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What Is a Breast Augmentation?

Breast augmentation (also referred to as breast enlargement, breast enhancement or augmentation mammoplasty) is the surgical procedure that is used to enlarge a woman’s breast size and improve its shape. It is the most popular cosmetic surgical procedure being done today by women and is associated with an extremely high satisfaction rate. Surgery involves the insertion of silicone or saline implants into a pocket created either directly behind the breast tissue or the pectoralis muscle of the chest wall. Breast implants consist of an outer envelope of silicone rubber that is filled with either silicone or saline.

The concept and procedure sound rather simple and straightforward but this is definitely not the case. In order to obtain the most ideal results, many variables need to be considered and decisions made prior to surgery. The goal of any breast augmentation procedure is to add volume and improve the shape of a woman’s breasts while keeping the tell-tale signs of surgery to an absolute minimum. To achieve this goal, the plastic surgeon must have an exceptional eye for aesthetics, an understanding of each individual’s tissue characteristics, an appreciation for the three dimensional effects of the implants on the tissues, consideration for the changes over time and superior surgical skills to implement these strategies. In addition, he/she must have the ability to understand and interpret the patient’s goals and needs and then translate that into outstanding results.

With these abilities and meticulous attention to all details and variables, Scottsdale plastic surgeon Dr. Steven H. Turkeltaub has consistently endeavored to ensure that the results he creates for his patients are exactly what they had desired. (See blog: Breast Augmentation Fail or When Not to Disclose One’s Assets to see an example of what does happen when surgical planning, precision and skill are not what they should be.)

I went to Dr. T. for a breast augmentation on recommendations of two of my friends who were very happy with their results. He listened to what I wanted, spent alot of time with me and gave me all the information that I needed to make my decision. I really liked him and his recommendations and decided to have him do my surgery. My breasts are perfect – exactly what I wanted! I am so happy now. I can definitely recommend him to other friends for their surgery.

Nikki Johnson

September 16, 2017


Are Breast Implants Only for Increasing Breast Size?

While breast implants are most commonly associated with achieving a larger breast size, this is by no means the sole enhancement and/or purpose they can provide. In many cases, implants can be an excellent option for improving the shape or symmetry of the breasts, restoring youthful volume following pregnancy or dramatic weight loss, addressing congenital issues (like Poland’s syndrome) or even reconstructing one (or both) breasts following mastectomy—with or without necessarily increasing one’s natural breast size appreciably.

Based on your unique needs and goals, Dr. Turkeltaub can help you select the most appropriate implant type, size and shape for the breast aesthetic you desire.

What Are My Breast Implant Options?

In today’s age of plastic surgery, breast implants come in numerous types, sizes, shapes, profiles and surface textures. At his practice, Dr. Turkeltaub offers round silicone gel implants with three tiers of silicone gel cohesiveness and saline implants, providing each patient with an immense number of choices that can yield precise customization and excellent results. In reality, effectively one hundred percent of patients select the silicone implants

Choosing the most appropriate implants for your breast enhancement procedure will depend on a variety of factors including your needs, preferences, anatomical indications, tissue characteristics and desired outcome. All of these considerations will be discussed in full detail during your consultation with Dr. Turkeltaub to ensure that the right implant size, type and shape is selected for your unique goals.

To learn more about implant options that are available, visit Dr. Turkeltaub’s page on breast implants.

*Dr. Turkeltaub does not offer or use the textured surfaced implants, either saline or silicone, for a few reasons including an extremely rare risk that has been associated with them.

How Is a Breast Augmentation Performed?

Breast enhancement is an outpatient procedure that is most often performed under general anesthesia. This approach is very safe and much more comfortable than a “twilight” or semi-awake type of anesthetic. It can be combined with many other cosmetic procedures, such as tummy tucks (as part of a “Mommy Makeover”) and liposuction, for a more extensive and cost effective improvement.

During surgery, the most appropriate implant for the patient will be selected based on the preoperative discussion of all the options and the patient’s goals. Dr. Turkeltaub uses a very precise, meticulous and gentle technique which helps to both minimize postoperative discomfort as well as the risk for less than ideal outcomes.

Incision Location

Breast augmentation patients can select to have their implants placed through incisions in one of three different locations. For a variety of reasons, the transumbilical, also known as the belly button technique, is not considered.

