Breast Augmentation

Breast Augmentation in Seattle, WA | PHASE Plastic Surgery

Real Patient Results

Proportionate, natural-looking breasts can complement your figure and boost your self-confidence. If you are unhappy with the lack of fullness, asymmetry, or overall appearance of your breasts due to changes associated with pregnancy or weight loss, a breast augmentation may be the ideal solution to achieving the aesthetic you desire. 

 

At PHASE Plastic Surgery in Seattle, WA, Dr. Richard A. Baxter is a nationally recognized plastic surgeon with expert knowledge and experience performing breast augmentations at his fully accredited and private surgical facility. His aesthetic insights and technical proficiencies allow him to create youthful, full breasts that elevate his patient’s self-confidence for years to come. World-class plastic surgeon Dr. Donald Brown is board certified by the American Board of Otolaryngology and the American Board of Plastic Surgery.  His goal with all surgery is to achieve a natural result and avoid the excessively over-operated look.

 

Continue reading to learn about breast augmentation in Seattle, WA, or complete our online form to schedule a consultation. PHASE Plastic Surgery is located in Northern Seattle, just outside of the hustle of the city. We also welcome patients visiting from out of town and neighboring cities.

What Is Breast Augmentation?

Also referred to as augmentation mammoplasty, breast augmentation is a surgical procedure involving silicone or saline breast implants being inserted either under the breast tissue or the chest muscle to enhance the size, shape, and contour of the breasts.

 

The overall goal of breast augmentation is to improve the appearance of the breast by enhancing its size to create balance and proportion to your natural figure. The procedure is ideal for women who have lost the volume and shape of their breasts during pregnancy, breastfeeding, weight loss, or aging. Each breast augmentation is uniquely created for each individual patient’s needs and desires. Dr. Baxter and Dr. Brown work with their patients to curate a treatment plan that addresses their specific goals and concerns while prioritizing their lifestyle.

Our Approach to Breast Augmentation Surgery

We use one of two approaches for breast augmentation. Click here to see an example of a Subfascial Breast Augmentation. 

In the past, breast augmentation was thought of as positioning the implants either over or under the pectoral muscles. However, subfascial placement offers patients a unique alternative for natural breast augmentation results in some patients. Initially developed for highly active women looking to enhance their breast size without risking distortion from muscle activity or hindering their movement, this method has become popular for women looking to achieve more subtle breast enhancement results.

Subfascial augmentation is a variation of sub-glandular placement by placing the implant in front of the muscle but right below the fascia—a thin but hardy tissue found on nearly every muscle in your body. Subfascial breast augmentation offers patients natural-looking results without the issues of submuscular placement, such as animation deformity.

Split Muscle Breast Augmentation

Dr. Baxter’s split muscle technique is unique because it doesn’t follow the traditional submuscular implant procedure called dual plane, which partially detaches the pectoral muscle. Instead, the split muscle technique involves splitting the pectoral muscle and avoids detaching it. The upper subpectoral pocket covers the top part of the implant, leaving the lower part of the muscle behind it. The lower pocket is subfascial, with the implant in front of the muscle. This enables the implant to be covered by muscle where it is most important for a natural look while preventing animation deformity and sacrificing muscle function.

Natural Beauty For Every Phase in Life

Types of Breast Implants

Patients have a variety of breast implants to choose from when considering their breast augmentation surgery. The two main types of breast implants include silicone and saline. During the surgery, saline implants are filled with a sterile saltwater solution, whereas silicone breast implants come pre-filled with a cohesive gel. Within these categories, there are several size and shape variations to choose from, each with its own unique characteristics and benefits.

Serene Saline Implants: The New Ideal Breast Implant

Saline breast implants are available in a round shape of varying profiles and can be filled to specific volumes according to the desires and needs of the patient. The Serene Saline Breast Implant (previously called The Ideal Breast Implant) is uniquely engineered to feel more natural compared to previous designs. The fill volume of Serene Saline Implants can be varied, which makes them especially useful for the correction of minor asymmetry of breast size as a different volume may be applied on each side.

Silicone Breast Implants

Silicone breast implants are best known for their natural feel and appearance. Patients can choose from a variety of different shapes and sizes. They come pre-filled with a semi-solid gel of varying degrees of firmness. The firmest gel is called cohesive, though all gels used have cohesivity.

 

During your consultation, our surgeons will discuss your implant type options and help you determine the best type for your lifestyle and desired outcome.

Breast Incision Types​

There are three common incision locations used for breast augmentation, including periareolar, inframammary, and transaxillary.

