiding this position are too numerous to ignore in most cases.

Subglandular implants on the left. Implant exchange with pocket revision and change to a submuscular position on the right.

What are the different type of implants?

Saline vs. Silicone

For most patients, saline and silicone gel implants look very similar. The patient shown to the right above has saline implants and the patient on the right below has silicone gel implants. Both of them look very natural and attractive. Silicone gel implants tend to have a slightly more natural feel to them and are the most commonly used implants at Wake Plastic Surgery. They have a lower risk of rippling and are strongly recommended for patients that have very thin skin or very little native breast tissue. Many patients are concerned about the often mis-perceived safety profile of silicone implants. But with the significant amount of research and data available today, it is our belief that both implant types are safe and reliable. Choosing the right implant, however, is a personal decision and their really isn’t a right or wrong answer for each individual.

Round vs. Anatomic

Dr. Stoeckel uses almost exclusively round breast implants. They look the most natural in both the upright and lying position and do not have a risk of becoming “malrotated”. Anatomic or shaped implants have received much attention in the media and with many plastic surgeons recently. The thought was that they would produce a more natural appearance. But, when round implants are placed under the muscle, they take on a shape that is almost identical to a shaped implant. There have been published studies that prove that most surgeons and patients can not tell the difference between the two types when looking at photographs of breast augmentation patients.

Smooth vs. Textured

The most commonly used implant at Wake Plastic Surgery is a smooth round implant, which follows the trend of most plastic surgeons in the United States. The smooth implant is quite forgiving and tends to move naturally with the overlying breast tissue for most patients. The newest generation of textured and shaped implants are gaining popularity with many plastic surgeons, but their risks and benefits are still being studied. The textured silicone gel implants are thought to lower the risk of capsular contracture (mostly when placed over the muscle) and have slightly higher cohesion properties. These implants are less likely to “move” on the chest wall, which could lower the risk of malposition over time. They seem to be slightly firmer than the smooth implants. Both implant types have their merits and our doctors will help you make the best choice.

How do I choose the right size?

Choosing the right size implant can be very challenging for patients. Most women tend to want to use implants that are slightly larger than what is probably ideal for their body frame and skin envelope. This can lead to a bit more of a “fake” result and can also increase the risks of future complications. Our doctors will take several measurements to help identify the proper range of implants that would be appropriate for your body frame. WPS also has the luxury of using 3D imaging with the Vectra imaging system. While not perfect, it can help many patients at least get an idea of what they may look like after surgery. In the end, we will clearly communicate the risks and benefits of different sized implants, but understand that the final decision is still yours to make.

What can happen to nipple sensation?

Very few patients have permanent issues with nipple sensation after breast augmentation, but quite a few have short-term issues that resolve during the first several months of recovery. Most patients will complain of hypersensitivity that results from nerve stretching. Very few will have a decrease or loss of sensation. The nerves that affect nipple sensation are not at high risk for injury at the site of the skin incision, but rather on the chest wall when the outside of the pocket is being developed. For this reason, Dr. Stoeckel is quite gentle with the lateral pocket dissection to minimize this potential complication.

What happens with breastfeeding after breast implant surgery?

The vast majority of patients are able to breastfeed effectively after breast augmentation. The changes that happen to the breast with pregnancy and breastfeeding are quite variable from patient to patient. We have several patients that have had pregnancies after their surgery and the results of their surgery are largely unaffected. But this cannot be expected for all patients. Our advice is that if you are expecting a pregnancy in the coming year or so, it might be best to wait to have your breast procedure 6 months after you stop breastfeeding.

How long do implants last?

Breast implants do not come with an expiration date, but nor have they been engineered to be lifelong products. Most patients should expect their implants to last 15-20 years. They could last longer or they might have a problem sooner. It just is impossible to predict how long an implant will effectively perform for each individual patient.