Breast Augmentation in Denver, CO

• 1-1.5 Hour Surgery
• Back to Work: 3-5 days

The decision to undergo breast augmentation is a very personal one. Some women are looking to achieve volume they never got as their breasts developed, while others are looking to add back the volume that was lost after pregnancy, breastfeeding, or weight loss. Regardless of the motivation, breast augmentation surgery requires an individualized approach to help you achieve your goals.

Choosing a board-certified plastic surgeon with significant expertise and experience in breast augmentation surgery in all its forms is essential for getting the results you want. At the Center for Cosmetic Surgery, our renowned breast enhancement specialists attract patients not only from the Denver Metro area, but from surrounding communities like Colorado Springs, Fort Collins, Vail, the Aspen Valley, and Cheyenne, WY. Our passion for impeccable results, outstanding patient care, and an experience that exceeds expectations attracts patients from the entire Mountain West region.

WHAT IS BREAST AUGMENTATION SURGERY?

Breast augmentation is a cosmetic surgery that increases breast size, usually with a silicone or saline implant, although fat grafting can be used to add volume in some cases. When an implant is used, a surgical pocket is created underneath the breast. Depending on the patient’s anatomy, activity level, and other factors, this pocket can be either above or beneath the chest muscles. Incisions can be located around the nipple, in the armpit, or, most commonly, in the fold underneath the breast. Each approach has advantages and potential drawbacks.

Fat Transfer Breast Augmentation

Breast enhancement surgery has evolved over more than a half-century, and modern techniques and new, improved implants allow patients to achieve better results than ever before, all with improved safety. In the past few years, breast augmentation with fat transfer has become a viable option for some patients. These patients need to be content with a modest increase of ½ to 1 cup size and must have an area or areas elsewhere in their bodies from which sufficient fat can be harvested for the procedure.

It is important to understand that the results of fat grafting can be unpredictable due to variability in the survival of the transplanted fat, and some patients may require subsequent repeat grafting to obtain their desired outcome. Fat grafting can also be used with implants in a so-called “hybrid breast augmentation.” In these cases, fat is used to add targeted fullness or soft tissue enhancement, while the implant provides the majority of the desired volume.

BENEFITS OF BREAST AUGMENTATION

A boob job offers benefits that are psychological as well as aesthetic. The enhancement of breast volume and shape can significantly improve body proportions and boost self-confidence. For some women, enhancing their breasts can play a vital role in regaining their femininity and self-image after pregnancy or weight loss. For others, the procedure can help correct asymmetry or congenital breast deformities or may simply add volume that nature never provided. Many patients report improved psychological well-being following augmentation, as the procedure can alleviate feelings of insecurity or dissatisfaction with their bodies. Overall, breast enhancement can be a multifaceted solution that blends aesthetic enhancement with emotional and psychological benefits.  Its wide appeal has made it the most popular cosmetic surgical procedure in the United States.

ARE YOU A GOOD CANDIDATE FOR BREAST AUGMENTATION?

If you are unhappy with your natural breast size, asymmetry, or the shape of your breasts after pregnancy or weight loss, you may be a good candidate for breast augmentation. You should be a healthy non-smoker at a stable weight. Our experienced surgeons carefully evaluate your health and lifestyle factors to ensure you are a good candidate.

CONSIDERATIONS FOR CUSTOMIZING YOUR BREAST AUGMENTATION

You have more options than ever before in terms of implant selection, placement, and surgical techniques. Our cosmetic breast surgery specialists, Dr. Andrew Wolfe, Dr. Steven Vath, Dr. Paul Steinwald, Dr. Matthew Freeman, and Dr. Teresa Cunningham, can help you decide which options will work best for you.

CHOOSING IMPLANTS

Saline vs. Silicone

At the Center for Cosmetic Surgery, our surgeons use both saline and the latest silicone gel breast implants; both types are safe, and each device has advantages and drawbacks.  

Saline

Saline implants offer the advantage of easier detection of a rupture, as the leaking saline would leak out of the implant and is harmlessly absorbed by the body.  There are 2 types of saline implants available in the U.S. The more commonly used standard saline devices have a single silicone plastic shell that is filled via a fill tube after they are inserted into the breast.

They have been in use for decades, and many patients are happy with them. They perform best in patients with adequate tissue to hide them and are usually placed beneath the muscle. Because of their lack of structure, however, they tend to be more noticeable in the breast, both in terms of look and feel. They are more likely to ripple, especially in those with less soft tissue coverage due to thinness, pregnancy, or weight loss. The implants may be palpable to the patient or her partner and may feel “sloshy” in some cases. Finally, they have a rupture rate higher than that seen in other devices.

