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Breast Augmentation

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ANESTHESIA for breast augmentation

The most common type of anesthesia for breast augmentations is general anesthesia.

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Incision for Breast augmentation

Your surgeon will make incisions in predetermined locations, considering factors such as your anatomy, implant type, and desired outcome.

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Your surgeon will carefully close the incisions using sutures or surgical adhesive.

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure designed to increase the size and enhance the shape of the breasts.

It involves the use of breast implants or, in some cases, fat transfer techniques to achieve the desired results.


Breast augmentation surgery is a common procedure performed in the following manner:

Anesthesia: Before the surgery begins, anesthesia will be administered to ensure your comfort throughout the procedure. The most common type of anesthesia for breast augmentations is general anesthesia.

Incision placement: Your surgeon will make incisions in predetermined locations, considering factors such as your anatomy, implant type, and desired outcome. Common incision options include:

  • Inframammary incision: Made in the natural crease beneath the breast. This is the most common incision.
  • Periareolar incision: Made around the edge of the areola, where the darker skin meets the lighter breast skin. The periareolar incision may be chosen for certain conditions, such as the tuberous breast deformity.
  • Transaxillary incision: Made in the armpit, allowing for implant placement without direct incisions on the breasts. This is an uncommon incision because there is less control over final position of the implant.

Implant placement: There are two primary options for implant placement:

  • subglandular (above the chest muscle). A subglandular position may be chosen in a body builder, or very active patient. A downside of the subglandular position includes possible capsule contracture.
  • submuscular (beneath the chest muscle). The submuscular placement is the most commonly performed. The advantages of this include thicker coverage of the implant. A possible disadvantage includes animation deformity.

Incision closure: Once the implants are positioned correctly, your surgeon will carefully close the incisions using sutures or surgical adhesive. They will ensure proper alignment, tension, and symmetry for optimal healing and minimal scarring.

Dressings and support: After the incisions are closed, the surgical sites will be dressed in bandages to protect them and promote healing. Your surgeon will also apply a surgical bra or compression garment to provide support and minimize swelling.

Recovery and postoperative care: You will be monitored in a recovery area as you wake up from anesthesia. The medical staff will provide instructions on postoperative care, including pain management, activity restrictions, and follow-up appointments.


Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure designed to increase the size and enhance the shape of the breasts. It involves the use of breast implants or, in some cases, fat transfer techniques to achieve the desired results. At Bluemont Plastic Surgery, our goal is to deliver the best breast augmentation in Washington DC.

Breast augmentation offers several potential benefits for individuals who are dissatisfied with the size, shape, or appearance of their breasts:

Enhanced breast size and volume: Breast augmentation can increase breast size and volume, helping individuals achieve a more proportionate and balanced figure. It is particularly beneficial for women who feel that their breasts are disproportionately small in relation to their body shape.

Improved breast shape and symmetry: Breast augmentation can also enhance breast shape and improve symmetry. It can address issues such as naturally asymmetrical breasts or breasts that have become uneven due to factors like pregnancy, breastfeeding, or weight loss.

Boost in self-confidence and body image: Many individuals report an increase in self-confidence and improved body image after breast augmentation. Feeling more satisfied with the appearance of their breasts can positively impact self-esteem and self-perception, leading to increased confidence in various aspects of life.

Restored breast volume after pregnancy or weight loss: Pregnancy, breastfeeding, and significant weight loss can cause breasts to lose volume and appear deflated. Breast augmentation can restore lost volume and provide a fuller, more youthful appearance to the breasts.

Clothing and styling options: Some individuals may find that their clothing choices are limited or that certain styles do not fit properly due to smaller or asymmetrical breasts. Breast augmentation can expand clothing options and allow individuals to wear a wider range of styles with confidence.

Emotional and psychological well-being: Breast augmentation can have a positive impact on emotional well-being by alleviating feelings of self-consciousness, dissatisfaction, or insecurity related to breast size or shape. Many individuals experience a greater sense of happiness and satisfaction with their bodies after the procedure.


A good candidate for breast augmentation is typically an individual who is dissatisfied with the size, shape, or appearance of their breasts and desires to enhance their overall breast aesthetics. Some characteristics of a suitable candidate for breast augmentation are:

Dissatisfaction with breast size: Candidates often express a desire for larger breasts or a more proportionate breast size in relation to their body shape. They may feel that their breasts are too small and want to achieve a fuller and more balanced figure.

Concerns about breast shape and symmetry: Candidates may have concerns about the shape or symmetry of their breasts. This can include naturally asymmetrical breasts or breasts that have become uneven due to factors such as pregnancy, breastfeeding, or weight loss.

Realistic expectations: It is important for candidates to have realistic expectations about the outcomes of breast augmentation. They should understand that the procedure can enhance breast size and shape but does not lift the breast. A breast lift or mastopexy is a procedure that lifts the breasts and can be combined with a breast augmentation.

Good overall health: Candidates should generally be in good overall health to undergo breast augmentation surgery. Candidate should not smoke or refrain from smoking for four weeks before and after their breast augmentation. Candidates should not be lactating nor have nipple discharge. Depending on age, candidates should be current on their annual mammograms.

