Breast Augmentation

With A Warm, Caring Staff and Stunningly Natural Results, Our Approach to Breast Augmentations is Anything But Plastic

Breast augmentation is a very personal decision, so it’s not surprising our patients come to us in Cary, NC with a variety of desired results. Some of the goals we hear most often are:

  • “I’d like to look better in my clothes.”
  • “I want to feel more feminine.”
  • “I’d love my breasts to look like they did before I had kids.”
  • “I’d like better proportion so that my breasts match my hips.”

Whatever your personal reasons, we’re here to help you explore the possibilities and to achieve the results that are best for you and your body. Whether you wish to increase the size of your breasts or improve their shape, breast augmentation is an enormously satisfying procedure for most patients.

Our team is committed to your understanding what a breast augmentation involves and the options that are available to you. CARE Plastic Surgery in Cary, NC is a state-of-the-art facility and Dr. Coan and  Dr. Zenn are national experts in breast surgery. You have found the right surgeons!  Let’s learn more on the subject.

What Are the Choices Available to You for Your Breast Augmentation?

In the past, surgeons often made all the choices for their patients. This led to a high revision rate and many women wishing they had more control over the process and the end result.  At CARE, we believe the best choices are those made together – surgeon and patient. Most women are aware that they can help choose the size of their implants as well as the type of implant (silicone or saline). But there are other decisions that must be made as well, including the:

  • Shape of the implant
  • Profile of the implant (the amount that the breast projects outward from the chest in profile)
  • Texture of the implant
  • Location of the ultimate scar

With all the available choices, no wonder people get confused!  Dr. Coan and Dr. Zenn are experts and will help guide you through the process.

“I went in a little worried about an interest I had for at least 15 years. Once I met Dr. Coan and his staff, I realized the time was now right. I was interested in breast augmentation. CARE made me feel more than a patient. I felt as if I was talking to friends/family. I could not be happier with my outcome. Dr. Coan and I talked several times, as he wanted to make sure he had a clear understanding of the results I was hoping for. I would HIGHLY recommend him to anyone! I’m so excited for the upcoming summer. For once in my life, I am ready for bathing suit season!! I’m one happy lady … and can’t speak highly enough for the CARE staff!! They are all just amazing people!” –LP  

“What An Amazing Surgeon! Dr. Zenn is definitely the best surgeon in the specialty of Plastic and Reconstructive surgery. I had the honor to work with him as an OR Nurse and see only wonderful outcomes. He had to be my surgeon, no doubt about it! Dr. Zenn has great bedside manners, he is very professional and knowledgeable, caring and compassionate. He helped me choose the right size of implants for my body frame, and explained to me every step of the procedure from the registration to recovery. He followed up with post- op calls himself and with his wonderful nurse JoAnn. If you are looking for breast augmentation that has a natural look to feel confident and beautiful, you must come and see Dr. Zenn.” –RealSelf review

Which Type of Implant Is Right for You?

Silicone implants, shaped, form-stable or anatomic silicone (often called “gummy bear”) implants, and saline implants -- many choices and all available in the United States.  Truthfully, saline are rarely used anymore as they feel less natural and go flat when they rupture. There was a time when all we could use were saline implants and people tolerated them. Since silicone implants have been studied and shown to be as safe as saline implants by the Institute of Medicine, silicone implants have been favored by most patients and plastic surgeons. Ask any patient in the ‘90s who may have had both.  No question that silicone is softer and feels more like natural tissue.

Some of the most popular silicone gel implants are round in shape and have cohesive gel. This gives a natural result that nicely improves the breast size and shape. Older gel implants had liquid gel inside and if they ruptured could have gel migrate throughout the chest and breast. This is not true of implants currently on the market that are “cohesive.” They can literally be cut in half and remain solid.  Shaped, “form-stable,” or “anatomic” implants are a special kind of silicone implant that represent the latest innovation in implant technology. Commonly referred to as “gummy-bear” implants, they are a different kind of silicone implant that is called “highly cohesive” because the silicone maintains its shape within the shell of the implant more than its cohesive precursors. An examination of your body type and an informed discussion of your desired result will help you and your doctor make the decision of which type of silicone gel implant is right for you.

Our expert team will help you decide not only the appropriate volume, but also the perfect fit for your body to achieve your goals. As an added benefit to our CARE patients, we utilize the virtual-reality technology “Crisalix” to allow you to visualize the possibilities during your consultation.