Puregraft Serene Breast Implants

To address these drawbacks while maintaining the safety and ease of use, engineers created the Serene breast implant (formerly the “Ideal Implant”). This is a multi-lumen saline device that has 2 saline chambers and multiple baffles that make them feel better and move more naturally than other saline implants. They also have a lower rupture rate than many competitors. There are limited sizes and shapes available, however, and they are relatively expensive. If you prefer saline and can find an implant that fits your dimensions and can afford the price, Serene implants may be an excellent choice.

Silicone Gel

Silicone breast implants are far more commonly chosen than saline. They offer a more natural feel and appearance for many patients; the less breast and body fat the patient has, the bigger the benefit she will get with silicone. Silicone options have evolved from less cohesive, underfilled devices to the more cohesive “gummy” implants with ideal fill ratios that we have today. The first “gummy” implants to be released in the U.S. were shaped, textured devices. The textured surface was later found to be associated with a rare but potentially dangerous condition called BIA-ALCL. Due to concerns surrounding texture, the U.S. market shifted dramatically back to smooth, round devices, and the manufacturers responded by creating round implants with the more modern “gummy” silicone fill.

Motiva® Implants

In late 2024, the FDA approved Motiva silicone breast implants for U.S. distribution. These are next-generation devices and have lower rates of rupture and capsular contracture. Importantly, Motiva implants behave well both beneath and above the muscle, opening up new opportunities for many patients. We have been working with these devices since 2018 and are well-versed in their use.

In-Office Ultrasound Imaging

Although they have many advantages, silicone breast implants are more expensive and are more challenging to evaluate for rupture, as they don’t change in volume if they are compromised. We recommend either MRI or ultrasound tests to evaluate their integrity. Ultrasounds, in particular, are quite useful and convenient. At The Center for Cosmetic Surgery, our commitment to state-of-the-art technology means that we offer in-office ultrasound as a part of our consultation process for patients with preexisting breast implants.

Implant Size

Aesthetic goals for a boob job vary from patient to patient and are an intensely personal decision. No two patients are alike, and an individual evaluation of each patient’s anatomy and an exploration of their preferred breast size and shape are an important part of the consultation. We offer both in-bra sizers and Vectra 3D imaging as resources for helping patients choose their implants. Of course, our clinical expertise is vital to guide patients with respect to developing and delineating appropriate implant volume ranges, setting realistic goals, choosing incisions and the implant plane, and deciding on a variety of other details that can impact the long-term success of the procedure in both aesthetic and functional terms.

You can read more about selecting your best implant size on our blog.

Implant Profile and Shape

In addition to size, choosing an implant with appropriate dimensions is of paramount importance. A patient with wider breasts tends to need a wider implant, while narrower breasts do better with implants with smaller base diameters. To accommodate a variety of different body types and aesthetic goals, implants come in different profiles, which are different base-diameter-to-projection ratios. Those wishing for a more augmented look will usually prefer the additional projection and roundness of high-profile implants. In addition to helping choose volume, our Vectra 3D imaging system can simulate before and after photos of our patients with different shapes and profiles, an invaluable asset when making such an important decision.

You can read more about selecting implant profile and shape on our blog.

INCISION OPTIONS

There are 3 possible incisions for breast implant insertion:

• Inframammary (breast crease)
• Periareolar (along the border of the areola)
• Transaxillary (armpit)

While every surgical approach has advantages and limitations, data gathered over the last 10 to 15 years strongly supports the inframammary incision. From a cosmetic standpoint, a small (2.5-4cm, depending on size and type) incision hidden right in the fold results in a minimal scar that is typically only visible as a faint line when the breast is lifted up.

An inframammary incision significantly lowers the risk of capsular contracture (a thickening of the scar that the body forms around the implant). Because the approach completely avoids the breast gland, there is less exposure to the normal bacteria that live in the breast ducts. Implant colonization with these bacteria is thought to be a primary cause of capsular contracture. Finally, sensation and breastfeeding tend to be protected with the inframammary approach, again due to less trauma to the breast gland.

Although the inframammary approach tends to be the best fit for most patients, we are well-versed in all approaches and can thoroughly discuss your options with you.

IMPLANT PLANE

The choice of which plane to use is complex. Surgeons can place implants above (subglandular or subfascial, both considered pre-pectoral) or beneath the pectoralis muscle (subpectoral). However, each of these options has nuances that bear further discussion.

Subglandular Placement

Subglandular placement has a short recovery time due to the lack of muscle trauma, and the implants are not affected by the activity of the chest muscles. However, there are limitations. In particular, capsular contracture was a common complication. Also, thin patients may notice rippling or other visibility challenges.

