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Precision in Practice

Breast augmentation in Orlando is a very picky surgery; there are ways to perform a breast augmentation so that your chances of revision become very, very low. In many cases, I will use a dissolving internal bra to keep your breast implants exactly where we want them to be!

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Do I Need an Internal Bra With My Breast Augmentation?

There are several types of patients who benefit from additional support of their breast implants to prevent "bottoming out" and to maintain "upper pole fullness" after breast augmentation. If you have one of the following breast or chest shapes, an internal bra with dissolving mesh will be helpful to keep your implants in a good position:

  • A prominent breastbone or steep chest wall
  • Very small or absent breasts
  • No breast fold (or only a minimal breast crease)
  • Previous massive weight loss (or a very stretchy breast fold)
  • A desire for a perky and high breast without a bra

Creating the Perfect “No-Bra” Look

If you simply want more of a “push-up bra” look with more fullness, especially without the need to wear a bra, then adding an internal bra is your best option. The internal bra material is made from the same suture I use to close the breast implant pocket: polydioxanone, aka “PDS.”

The entire bra dissolves in about three months but has lasting support for your breast implants. It truly acts like an internal bra, giving you support without needing an external bra! Please visit here to learn more about my internal bra material, DuraSorb. To get more information about my approach, click the button below.

Learn More About Internal Bra Breast Augmentation

Subfascial or Dual-Plane Approach

In some cases, I use a dual-plane approach to placing the implants. While you can read more about the dual plane below, the summary is that the implant goes partly under the muscle. In many cases, however, we will place the implants over the muscle in the subfascial plane.

Here are three reasons we may opt for a subfascial breast augmentation in Orlando:

​1. You Lift Weights and Work Out

In these women, the pec muscle may be too strong and active to maintain the security of the pocket. There is also “animation” of the breast when you flex. We may avoid a submuscular (dual-plane) approach for these reasons.

2. You Are Borderline in Need of a Breast Lift

A subfascial approach does more to lift the breast and nipple than a dual-plane approach, so we may take the subfascial approach instead if we opt out of a lift.

3. You Want a More Round, Augmented Look

Because the muscle does not cover the implant, the top part (upper pole) has a fuller and rounder appearance. If that’s your goal, a subfascial pocket might be best.

To use the subfascial plane, we usually need to be able to “pinch an inch” of breast tissue on your chest. In other words, if the breast skin below your clavicle is too thin, we will need to use the muscle (dual plane) for coverage, and we won’t be able to use the subfascial approach.

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What Type of Implants Are Used in the Subfascial Approach?

We use gummy bear implants in the subfascial plane. These implants are slightly firmer than my standard gel implants. We choose a firmer gel because it is less likely to ripple when over the muscle. You can also read more about these “gummy bear” implants below.

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How Long Do Breast Implants Last?

While your implants may not last forever, the issue with today’s modern implants is NOT that the breast implants themselves rupture or leak nor that they become encapsulated. The issue is most often that breast implants shift out of the pocket. This leads to asymmetry and uneven breasts after breast augmentation.

While the pocket dimensions can be controlled in surgery, they can’t often be controlled afterward. This is why I am considering an internal bra in more and more patients—extra support of the original pocket. For similar reasons, I am opting to go over the muscle (subfascial) in more women: this minimizes the forces of the pec muscle on the implant over time. My number one goal is to be an expert technician for your breast implants and to have as much longevity as possible for you and your results.

How Much Does Breast Augmentation Cost?

The cost of a breast augmentation in Orlando with Dr. Oppenheimer starts at $7,995. Contact us to find out more information and to schedule a consultation.

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Breast Implant Technical Key Number One: Truly Sterile Technique

There are dozens and dozens of medical journals that discuss all of the ways to avoid complications after breast augmentation. All of the critical factors involve avoiding bacterial contamination of breast implants. Not only does this decrease infection, but bacteria on the surface of the breast implant can lead to chronic inflammation and capsular contracture. Here are the many steps that I take to maintain a Truly Sterile Technique during breast augmentation.

  • Preoperative IV antibiotics
  • Chlorhexidine skin prep
  • Nipple shields
  • Inframammary breast crease incision
  • Bloodless dissection
  • Triple antibiotic irrigation
  • Betadine skin re-prep
  • Changing gloves
  • Keller Funnel for "no-touch" technique

Each of these technical steps has been shown to decrease capsular contracture after breast augmentation. That means the OPPOSITE is also true. If any of these steps are NOT done, your surgeon is doing you a disservice during your breast surgery. This is what I call "cutting corners to cut costs." If the surgery costs less elsewhere, they are most certainly not doing everything they can in order to maximize your long-term safety during breast augmentation. Please go back through this list. Is your doctor using a nipple approach? The nipple incision is not the safest option! Is your doctor placing your implants with a Keller Funnel? Good idea for your long-term safety!