Periareolar Incision

The periareolar incision is placed around the outer edge of the areola, the darker skin surrounding the nipple. Once the incision has been made, a pocket is created under the breast or underneath the muscle. The implant is gently placed into the pocket, usually with a Keller funnel. Because the border of the areola is transitioning from darker to lighter skin, any scarring is generally camouflaged. However, a periareolar incision may be associated with a slightly higher chance of capsular contracture.

Inframammary Incision

The inframammary incision is a short incision made in the crease at the bottom edge of the breast. The scar from an inframammary incision is thin and typically well-hidden. In addition to effectively hiding the scar, this type of incision can allow our surgeons to place larger implants and allows for subfascial, subglandular, or subpectoral (submuscular) implant placement.

Transaxillary Incision

The transaxillary incision allows the implant to be placed without scarring on the breast. However, Dr. Baxter and Dr. Brown believe this method doesn’t allow for as much precision in placement, so they do not recommend it.

Meet Our Board-Certified Plastic Surgeons

Discover personalized and transformative aesthetics with our expert plastic surgeons, who combine artistry and scientific aptitude to make a difference. PHASE Plastic Surgery and Longevity Institute offers a personalized and collaborative approach, state-of-the-art care, and an on-site, accredited ambulatory surgery facility.  Schedule a consultation today and embark on a journey towards natural beauty and personal enhancement!

What to Expect from Your PHASE Plastic Surgery Breast Augmentation Consultation?

During your personalized consultation, our surgeons will discuss the details of your individualized procedure and decide between the different options of breast implant types and incision locations. Our surgeons will provide you with comprehensive information regarding your procedural details and may use VECTRA 3-D imaging to show the exciting possibilities of your simulated aesthetic procedure.

 

To help you feel more comfortable, you will spend time with the doctor and their clinical staff, who will be present and likely involved on the day of your surgery. Building a relationship helps develop trust and a level of comfort that ensures continuity and ideal personalized care. 

 

At PHASE Plastic Surgery, you are not just a patient but an active participant and team member. Your opinions, questions, and concerns will be addressed with professional care and intent as we walk beside you on your journey to feeling your best at every phase of your life.

What to Expect from Breast Augmentation Recovery?

We prioritize preparing our patients for a smooth and comfortable experience during their surgery and recovery with a program called ERAS (Enhanced Recovery After Surgery), which has been proven to reduce stress, minimize post-operative discomfort, and make easy recovery from anesthesia.


After breast augmentation, patients are advised to avoid arduous activities and heavy lifting for several weeks following their procedure to allow the breasts to heal properly and avoid shifting the implants. It’s essential to follow your surgeon’s post-operative instructions to ensure a successful recovery.


Patients are generally safe to drive after a week, and full exercise can be resumed within six weeks. Patients will notice an immediate change in the shape and size of their breasts, but it will require some time for the breasts to settle into the final position. Our team will be readily available to answer any questions or concerns that may arise during the recovery process.

Why Choose PHASE Plastic Surgery for Your Breast Augmentation?

PHASE Plastic Surgery is at the forefront of new technology and techniques. We have extensive experience with the internal bra when needed for stable breast augmentation results and Exparel’s long-acting local anesthetic to help keep our patients comfortable during the first few days of recovery.


We focus on our patient’s natural beauty, transforming their features in ways that better express their individuality and complement their shape. Our personalized approach and care set us apart as we explore every option and help you decide on the best course of action in an environment that feels nurturing, respectful, and professional.


As an art major with a science aptitude, Dr. Baxter approaches every breast augmentation procedure with a keen artistic eye. From studying and drawing figures, he understands how to create graceful curves, cohesive features, and beautiful results. Dr. Baxter is also a nationally recognized plastic surgeon and an expert in breast augmentation and breast revision surgery. He has been voted “Western Washington’s Favorite Plastic Surgeon” by his patients and peers and was elected to be listed in the “Guide to America’s Top Physicians.”


To learn more about breast augmentation at PHASE Plastic Surgery, simply complete our consultation form or call us at (425) 776-0880.

Breast Augmentation FAQs

There is probably no product which has undergone more thorough scrutiny than breast implants. Because of allegations of health concerns, the safety question was reviewed in detail by the Institute of Medicine, which considered all available scientific data in addition to testimony from breast implant patients. It is interesting to note that, while silicone breast implants were restricted by the FDA from 1991 through 2006, silicone was still approved for injection directly into the eye for treatment of retinal detachment. It seems to me that if it is safe enough to inject into your eye then it might be OK for a breast implant.

Could it be that natural herbal supplements are dangerous while silicone is safe? Several products have appeared over the years claiming to enlarge breasts using “safe, all natural” herbal supplements. Yet despite the marketing claims, no clinical studies have ever been published to verify either the safety or effectiveness of these supplements. An article published in the medical journal Obstetrics & Gynecology raised serious questions about both aspects. Since the intended effect of these products is stimulation of the breast tissue in a manner similar to estrogen, there is a real possibility that the risk of breast cancer could be increased. Only large scale, long-term studies could answer this question.

