Breast Augmentation in New York City

The two primary breast implant options available for cosmetic breast augmentation are silicone implants and saline implants. Both breast implants are safe, FDA approved devices that are excellent choices for breast enlargement. The current generation of silicone breast implant is pre-filled with a cohesive silicone gel, and saline implants are filled with salt water solution at the time of surgery. Each has a similar silicone elastomer outer shell. At comparable volumes, the look of each implant is virtually identical. To the touch, the silicone gel implants have a more natural, breast-like feel.

Breast augmentation can be performed using incisions in the lower crease beneath the breast (inframammary crease incision), along the lowest border of the pigmented areola (periareolar incision), or within the underarm (transaxillary incision). In consideration of a variety of factors including areolar size, breast shape, breast glandular density, inframammary fold definition, size goals, implant selection, and personal preferences, Dr. Kolker will advise you on the best breast augmentation incision options.

To minimize incision length and to gently introduce silicone gel implants with a minimal or “no-touch” technique, a Keller Funnel is uniformly used. The Keller Funnel is an implant insertion device with a slick, low-friction surface that enables the placement of silicone breast implants through smaller incisions. Using these devices since 2010, Dr. Kolker uses the Keller Funnel for every breast augmentation.

Breast implants can be placed below the muscle (submuscular augmentation), or above the muscle (subglandular augmentation). Submuscular augmentation confers the following benefits:

• Provides increased coverage of the breast implants
• Softens the upper pole of the breast leading to a more seamless, natural transition from collar bone to nipple
• Maintains long term stability of the breast pocket
• Markedly decreases rates of capsular contracture
• Lessens influence on mammography

Dr. Kolker uniformly utilizes a submuscular pocket plane. “Dual plane” augmentation is a form of submuscular augmentation that allows for maximal coverage of the upper pole of the implant by muscle, and direct effacement of the lower breast gland; this maneuver is employed when there is minor lower pole soft tissue excess or mild droop (ptosis) of the breast.

Breast implants are available in a wide array of shapes, profiles, shell textures, and sizes. Round implants or anatomical implants can be used. Both implants assume a tear-drop shape when upright. The shells of breast implants can be smooth or textured. Implant profile refers to the projection of an implant for a given base dimension. Choices are made from among three profiles, corresponding to low or moderate projection (less volume and anterior convexity), midrange or moderate plus projection (intermediate volume and convexity), and high profile (maximum volume and convexity). Considering the nuances of your anatomy and the subtleties of your specific desires, Dr. Kolker will advise you on the best breast implant style, profile, and projection options to achieve your goals.

Choosing the correct breast implant size is a process that begins with your initial consultation. Dr. Kolker is fastidious about getting to know the nuances of every individual’s wishes and goals. These desires are married with the careful anatomical measurements and tissue assessment to establish an initial size “range”. At a preoperative visit approximately two weeks before surgery, the goal is further confirmed with a series of neoprene bead-filled sacs used as “sizers” that are placed into a special brassiere; you will try a range of sizes to get a better sense of dimension and proportion. Finally, Dr. Kolker uses silicone gel or saline implant sizers during surgery to confirm the size selection. As a rule in realizing the most beautiful endpoint, Dr. Kolker strives to achieve natural and proportional size and shape, directed by your thoroughly considered desires and goals. With his years of experience and attention to detail, Dr. Kolker has earned a reputation amongst his patients for providing high quality breast implants and cosmetic surgery.