Breast Implant Technical Key Number Two: Meticulous Blueprints

Blueprints are my mantra for breast augmentation. Precision marking leads to precision surgery. Symmetry. Balance. And even-appearing breasts. Breast augmentation requires a very meticulous and OCD surgeon to get it right. Implants are easy to just put in but hard to place precisely. I am obsessive with the details! When the markings for breast augmentation are symmetrical, the breast augmentation comes out symmetrical. This sounds super logical, but it requires an expert technician! One who is ready to focus on every last detail. That's me.

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We Choose Your Breast Implants Together

There are many different versions of beautiful breasts. Together, we will select implant size and shape, allowing you to get the look you want. 

Options for a Natural-Looking Breast Augmentation

The best option for natural-looking breasts is moderate profile implants. It's worth noting here that the lower profile implant—namely the moderate implant—is more likely to create a slightly wider breast shape. This wider breast is responsible for more "sideboob." While I wouldn't say I like that term, it does best describe the smooth outer breast curve of a slightly wider breast.

Options for a Fuller and Rounder, More "Augmented" Look

A high profile is the best option for a full, round, "augmented" look after breast implants. These implants settle less than other options and contribute to more fullness at the upper pole of the breast. In addition, an internal bra may help to support your breast implants and keep them higher up on your chest. Lastly, a subfascial approach is going to allow the breast to be more round and full at the top and in the cleavage.

Choosing the Right Size Breast Implants

Choosing the right breast implant requires an understanding of your existing breast size in addition to your goal cup size. A full C is the most commonly requested final cup size after breast augmentation. While it depends on your height and weight, I like to use the 150 rule to connect breast implant size to breast cup size.

The 150 rule: 150cc Equals One Cup Size

For example, if you are a small B cup looking to get to a small C cup, you should use a 150cc implant. If you are a small B cup looking for a full C cup, you may need an implant closer to 300cc. This would give you a two-cup size boost to get you to the full C-cup look.

Gummy Bear Breast Implants Are More Cohesive (Firm)

Gummy bear breast implants are more firm than traditional silicone breast implants. Unfortunately, there are a lot of different opinions on what a gummy bear implant actually means. Gummy bear implants are just a firmer gel. For example, Allergan Inspira implants come in three different types of firmness: SRF (responsive gel, the softest), SSF (SoftTouch gel, ironically named because it is HARDER than the SRF), and SCF (Cohesive, the most cohesive silicone and therefore the hardest and firmest to the touch). Implants come in two types of silicone cohesivity or "firmness," essentially closest to the SSF and SCF for their softer and firmer silicone gel breast implants. Cohesive implants (some say gummy bears because of the firm gummy bear feel) are used in subfascial and revision breast augmentation because the firmer implant is less likely to ripple or wrinkle.

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Incision Placement

My incisions for breast implants are about 1.5 inches long, and they hide right in the crease. Incisions in the armpit and the nipple cause several problems, in addition to increasing the chances of developing firm breasts (capsular contracture). While it seems appealing to have a "hidden" incision, a nipple approach can actually make the scar more obvious. Furthermore, a nipple incision can indent, leading to a depressed nipple near an implant, which is precisely the opposite of a hidden scar. Crease incisions, on the other hand, hide the best, are placed in a wrinkle under the breast, and have the lowest risk of capsular contracture.

Here is a beautifully settled look of a dual-plane breast augmentation. Note the smooth slope transition of the upper breast (implant covered by muscle) and the nice full and round look of the lower breast (implant covered by breast only).

Don't Fear the Gap!

Cleavage is everything with breast augmentation, and one of the key elements of breast implant surgery is close cleavage. I often hear about how nervous patients are about a wide gap between their breasts after implants. While some cleavage is genetically determined, in most cases, the cleavage can be closely spaced with very little gap between the breasts. The cautionary step to avoid is symmastia, or breasts that touch across the midline. Close but not too close is the goal. 

The best way to get the right amount of cleavage is to mark the cleavage goal beforehand and to dissect just that amount in surgery. It sounds simple to get the cleavage right after breast implants, but it requires a bit of obsession in surgery and in markings! 

Implant Placement: The Meaning of "Dual Plane"

Everyone has heard of "overs" and "unders," but I get a lot of questions about dual-plane breast augmentation. I think of dual-plane breast augmentation as partial under. Ideally, the implant should be placed under the breast to augment it. This is why I am increasingly placing implants in the subfascial plane. 