There is a lot of confusion about the potential benefits of “gummy bear” implants, also known as cohesive implants, but most correctly called “form-stable” silicone implants (Allergan Style 410, Mentor CPG, and Sientra). These have been in use around the world for several years but only became available in the U.S. in 2012-2013. In order to understand the role of shaped implants, we need a little history: a while back, implants with a “teardrop” profile were introduced because that was believed to create a more natural shape. However, it was later shown that the round implants actually had the exact same profile in the upright position. Round implants, on the other hand, “behave” more like a natural breast and so become the most popular choice.

But there remained a concern about silicone gel leakage; what happens when the implant ruptures? The answer is basically nothing. That is because gel is a semi-solid, not a liquid. In scientific words, it is cohesive. The newer implants were called “gummy bear” implants, used that term to emphasize that the silicone is highly cohesive, meaning that you could slice into it like gelatin and it holds its form. (Hence the correct term “form-stable.”) But the softer gel in round implants is also cohesive, just softer, so it may very well continue to be the more natural-feeling implant. And the form-stable implants have a further disadvantage of requiring a larger incision for insertion, so there is a longer scar.

But because form-stable implants are shaped, not round, they provide an option where the foundation of the breast aren’t round. They provide a choice where the round implants may just not fit the size and projection that the patient wants. Bottom line is for a more natural result, you need to take into account your goals as well as the limitations of your existing anatomy, not make a choice based only on the features of the implant.

There are several compelling reasons to place the implants under the pectoral muscle, which is behind the breast tissue: lower risk of capsular contracture, more thorough and easier mammograms, a more natural look for many patients, less visible rippling of the implants, and less sagging of the breast over time. The downside is a high percentage of distortion of the breast with muscle flexion, called animation deformity. Using the traditional technique for submuscular placement of (dual plane), this occurs to some degree on more than 3 out of 4 cases. In order to achieve the benefits of going under the muscle without the common problems, I developed the split muscle technique.

Basically, the idea is to use the pectoral muscle to cover the upper portion of the implant, where it is most important. The difference between this and the dual-plane subpectoral method is that the split muscle technique preserves the normal attachments and function of the muscle by leaving the lower portion behind the implant. The reason for this is that the dual-plane method detaches the muscle from its attachment to the rib cage and this free edge of muscle then heals onto the scar capsule in front of the implant. When the muscle is contracted, it pulls on the capsule, causing animation deformity and often double bubble.

The subfascial (or subglandular) technique generally eliminates this, but sometimes at the expense of inadequate coverage of the upper portion of the implant. A variation of the subfascial technique called the split muscle method is often a good solution, where coverage of the upper portion of the implant is needed.

When the FDA approved silicone breast implants in 2006, they deemed them to be safe, but cautioned that they would need to be replaced every 10 years. This seemingly definitive statement is in fact misleading. Breast implants sold in the U.S. in fact have a lifetime warranty against leakage/rupture, and it seems self-evident that the manufacturers are not planning on replacing every implant for free within 10 years. The FDA points to a high re-operation rate (up to 40% over 10 years after implantation), but that is not the same as saying implants have to be replaced. Most of these re-operations are for conditions not requiring implant replacement or for simple size change request. In fact, we can expect most implants to last quite a bit longer than 10 years.

High profile, round implants have a smaller diameter but more projection compared to the standard implants. My experience is that when the implant diameter matches the natural base diameter of the breast, the result is more natural appearing and there is less rippling. With the availability of various implant profiles – high. Moderate, low – we are now able to match the diameter with a choice of different sizes.

A Keller funnel is a device that enables a breast implant to be placed with a “no touch” technique. It looks like a pastry funnel and minimizes any micro-contamination that can lead to problems such as capsular contracture (CC). We participated in a multi-center study a few years ago, demonstrating a reduction in CC to around 1% after using the funnel routinely. A Keller funnel also makes it possible in some cases to use a shorter incision. Learn more here.

Three proportions are considered to determine the right one for you. These are projection, volume, and diameter. The implant’s diameter, or width, must match the breast’s base diameter. Once that is decided on, the other two are linked; in other words, you increase implant volume (size) by using a more projected implant or decrease it by using a flatter implant. Often we use VECTRA 3D imaging to simulate results with different sizes. Learn more about VECTRA 3D imaging.