  1. Inframammary incision: This is the most common approach used for the placement of breast implants. It employs an incision near or in the crease at the lower part of the breast where it joins to the chest. This location allows for the most flexibility, both short and long term, better visualization and exposure for surgery, and more predictability of results compared to the other sites. Additional important advantages have been documented as well and can be discussed during your consultation with Dr. Turkeltaub.
  2. Periareolar incision: The incision with this technique is placed at the margin at the lower half of the areola where it borders the normal colored skin. Some individuals may prefer this location but they do need to consider some important issues before selecting it. Smaller sized areolas will make this approach difficult or impossible particularly if using silicone implants.
  3. Transaxillary incisions: The big selling point here is that the incisions are placed in the armpit so that there is no scar located on the breast itself. This is the second most common choice for breast implant placement and when done endoscopically, can yield good results. As with the periareolar location, several issues should be considered before electing this route.

  1. Inframammary incision
  2. Periareolar incision
  3. Transaxillary incisions
Breast Implant Placement

Breast implants can be placed either behind (subpectoral or submuscular) or directly in front of (submammary or pre-prectoral) the pectoralis major muscle, the large chest wall muscle. The appearance and dynamics are different in these two locations as are the consequences of the effects of time.

The most significant advantages of placing the implants behind the muscle include:

  1. Mammograms are more easily and accurately interpreted as compared to implants situated in front of the muscle (submammary).
  2. There is a lower risk for capsular contracture (hardness of the breast caused by the formation of scar tissue around the implants).
  3. There is more soft tissue coverage of the implant resulting in a decreased risk and extent of visible rippling as seen on the skin.
  4. A better and more natural interface is present with the implant and chest wall allowing for a more normal appearance.
  5. The muscle provides better long term support of the underlying implants as compared to skin only support when the implants are above the muscle. In this latter situation (submammary), the weight of the implant will cause greater stretching and thinning out of the skin over time as well as its own descent on the chest wall.

For most patients, Dr. Turkeltaub recommends that the implants be situated behind the muscle.

Do I Need a Breast Lift with My Augmentation?

In general, if you have a moderate to significant amount of excess skin of your breasts along with drooping you will likely need a breast lift (mastopexy) in combination with your breast augmentation in order to achieve desirable results. Having a breast enlargement alone without removing extra skin or lifting breast tissue in these cases would result in abnormal, bizarre appearing breasts. Some surgeons, trying to avoid performing a lift in these situations, place extremely large, inappropriately sized implants above the muscle in a misguided effort to take up the skin slack and avoid the additional incisions associated with the lift. The long term consequences of this, including very thin skin and deformed, elongated breasts, can be extremely bad and virtually impossible to completely address at a later time.

During your consultation, Dr. Turkeltaub can help you determine if a breast augmentation alone or in combination with a mastopexy would be best for your needs and goals. If you would like to learn more about this option before scheduling a consultation, please feel free to explore our page on breast augmentation with a lift.

What Is Recovery from a Breast Augmentation Like?

A dressing that provides some compression and maximizes comfort is placed for around 2 – 3 days. This is then replaced with a sports type bra that is worn day and night for at least 1 week. After that, a supportive bra should be worn on a regular basis, especially if you have relatively large implants, so as to help maintain the breast shape and minimize drooping over time.

Discomfort for the first few days can be mild to moderate though most patients can return to a non-strenuous job or school within 5 – 7 days. It is recommended that you avoid vigorous activities such as sports and aerobics for three weeks. You may experience muscle tightness and even spasms early on but these resolve fairly quickly.

Initially your breasts will be moderately swollen, firm and may appear larger than you were anticipating. After several weeks, much of the inflammation will subside resulting in a more defined shape and a size closer to what you can expect long term. With time, the skin and muscle (if placed in a submuscular location) will relax resulting in a softer, more natural feel and appearance.

There are many long-term benefits associated with breast enlargement. Included among these are looking better, feeling more attractive and feminine, having greater self-esteem and being able to find clothes that fit and that are more complementary. The overwhelming majority of breast enhancement patients are extremely pleased with their results.

For more information on the postoperative period after breast augmentation surgery, read Dr. Turkeltaub’s Blog: “Recovering From Breast Augmentation Surgery.”

Will I Have Breast Augmentation Scars?

The visibility and overall appearance of breast augmentation scarring will depend on a variety of elements including incision location, one’s genetic makeup, the incision closure method employed, level of surgeon’s skill, adherence to post-surgical advice, healing response, usage of scar mitigation products and whether one is on a restrictive diet (vegan, etc.) or not. Most commonly, the incision used to place implants will be made in or near the inframammary fold, resulting in a scar that is concealed beneath the breasts. Other scar locations include along the outer border of the lower half of the areola or in the armpit, both of which can result in relatively inconspicuous scarring (though they are utilized less frequently for a number of reasons that can be explained during your consultation).

