Breast Expectations

Breast augmentation still reigns as one of the most popular cosmetic procedures around the world according to the American Society of Plastic Surgeons. Women chose to have this procedure for many different reasons, having larger breasts is just one of them.

The most common goals of augmentation are to restore breast fullness, to create symmetry due to uneven breasts and look better in clothing and enhance self confidence.

At New Image Plastic Surgery, Board Certified Female Plastic Surgeon Dr. Roberta Gartside chimes in to help answer some of the most asked questions in her practice with regards to breast augmentation.

Silicone vs. Saline vs. IDEAL implant?
It’s not unusual to be confused about the type of implants to choose. For the most part one will probably find that the majority of plastic surgeons recommend silicone gel implants more often. The main reason for recommending silicone is that they feel more natural followed by a slightly reduced risk of seeing rippling through the skin.

Saline and IDEAL implants are both filled with sterile salt water and offer adjustability. For women who have asymmetry in the volume of one breast versus the other, saline implants offer the ability to do more fine tuning and adjustment to the size. Additionally, since these implants are placed prior to being filled they can be inserted using smaller incisions.

When comparing the standard saline implant to the IDEAL saline implant, the distinct difference is that the IDEAL implant has an internal baffle system which reduces the risk of rippling and is more similar to the silicone implants in that they feel more natural than regular saline implants.

Of course the biggest difference between saline and silicone is that if saline ruptures you will notice it immediately while silicone ruptures are more difficult to detect and require imaging such as an MRI. Both have very low rupture rates though.

Implant placement? (Under vs. over the muscle)
I recommend implant placement based on my patient’s physical examination and desired breast size. In general, the position under the muscle is favored as studies have shown a lower risk or capsular contracture, although the difference is small. Under breast tissue may be recommended in extremely physically activity women to lower the risk of any muscle distortion as well as in women with borderline sagging or ptotic breast who choose not to have a breast lift.

Breast Incision site and why?
I favor the crease under the breast (inframammary fold) as it tends to be well hidden and allows access for any size implant whether it be silicone or saline, and may have a slightly lower risk of capsular contracture because there is less contact with breast tissue during insertion.

How long do I need to take off of work?
Typically the recovery from breast augmentation surgery is quite quick in that within a week a majority of women are able to drive and return to work, depending on the nature of the job. Strenuous activities will be restricted for at least a month.

Do they need to be changed every 10 years?
The general rule with breast implants is if they are not broken don’t fix them. There seems to be a myth that implants need to be changed every 10 years. I think this impression comes from the warranties associated with breast implants which are for 10 years.

Reasons to have your implants exchanged:
• If they rupture or leak.
• Over time as the breast changes, women may find that they no longer desire implants or would like to change the implant size.
• Due to complications such as capsule contracture.
But in most cases it’s important to remember that they’re not intended to last a lifetime with no upkeep.

If you would like to schedule a complimentary consultation with Dr. Roberta Gartside to discuss breast augmentation options, please call 703-742-8004 or visit

Roberta Gartside
Roberta L. Gartside, MD, FACS is certified by the American Board of Plastic Surgery and with over 25 years in practice, Dr. Roberta Gartside is one of the most experienced and highly sought-after plastic surgeons in the area. In addition to offering patients a wide range of reconstructive and cosmetic surgery procedures, she also offers outpatient skincare treatments such as fillers, like Botox, and lasers, including the Gentle Waves Skin Fitness System™ - a breakthrough LED light treatment therapy that helps rejuvenate aging skin. While patients certainly appreciate Dr. Gartside’s vast experience and offerings, they also place great value in the time she and her gregarious staff take to explain each and every option available to them. Committed to upholding the utmost standards in her specialty, in addition to working on the medical staff at Fairfax Hospital, Fair Oaks Hospital and Reston Hospital Center, Dr. Gartside has served as Vice President of Membership and Communications for the American Society of Plastic Surgery and as a Board Representative of the National Accreditation Program for Breast Centers. She has also worked with Operation Smile and the Fairfax Skindeep Tattoo Removal Program in the past.