Subfascial Placement

In the early 2000s, some surgeons began placing implants above the muscle, but beneath the fibrous fascial covering of the muscle. This subfascial approach was an attempt to add soft tissue cover and perhaps decrease capsular contracture. It had some measure of success but was not completely protective of rippling or thick capsules.

Subpectoral Placement

Surgeons began placing implants beneath the muscle in increasing numbers to avoid the drawbacks of placing them in front of the muscle. Initially, they were totally covered by muscle, but this led to various distortions of the breast.

Dual Plane Placement

The procedure became more nuanced with the broad adoption of dual-plane placement as described by famed breast surgeon John Tebbetts in 2001. In a dual plane procedure, the muscle is released along its lower margin and to varying degrees onto the sternum, with the release of the overlying gland in the more aggressive dual plane 2 and 3 procedures. This allows the implants to sit down in the breast in a more natural position. One significant advantage of the submuscular approach is that the muscle provides soft tissue cover, resulting in a more natural feel and appearance for some patients. This is especially valuable with saline devices but can be beneficial in thin patients with any device. Another benefit of subpectoral placement is a reduced risk of capsular contracture, as documented in numerous published studies.

Subpectoral placement does have challenges, including postoperative discomfort that typically requires narcotic pain medication for a few days. Long-term studies do show some decreased strength in the chest muscles. Also, because the implant is partially covered by the muscle, flexion of the pectoralis muscle can impact the shape of the breast, resulting in so-called animation deformity. The severity of this animation can range from a mild, subtle shift in the breast shape to a dramatic and unattractive deformation of the entire breast. Finally, a constant downward push of the muscle over time can lead to bottoming out or lateralization.

Despite these downsides, most U.S. surgeons have predominantly used the subpectoral plane. Many felt it was the best compromise, given the limitations of implants regarding rippling and capsular contracture.

If you’d like to learn more, read our blog post about breast implant placement options.

WHAT TO EXPECT

At your initial consultation, your surgeon will have a detailed discussion of the various options available to you based on your history, anatomy, and aesthetic goals. A physical exam will be followed by a detailed and highly accurate sizing process utilizing both in-bra sizing implants and Vectra 3D imaging. The Vectra can also simulate a breast lift, if indicated.

A history and physical exam with one of our highly trained R.N.s takes place roughly two weeks before your scheduled surgery. They’ll explain consent forms, which require your signature. We’ll take photos and electronically submit prescriptions to your pharmacy of choice. We’ll draw your blood if lab work is needed.

Our surgeons perform surgery at Apex Surgical Facility, our AAAHC-accredited surgical location. On the day of surgery, a nurse inserts an IV, and your surgeon will meet with you and mark the breasts. You will meet with one of our board-certified anesthesiologists, who will explain the anesthesia process. In the OR, you will be placed under general anesthesia. Because you’re completely asleep, you’ll feel nothing, and the surgery can proceed efficiently and safely. The surgery itself takes approximately 1 hour, while augmentation with breast lift takes around 2 1/2 hours. A nurse places sterile dressings and a surgical bra after the surgery. You’ll then be taken to a recovery room. After an hour or so, once you’re feeling ready your ride can pick you up and take you home.

WHAT IS BREAST AUGMENTATION RECOVERY LIKE?

PAIN/DISCOMFORT AFTER SURGERY

There is some discomfort after the procedure, although many patients are surprised with how easy the recovery is. If the implants are placed beneath the muscle, then the pain typically requires narcotic medication for 1 to 4 days. Muscle-relaxing medications can help with muscle spasms. If they are placed above the muscle, some patients require nothing more than Tylenol to control the mild discomfort, while others require stronger medication for a few days.

BREAST AUGMENTATION RECOVERY TIMELINE

Even though healing after a boob job is different for everyone, here is a typical postoperative timeline:

• First 24 hours post-op: Patients are typically fatigued from surgery and anesthesia. Some experience nausea, which can be treated with medications and tends to resolve fairly quickly. The chest can feel tight, especially if the procedure involves submuscular placement. It is common to have sensory changes after surgery, and some parts of the breast may be numb or oversensitive. The implants start high and will settle with time. This can be pronounced during the first week. Bruising is typically mild. If a mastopexy was performed, the longer incisions and more involved surgery may lead to more significant bruising.
• 5 to 7 days post-op: By the end of the first week of recovery, most patients are back to non-strenuous work. If you’ve stopped taking narcotics or muscle relaxants, you can resume driving. Many people start taking walks. Heart rate and blood pressure should remain normal for 2 weeks after surgery, however.
• 2 to 4 weeks post-op: The acute discomfort after surgery is typically gone by this point, though the breasts can remain tender for weeks. Patients should continue wearing a supportive bra for the first month. You can engage in light exercise that doesn’t involve the upper body.
• 4 to 6 weeks post-op: More vigorous activities can resume after the first month. The breast implants will have started settling, although the final shape can take months to evolve. You can apply scar creams to healing incisions as soon as the surgical tape falls off. Patients can start more aggressive scar therapies like microneedling or fractional laser treatments at 6 weeks.