Placing implants beneath the pectoral muscle provides coverage that can create a more natural look but also has drawbacks. There are 4 options: subglandular or under the breast in front of the muscle; subfascial, which is in front of the muscle but with the thin fascia layer adding support; under the muscle with dual plane, which is the most common; and under the muscle with the split muscle technique, which Dr. Baxter pioneered and is our preferred method. Dual plane can cause a problem known as animation deformity, a distortion of the breast when using the pectoral muscle because the muscle is partially detached. This is avoided by using the split muscle method, which still covers the upper and inner parts of the implant but without detaching the muscle. Athletic women may do best with the subfascial method or the split muscle, which preserve muscle function and strength.

 

Related Blogs:

An internal bra is considered when the breast, implant, or both need extra support. Primary augmentation would be done for large implants in a patient with loose, sagging breasts. 

While there are different concepts of ideal cleavage, most agree that implants too far apart are unnatural and implants too close together are not everyone’s cup of tea. For implants under the muscle, the attachment of the muscle along the sides of the breast bone (sternum) limits how close the implants can be. Subfascial placement may allow for closer and higher placement. Another important consideration is nipple position; if they are naturally more lateral, then implants close together may leave the nipples pointing to the side. Implant diameter is also important. Learn More

Breast implants restore volume and a breast lift restores shape and nipple position. After breastfeeding or weight loss, breasts may have a deflated appearance that looks like sagging but can be corrected by adding back the lost volume with implants. Breasts that have sagged will need a lift (mastopexy.) A rule of thumb is that if the nipple position is lower than the inframammary fold or bottom edge of the breast, then a lift is the way to go.

Most patients can resume exercising after a week and resume most activities before that. 

Several things contribute to how natural a breast implant feels: size, profile, placement, and the firmness of the gel or saline. Very large and high-profile implants will usually look and feel less natural than a moderate profile in proportionate size. More breast tissue to conceal the implant and under the muscle for more coverage can help. There are different options for gel firmness, also known as cohesivity. More cohesive silicone gel implants are more resistant to rippling but may be too firm for some patients. 

It is not common to lose nipple sensation after breast augmentation, but the risk is higher with larger implants.

No, you will not have drains. We use buried dissolvable sutures, so there are no external stitches to remove.

Overall, complications are uncommon. In the early days after surgery, there is the potential for bleeding, which could require a return to the operating room, though this is rare. The long-term risks of concern are capsular contracture, in which the scar capsule squeezes and distorts the implant, causing it to feel firm and implant rupture. Our rate of capsular contracture is around 1%, far lower than published statistics. Implant rupture is typically a silent event and could go unknown for a long time. Therefore, they should be evaluated every few years, which we do here in the office with ultrasound. Learn More

Implant size is determined by both the patient’s desires and anatomical constraints such as breast diameter. After doing measurements, we will recommend a range of sizes and profiles. You can try sample sizers in a bra and/or VECTRA 3D simulations. We do this at the consultation and then confirm at the pre-op visit, so there is no pressure to make a decision too quickly. Learn More

It is impossible to place implants without a scar somewhere, but we make it as short and inconspicuous as possible.

Although all breast implants have a lifetime warranty for rupture, it can happen. When it does, it is usually a silent event because the silicone gel is a semi-solid material, so it doesn’t go anywhere. (Saline implants, on the other hand, will show obvious signs of deflation when that occurs.) We recommend having the implants screened with ultrasound every few years, which we are happy to do here in the office.

You should not avoid having mammograms because of implants. Damage to the implants is very unlikely to occur because of mammography.

We do usually recommend wearing a bra after having breast augmentation. This helps support the implants while the scar capsule forms, and we believe that it helps prevent the implants from sagging out of position. 

A smooth experience with anesthesia means selecting the type that is both safest and the most comfortable. Most often, this is general anesthesia. Learn More

You should have someone with you for 24 hours after any surgical procedure.

FDA guidelines require us to tell you that breast implants are not considered lifetime devices. In the past, implants needed to be replaced every ten years or so, but now the manufacturing standards and implant designs have improved. All implants now have a lifetime warranty for rupture. The way I see it, it is unlikely that the implant companies are operating under a business model where they replace them for free every 10 years, or even that all of them will need to be replaced sometime during a patient’s life. 

There is no substitute for long experience with breast augmentation, where the surgeon can see how patients do over several years. Also, because Dr. Baxter has earned a national reputation for correcting difficult problems such as animation deformity, he has a better understanding of why those problems occur and how to avoid them. His background as a formally trained artist makes Dr. Baxter and the PHASE Plastic Surgery team uniquely qualified.

Our technology & science meets your beauty.

Our expertise, coupled with science-based technologies and the latest in advanced techniques at PHASE Plastic Surgery, is how we continue to be the best surgical and non-surgical facility Seattle has to offer. We’re honored and excited to join you on your aesthetic journey toward looking and feeling your best. To get started, complete our consultation form, or call us at (425) 776-0880.

=