Nonetheless, in a dual-plane approach, the muscle is released slightly to allow it to "window shade" upwards. This makes the implant sit under the muscle up high, providing coverage of the upper pole of the breast. That upper pole coverage creates a smooth transition of the breast (instead of a more rounded look).

The lower pole of the breast has direct contact with the implant, creating a nice, full, round shape below. This allows the breast to be augmented where it should be: at the level of the breast and not the pec! If you think about it, the breast is ever so slightly lower than the pec muscle. Voila. Dual-plane breast augmentation explained.

If you have little to no breast tissue, we might opt for a dual plane. This way, you have a smooth transition to the upper part of the breast by covering the implant partway with your pec muscle.

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Comparing Apples to Apples: Choosing the Right Surgeon

At Oppenheimer Plastic Surgery in Orlando, FL, my goal is to give you the best results safely. Doing a breast augmentation the right way costs more upfront. There are corners that can be cut to make it cheaper. I don't cut corners. Trust me when I say it's worth investing in results you'll love. 

There are added benefits to having surgery with me.

  • I use a Keller funnel to place the implant via the No-Touch technique.
  • I have an accredited surgery center with all of the safety mechanisms in place: proper staffing, sterilization, monitoring, and care.
  • We provide all the #postOPP necessities. Two bras for recovery and beyond, skin care and scar care, nerve blocks, 24/7 on-call services, and unlimited follow-ups.
  • Our revision rate is so rare (1 in 100 cases) that we never charge surgeons fees in those rarest of circumstances where a revision is required.

Your Consultation

There's nothing easy about sharing your insecurities, even if it is with me, your doctor. I do everything I can to make this process as easy as possible for you. First, you will talk with my nurse, who will help you fill out your medical intake. We are a paperless office; we like to keep things lean and save a tree! I like to make sure that we address all of your concerns and goals, so I'll then come in the room, and you can share any wish pics or goals for your breasts. 

I will definitely ask you about the following:

  • Your current cup size
  • Your goal cup size
  • Your goal look: natural, full, or augmented (very round)

Next, I will step out, and you can get changed. My patient care coordinator and I will come back into the room to do a basic breast exam, take some measurements, and look at your overall breast shape.

I will then do a scan of your breasts with a virtual reality camera. My patient care coordinator will help with some in-office sizing, using silicone gel inserts ("cutlets"), and you'll be able to look in the mirror and see what sizes work best for you. Based on that, I can perform "virtual surgery" and show you what the results could look like with the shape and style of implants that you like!

Scheduling Surgery

I'm ready to work and more than willing to meet the demands of YOUR schedule. To learn more about our scheduling policies and procedures, click HERE.

The most common question I'm asked about scheduling is, "How far are you booked out, Dr. Oppenheimer?" The short answer is "not long," And usually within 3-6 weeks. Because I have full control over my schedule, because I am the only surgeon in my surgery center, and because I am obsessed with helping women achieve their goals.

The Price of Breast Implants in Orlando

Our goal is to be fully transparent when it comes to the surgery pricing and what is included. That's why we make our price list easily accessible for our patients to review. Everything is included with us. Breast augmentation starts at $7,995, and you can click HERE to access our full pricing list.

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Breast Implants: Things to Know on the Day of Surgery

Don't worry; I'll do that for you. It's literally my job to worry about the results of your breast augmentation. I will stress the markings, the cleavage, the sterility, the incisions, the scars, and the anesthetic. It's my job to make this right for you.

Since we have our own facility, it will be a super private and confidential experience. There will be no "check-in" process. You'll come to the surgery entrance; my nurse will let you in, and she will get you into a gown. The urine pregnancy test and IV are next. Your spouse, girlfriend, mom, or family member can stay with you in the room for as long as you want (or don't want!).

I will come in smiling and ready with my Sharpies to make all the required marks, answer any questions, and go over the game plan for your size and profile and any other details or questions you have. I'm never in a rush!

Once we get the Sharpies on, we will walk you back to the OR, where you'll be gently sedated by my anesthetist. "Pick out a nice dream!" you might hear me say. You'll wake up in a jiffy. Even if you haven't had anesthesia before, we will make sure your breast augmentation is super safe. That's the number one goal. The surgery takes about 1.5 hours total from in the room to recovery, and your family can see you right afterward.

Recovery From Breast Augmentation

The flash recovery breast augmentation sounds great; go out to dinner that night! While my patients have all of the elements of a flash recovery breast augmentation (bloodless surgery, gentleness to the ribs, no bruising, nerve blocks, and rapid recovery anesthesia), please don't go out to dinner the night of your breast augmentation. It's best for you to lay low and take it easy at home. While problems are rare after surgery, overdoing it can be one of the causes of bleeding or infection.