Patients are encouraged to contact our office at any point after surgery if they have questions or concerns.

POST-OPERATIVE CONSIDERATIONS

There are a few issues to plan for after surgery. Attention to these considerations can enhance recovery and avoid postoperative setbacks.

 The Best Sleeping Positions

It is important to get lots of sleep after any surgical procedure. For most patients, sleeping on the back with the torso in a mildly elevated position works best. This can be in an adjustable bed, in a recliner, or simply propped up on a few pillows. As the breasts heal, patients can transition to side sleeping if preferred, so long as undue pressure is not applied to the breasts.

Bathing and Swimming

Depending on the type of dressings applied after surgery, you can either shower immediately or avoid it for 24 to 48 hours. These instructions will be provided at the preoperative history and physical, but patients can always contact the office for questions. Swimming is typically fine once incisions are well healed, with no open areas of delayed healing. This can take a few weeks.

The Right Bra

It’s important for the breasts to be supported properly in the weeks following breast augmentation. For the first 6 weeks, we recommend avoiding any underwire bras, as they can irritate healing incisions. Pushup bras are also discouraged since they can affect implant placement during the healing process. A medical-grade bra that supports the breasts as they heal is generally the best choice. These bras generally close in the front, allowing for easier access while patients are stiff, sore, and healing.

Exercise After Surgery

Mild, non-strenuous activities that don’t involve the upper body are fine during the first few weeks after surgery. This could be a relaxed walk or a gentle spin on an exercise cycle. Heart rate and blood pressure should remain normal for the first 2 weeks to avoid stressing healing blood vessels, which can result in postoperative bleeding that might need urgent surgical intervention.

You can begin mild cardio workouts after 2 weeks; you should pay attention to your body and not overdo it too soon. More strenuous upper body activities can begin at 6 weeks, with a gradual increase in intensity as the body gets back to normal. It may be months before the upper body feels normal, so patients should not be discouraged if they remain stiff or feel a bit weak for quite some time. Recovery will generally be quicker with above-the-muscle placement, but these general guidelines apply to all surgical approaches.

WHEN WILL YOU SEE YOUR FINAL RESULTS?

It takes months for the breasts to evolve into their final form after surgery, and a variety of factors affect this process. Smooth implants tend to drop a fair bit after surgery, so they will begin in an elevated position and settle over 3 to 6 months. The tighter the breast, the longer this “drop and fluff” may take. Additional procedures like a breast lift or the addition of mesh support can alter this timeline one way or another.

ABOUT BREAST AUGMENTATION SCARS

Scars are a necessary component of any breast surgery. Our surgeons place incisions in the most inconspicuous locations and perform precise, meticulous closure with long-lasting but dissolvable sutures to support healing. The incisions are typically covered with surgical tape for 3 to 6 weeks, and scar creams can be applied once the tape falls off. For most people, incisions start as fine, pink lines that may take 18 to 24 months to fully fade. Read more about the incision healing process and how to minimize scars in our blog post.

COMBINING BREAST AUGMENTATION WITH OTHER PROCEDURES

It is very common to combine cosmetic breast surgery with liposuction and tummy tucks as part of a Mommy Makeover. Virtually any other procedure can be performed under the same anesthetic. Many patients choose to have multiple procedures at once to save time, money, and recovery intervals. There is a limit to how much can be done at one time, however, based on a variety of factors. Our knowledgeable staff can help guide you should you wish to add additional procedures.  

BREAST AUGMENTATION VS. BREAST LIFT

In some women, implants and/or fat alone create beautiful, filled-out breasts. In others, an enhancement with a breast lift (or mastopexy) is necessary to reshape and reposition the breast in addition to the addition of volume. When expertly performed, the results can be transformative, but this can be a challenging combination with compromised results in the hands of a less talented surgeon. Our skilled breast enhancement surgeons will guide you through all the decisions involved in creating your ideal results.

See our section on mastopexy for more information.

BREAST AUGMENTATION REVISION SURGERY

Most patients who get breast implants are happy with their results. Unfortunately, a significant number will need some sort of revision. Even if everything goes perfectly, implants don’t last forever and will need to be replaced at some point. Revision surgery is generally more complex and challenging than primary cases and requires special expertise.

Read more on our breast augmentation revision page.

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