In Dr. Turkeltaub’s experience, breast augmentation patients rarely have any issues with the final appearance of their scars particularly when post-operative instructions are closely followed and recommended scar care products/treatments are utilized.

How Long Do Breast Implants Last?

Breast implants are not guaranteed to be lifetime devices. On average, they can last anywhere from 5 to 30 years though it can be less or even more. Silicone implants generally last significantly longer than saline ones.

Being able to determine when one’s implants will need to be replaced (or just removed) because they have worn down or lost their integrity is a relevant concern. How you can realize when it is that time is quite different between silicone and saline breast implants.

  • Silicone Implants: “Ruptures” or breakdown of these implants often lead to no discernible changes in breast size or shape, particularly with the modern, more cohesive implants. In such situations, the gel usually remains in the capsule resulting in what is often called a “silent” rupture as there are no visible signs of change. The loss of implant integrity may be noted on a routine screening mammogram or a digital ultrasound. If there is concern or a suspicion of a broken implant, an MRI or digital ultrasound can be used to make the diagnosis most of the time.
  • Saline Implants: The detection of a leak in saline implants is much simpler compared to silicone ones as there is generally a relatively rapid decrease in size of the breast implant (and breast) as your body harmlessly absorbs the saline. Most of the time this becomes quite evident over a period of a few hours though in some cases this can take a few days or longer. You may also be able to feel and see the “edges” of the deflated outer envelope of the implant.

Ultimately, if there is any concern about the integrity/condition of your breast implants especially if they are getting up there in the years, you should seek the advice of your plastic surgeon.

Can I Breastfeed After Breast Augmentation?

If your body is capable of producing breast milk prior to the placement of your implants, you should still be able to breastfeed after your augmentation procedure, particularly if the periareolar incision technique is not utilized. It is important to understand, however, that some women are not capable of producing a sufficient amount of milk for breastfeeding regardless of whether or not they have breast implants. Therefore, if you have never tried to breastfeed prior to breast augmentation, your ability to do so after receiving breast implants may be uncertain. This fact greatly contributes to the misconception that breast implants impact one’s ability to breastfeed.

Another common false belief regarding breastfeeding after breast augmentation is that material from the implants will contaminate the breast milk. In actuality, the cohesive silicone gel or saline solution inside implants should not get into the breast milk or harm milk production glands and/or breast tissues. However, the periareolar approach for implant insertion can lead to some risk of disrupting milk glands. This is another reason why Dr. Turkeltaub recommends inserting breast implants through an inframammary incision for virtually all of his breast augmentation patients.

Ultimately, if you wish to start—or grow—a family after breast augmentation and are hoping to breastfeed, Dr. Turkeltaub suggests that you disclose this information during your consultation. By doing so, your plastic surgeon can more appropriately plan your procedure.

Breast Augmentation and Mammograms

The vast majority of women undergoing regular screening of their breasts for breast cancer will have the standard two image mammogram (with the rest primarily having an ultrasound). For those women who either have had a breast augmentation or are considering one, it is therefore important to know that the breast implants used in a breast augmentation will impact the quality of routine mammograms to a varying degree. Fortunately, this can usually be easily addressed with very common standard modifications of the study.

Mammograms use very low energy x-rays to penetrate through your tissues in order to radiographically visualize your breasts. Both silicone and saline breast implants partially block penetration by these x-rays making tissue visualization and evaluation on mammograms less clear and more difficult. The effective solution for this typically is having two additional views taken along with some repositioning of the implants and/or breasts. Therefore, it is always important that when you are scheduling your mammogram as well as when you are having it done, you inform the appropriate people that you do have breast implants so appropriate measures can be taken.

For more information on this, read Dr. Turkeltaub’s blog: “Do Breast Implants Interfere with Mammograms Evaluations?

What Does Breast Augmentation Cost?

The American Society of Plastic Surgeons (ASPS) reports the average cost of breast augmentation to be approximately $3,700*. This price is a bit misleading, however, because it refers solely to the plastic surgeon’s fee and does not take into account other related and inherent costs including the specific implants chosen, the surgical venue (hospital or private operating facility) and anesthesia expenses. Additional components that are also not accounted for in this number include such items as medications during recovery and preoperative mammograms. Of course, these numbers will also be affected if a breast lift is performed as well.