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Our In-Office Pharmacy

As a fully licensed in-office pharmacy, we offer seamless access to all the medications needed for your post-breast augmentation recovery. Conveniently fill your prescriptions on-site, benefit from our package pricing, and explore a comprehensive list of available medications for your comfort and ease.

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Time to the Final Result

It takes three months for your implants to settle to their final place after breast augmentation. Early on, your implants will sit high, and the nipples will be pointing low. Sometimes, one breast will settle quicker than the other, which can be related to your dominant hand. If the implants are sitting too high, we may provide you with a recovery band or bra bandeau, but this is very uncommon. The "drop and fluff" takes about three months to finish, which is the settling and filling out of the implants in the breast.

One Month to the Gym, Three Months to the Ring

This may sound like a joke, but since we have treated many women of the WWE (professional wrestlers), as well as bodybuilders and CrossFit athletes, we like to be very clear. One month is ok for light cardio in the gym. Six weeks to light weights. And really, three full months before resuming CrossFit after your breast augmentation. Enter the ring at your own risk.

Breast Lift With Implants

In cases where there is drooping of the breast, a lift may also be required. Fighting gravity isn't easy, and it takes a thoughtful approach! The answer is not "we'll just put in a bigger implant," so beware of doctors who offer that as an option. Unfortunately, gravity always wins. There are really two options to fight gravity when it comes to breast surgery. Each option is PERFECT for the right person. It just depends on your current breasts and your goals.

Option 1: Breast Lift/Reduction 

Breast lift/reduction is a perfect option for women who don't want implants and who prefer a more natural look. This will lift the breast and hold it in place temporarily. But gravity can still pull the breast down over time. The smaller the breast, the less gravity will have an effect.

​Option 2: Breast Lift/Reduction With Breast Implants

Breast lift/reduction with implants is the best way to trade drooping breasts for fuller, rounder breasts. In some cases, we will also use an internal bra to support the implant!

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Breast Lifts Require Scars

Unfortunately, breast lifts require scars. In my practice, the only scar patterns that work well long-term are the anchor scars: a lollipop scar around the nipple and down the front of the breast and a scar in the breast crease. Donut scars (the Benelli mastopexy) around just the nipple sound really appealing, but they end up stretching the nipple over time, causing problems with the scar appearance and breast shape. I try to avoid scars on the breast whenever possible, but if you need a lift, it's most likely going to be an anchor scar pattern.

When performing a breast lift with implants in Orlando, the implant pocket must be made tightly to avoid the implant and breast stretching over time. Implants with a lift, when placed tightly under the muscle, will stay in place and will not slide off the chest or bottom out. This is particularly important in women who have a prominent breast bone. This is sometimes referred to as pectus carinatum (bird chest deformity). Patients with pectus carinatum are at risk for breast implants sliding into the armpits. In these patients, we often recommend an internal bra.

Scars Can Heal Beautifully in All Skin Types

Understandably, women of color are more fearful of scarring. This is because keloid scars tend to be more common in darker skin tones, particularly in women of African American descent. That said, the appearance of scars can be drastically reduced with good surgery by a good surgeon! 

Anchor Scars Are the Most Reliable Way to Lift Breasts

Women with drooping breasts most often want two things:

  1. A lifted and full upper breast
  2. A smaller areola

Anchor scars are the most reliable way to lift the breasts and make the nipples smaller.

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Hyper-Meticulous Suture Work

It's a hard truth, but all surgeons are not created equal. Just like some tattoo artists have unique skill, so too do some surgeons have unique gifts with their hands. If you're reading this far, you can already tell that it's true. I place every stitch by hand using absorbable sutures buried underneath the skin. This means no suture marks and the thinnest scar possible.

The Journey: Breast Augmentation instead of Breast Lift with Implants

Breasts should always look good, really, at every part of the journey. Because of that, I'm never afraid to share the journey.

View Our Breast Lift Gallery

The Nipple Stays Attached With a Breast Lift and Does Not Lose Sensation in Most Cases

The nipple stays attached to your body during breast lift surgery, and the sensation is preserved by keeping the nerves connected. Some women actually have more nipple sensation after a breast lift.

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Why Choose Me?

Choosing Oppenheimer Plastic Surgery for your breast augmentation means you will be under the care of a top-tier surgeon devoted exclusively to your well-being. I meticulously assess every detail the day before your procedure and visualize the surgery to ensure optimal results. My approach prioritizes gentleness, not only because it feels right but because it significantly enhances your healing process.

Consider me akin to a compassionate pediatrician, deeply committed to your medical care and aesthetic outcomes. My primary motivation is to assist mothers in reclaiming their bodies, and that dedication is what drives me to work each day. I am prepared to give my utmost effort to help you achieve your best self—nothing more and nothing less.

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