  • Watch Video On Silicone Implants

  • Watch Video On Saline Implants

Why Do Implants Come In Different Textures

Implants also come with outer shells that are smooth or textured. Of course, textured implants do not feel textured after your surgery. Your breasts will still feel smooth and normal to the touch. Textured shells, however, can adhere more easily to the surrounding tissues and this is important if you have a shaped implant that must not rotate or it would appear crooked. This is less of a problem when the implant is round and there is no “crooked.” Drs. Coan and Zenn will discuss with you in-depth what would be best for your particular situation.

How Is Breast Augmentation Performed?

Breast augmentation is generally performed using deep IV sedation anesthesia. You are monitored thoroughly at the highest level of safety, and a local anesthetic is applied to the breast region and chest after you are fully sedated. You will not be awake and you will not have any recollection of the surgery. We have found this method allows for a more rapid and comfortable recovery. General anesthesia is available upon request. Most breast augmentations take about an hour. After some time in recovery, you can go home with assistance to rest the remainder of the day. You may shower 24 to 48 hours after surgery. You should plan to take a few days off work.

What Are the Incision Options for Breast Augmentation?

Most breast enhancement surgeries are done using one of two incisions:

  • Inframammary incisions are under the crease of the breast. This incision choice is preferred by the majority of patients. It is necessary if anatomic form stable implants are used in order to place the implants properly.
  • Periareolar incisions go part way or all the way around the areola (the darkened skin around the nipples). When the scar fades, it is well hidden in the transition between the areola and breast skin. This incision choice is best for the patient who requires areola reduction or nipple repositioning due to droopiness of the breast. This is common in mothers or women who have lost volume due to weight loss
  • Importantly, numbness of the nipple, which can be permanent in 5% of breast augmentation patients, is not related to the scar location as the nerves to the nipple come from underneath the breast.

Drs. Coan and Zenn will review these incision choices with you during your consultation and examination, and will guide you in making your decision.

Should Your Implant Be Placed Above or Below the Chest Muscle?

When the implants are placed directly below the breast, it is called subglandular or subfascial. When the implants are placed under the muscle, it is called submuscular or subpectoral.  There is no ideal location for an implant because it depends on your body shape, breast skin quality, amount of droopiness, and amount of breast tissue hiding your implant.  No worries.  Drs. Coan and Zenn will explain the difference in your particular case.

What Can You Expect During Recovery from Breast Augmentation?

In most cases, you can return to work and non-strenuous activities within two to three days after your surgery. You must wear a sports bra and sleep on your back for a few weeks.

You may feel sore for several days, but most patients are comfortable using only Motrin or other over–the-counter pain medicine by the third day. Most patients have no bruising, while some patients occasionally experience minor bruising for a short time. Initial swelling may take several weeks to fully resolve and complete resolution of swelling and settling of the implants will take a few months. The scars will gradually become smoother and lighter in color during the months following your surgery. Within a month, you will be able to resume vigorous exercise and lifting heavy objects.

Breast implants do not limit your ability to get routine mammograms as indicated by your age. They have not been shown to contribute to an increased risk of breast cancer, nor have they been shown to delay the diagnosis of breast cancer. We recommend that you perform self-exam regularly and get annual mammograms starting at age 40. Drs. Coan and Zenn may ask you get a screening mammogram prior to your surgery that may not be covered by your insurance.

What Are Capsular Contracture and Other Complications of Breast Augmentation?

While complications after breast augmentation are uncommon, it is important to be educated about the possibilities that may occur at some point in your lifetime. Capsular contracture,  rupture, or rippling of the implant can occur and may necessitate a breast implant revision procedure. Your CARE team will discuss the factors with you that can lead to these conditions. They will also discuss the techniques we utilize to minimize these possibilities.

Capsular contracture occurs when the normal scar tissue that forms around the implant (the capsule) becomes thickened or tightens. This can distort the shape of the breast and make it feel hard.  This has been associated with infections and bleeding around the time of surgery.

Rupture and leaking are easily detected if the implants are saline-filled, but they cannot be detected without a mammogram or MRI if the implants are silicone. Most cases of rupture are not symptomatic and are found incidentally on mammography.  Should that occur, we will discuss your options which may involve a surgery to replace the implants.

You have started your education about breast augmentation. The next step is to come to CARE!  More detailed information specific to you and your body will help you decide if breast augmentation is right for you.


Breast Augmentation Videos


Care Plastic Surgery is the only office in Cary offering 3D imaging technology by Crisalix. Discover how you can look after a cosmetic procedure or plastic surgery. 

Call CARE today at 919-484-4884 to make an appointment for your consultation. We are happy to answer any questions you have about breast augmentation.

Care Plastic Surgery 9:32 pm