To receive a personalized quote for the cost of your breast augmentation, a consultation with Dr. Turkeltaub is necessary. During this meeting, he will listen as you describe the look you wish to attain, help you select the most appropriate implants based on your goals and desires and then formulate a customized surgical approach for you. Once a treatment plan is agreed upon, he can then provide you with a breakdown of all expenses that contribute to the total cost.

If you are considering financial assistance for breast augmentation, a member of our team will be available to introduce you to several healthcare lenders that offer affordable payment plans for almost any budget. The online application process is simple and the decision regarding approval is generally obtained quickly.

*This price is taken from data collected by the American Society of Plastic Surgeons; it does not represent the exact cost of breast augmentation at Dr. Turkeltaub’s practice.

How Do I Choose a Breast Augmentation Surgeon?

Choosing the right breast augmentation surgeon is very important in helping to maximize the likelihood that you will receive excellent care, safe and ethical treatment and results that meet—or even exceed—your breast enhancement goals. Some of the most important factors to consider when making your decision include:

  • Board Certification – The American Board of Plastic Surgery (ABPS) is the only Member Board approved by the American Board of Medical Specialties to assess and certify plastic surgeons. While there is no guarantee that a doctor who has obtained board certification through ABPS will provide superior treatment to a physician who is not board-certified, this “board-certified” distinction is evidence that the breast augmentation surgeon you are considering has undergone the rigorous training needed to make ethical decisions and deliver exceptional care.
  • Before-and-After Photos – Viewing pre- and post-operative pictures of former patients can be beneficial in assessing the skill and experience of a breast augmentation surgeon, as well as ensuring that their overall aesthetic goals align with your own. When browsing through photos, it is often best to focus on patients whose breast size/shape before and after surgery are similar to your current anatomy and ultimate goals, respectively.
  • Communication and Trust – To maximize the potential for an optimal outcome, you should be certain that your breast augmentation surgeon sincerely listens to your aesthetic concerns and fully understands your treatment goals. In addition, you want to be confident that your doctor is completely open and honest with you about what can and cannot be achieved based on your unique anatomy, which is imperative to establishing realistic expectations that ultimately results in higher post-operative satisfaction.
  • Operating Facility – As a major surgical procedure, breast augmentation should be performed in a hospital, outpatient center or a properly accredited operating facility (such as one that has received AAAASF accreditation). This not only ensures your plastic surgeon will be held to a high level of safety and ethical standards, but that they also have access to quality medical equipment and technology in the event a complication should arise.
  • Treatment Pricing – A plastic surgeon’s fee for breast augmentation is often a reflection of their credentials, skill and experience. As a result, choosing a breast augmentation surgeon based on price alone is never recommended. Should the expense of treatment be a limiting factor in selecting the doctor you feel is best for you, plastic surgery financing and payment plan options can often help make the procedure more affordable.

In the end, you should have no reservations about the breast augmentation surgeon you ultimately select, so take your time, do your research and only move forward with treatment when you are entirely comfortable with your choice.

Breast Augmentation Before-and-After Photos*

Dr. Turkeltaub is a very experienced plastic surgeon who has performed a large number of breast augmentations in over 30 years of practice. The following are examples of his expertise in this procedure.

Due to social media policies, the following images have been censored. Please click on the button below to view the image.

bna-sample Before
bna-sample After
bna-sample Before
bna-sample After

*Individual Results May Vary

Breast Augmentation Gallery

“One year ago, I made one of the best decisions of my life to have you perform my breast augmentation surgery! I am quite pleased with my result. The boost in confidence I experienced due to the surgery led me to compete in two fitness shows this year. I plan to compete on a national level in November. I want to thank you and your great staff for the professional but very caring experience I had last year.”

L.W. Breast Augmentation Patient, Phoenix AZ*
*Individual Results May Vary

Breast Augmentation Patient Testimonial Videos*

*Individual Results May Vary


For additional helpful information on a variety of issues related to breast augmentation, you can visit Dr. Turkeltaub’s Blog.
Dr. Turkeltaub is also experienced in a variety of other breast surgery procedures, including breast lift, breast reduction, and breast reconstruction.

Interested In Breast Augmentation Surgery?

If you are interested in breast augmentation, please contact Dr. Turkeltaub to schedule a convenient consultation. With two locations, Dr. Turkeltaub’s practice is easily accessible.

We look forward to helping you.

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