Stable emotional well-being: Breast augmentation is a personal decision that can have an impact on emotional well-being. Candidates should have a stable emotional state and a positive body image. It is important to understand that breast augmentation is not a solution for unresolved emotional or psychological issues. However, there is no reason why someone with depression or other mental health issues cannot undergo a breast augmentation. Like any other medical disease, a mental health issue should be stable and optimized before surgery. For example, diabetes is a risk factor for poor healing. A patient with diabetes could undergo a breast augmentation if their blood sugar is under control. Likewise, a patient with depression could undergo a breast augmentation if they are not experiencing episode and their depression is being monitored by a mental health professional.

Fully developed breasts: Candidates should have fully developed breasts before considering breast augmentation. Breast development typically completes by the age of 18. The Food and Drug Administration has approved silicone breast implants for patients 22 and older. Saline breast implants are approved for age 18 and older.

Realistic understanding of the procedure and recovery: Candidates should have a good understanding of the breast augmentation procedure, including the potential risks, the recovery process, and the need for follow-up care. This is accomplished though preoperative education during our office consult.


Before and after results of our procedures.

Before Image After Image


Here are some common questions people ask about breast augmentations:

Augment comes from the old French word “Augmenter” which means to make larger. Breast augmentation is a procedure where implants are placed under the breasts to increase their size.

Breast implants are used during breast augmentation. Breast implants are the objects placed under the breasts to increase their size. “Breast augmentation” is the name of the entire procedure.

In 2020, breast implants costs between 5 to 10 thousand dollars. The cost varied considerably based on the training of the surgeon (plastic surgeon = costs more, cosmetic surgeon = costs less), facility (certified operating room = costs more), and other factors such as the patient and complexity of the procedure.

The average cost of breast augmentation surgery was $3947 plus facility and anesthesia charges in 2019 according to the American Society of Plastic Surgeons. This cost does not include the total price, which will include the cost of the implants, anesthesia, operating room, and scar cream. During consultations, we provide our patients with custom quotes that explain the total price.

Nipples have smooth muscle which erect the nipples when a woman is feeling cold or stimulated. A breast augmentation does not affect these muscles. Sometimes sensation to the nipples can change after breast surgery. This risk is decreased by using an incision away from the areola, such as under the breast.

Yes – they are larger and fuller.
No – the skin is still the same.

Breast augmentation and breast lift patients are both comfortable enough to go home the same day of surgery. Surgeons will often use long-acting numbing medication to reduce discomfort for the first 48 hours. At that point, the need for narcotic pain medication is reduced. Most patients can return to light activities within a week.

Most surgeons recommend that patients wait 4-6 weeks before intimate activity with their augmented or lifted breasts. This gives the incisions time to heal.

What are the differences between saline and silicone breast implants?

Silicone and saline breast implants differ in terms of their composition, consistency, and potential advantages.

Composition: Silicone implants are filled with a cohesive silicone gel, which is a semi-solid substance that closely mimics the feel of natural breast tissue. Saline implants, on the other hand, are filled with sterile saline solution (medical saltwater) .

Consistency and feel: Silicone implants are known for their soft and natural feel, closely resembling the texture of natural breast tissue. They tend to provide a more natural appearance and a softer, more supple feel compared to saline implants. Saline implants, in comparison, are firmer and can sometimes feel less natural.

Rupture detection: Ruptures or leaks in implants can occur, although it is relatively rare. One advantage of silicone implants is that when a rupture occurs, the cohesive gel tends to stay within the implant shell or may have limited spread in the surrounding tissue. On the other hand, saline implants deflate visibly if a rupture occurs, making it easier to detect as the saline is absorbed by the body.

Incision size: Silicone implants come pre-filled, requiring a slightly larger incision for placement. Saline implants, on the other hand, can be inserted through a smaller incision as they are filled after placement. Most patients find the difference in the incision size to be minimal.

Shape and profiles: Both silicone and saline implants are available in a variety of shapes (round or anatomical) and profiles (projection). The choice of shape and profile will depend on factors such as the individual’s body shape, desired outcome, and surgeon’s recommendation.

Monitoring and FDA regulations: Silicone breast implants require regular monitoring to detect potential silent ruptures. The FDA recommends MRI screenings three years after the initial implantation and then every two years thereafter. Saline implants, which deflate if ruptured, do not require routine MRI screenings for rupture detection.

Fat transfer option: In addition to breast implants, some individuals may opt for a breast augmentation procedure using autologous fat transfer. This technique involves extracting fat from another area of the body through liposuction and then injecting it into the breasts to enhance their size and shape. This method is suitable for individuals seeking a more subtle increase in breast volume, such as one cup size.


Patients may shower the next day. Recovery time is approximately one week. A bra is worn for comfort and to help hold the dressings in position. It may be loosened or removed for bathing, beginning the day after surgery. For several weeks, patients should not wear any underwire bras to allow their breast implants to settle into place. Follow up appointments are at 7-10 days after surgery, 1 month and 3 months.

Why us?

With over 70 plastic surgeons in the area, patients choose Dr. Domanski because they trust him. We believe you will not find a more honest surgeon than Dr. Domanski.

“Be Yourself,
Everyone Else Is Taken.”

– Oscar Wilde



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