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Before & After

Many women feel dissatisfied with the size or shape of their breasts for a variety of reasons; some patients come to restore volume lost by pregnancy and lactation, others feel their breasts are not proportional or in balance with their body, have asymmetry, or need an improvement of shape. All of these issues can make it difficult for clothing to fit properly and can be detrimental to confidence self-esteem.

Breast Augmentation - sometimes referred to as a "breast aug" or "breast lift" by patients - is a very personal procedure that is only as obvious to others as a patient chooses it to be. The procedure involves using breast implants or fat transfer to improve the overall look and feel of your breasts. It can restore volume lost after weight loss or pregnancy, achieve a more rounded breast shape or improve natural breast size asymmetry. 


How it works

In minor sagging cases, an incision is made around the nipple, and the extra skin is tucked in toward the nipple. This procedure can do an excellent job of restoring breast contour by bringing the skin and breast tissue into youthful balance, but it cannot be used with extensive drooping, or a too-flat breast will be the result. The scar around the nipple will be visible only when the breast is completely exposed.

In more severe cases of sagging, it is necessary to extend the incision from the nipple to the under-breast fold to deal with the extra skin. A vertical incision from the nipple to the fold removes and tucks breast tissue and skin. The scar will heal very well and be inconspicuous.


Internal breast sutures do an excellent job of creating a youthful, self-supporting breast shape, so there is no tension on the skin surface to cause the scar to widen.

Even in more severe cases, a small horizontal extension of the incision into the fold under the breast will not be visible in most types of bathing attire. The freedom from fill-in foam or push-up bras is well worth the effort. The secret in correcting more advanced cases of drooping is the sophisticated suturing inside the breast tissue, which replaces the support lost when collagen bands stretch out with age. A small saline implant under a lift may be used which will not be visible and is almost impossible to feel in order to maintain cleavage even in bra-less situations.

Saline, Silicone or Gummy Implants?

Breast implants can be filled with either saline or silicone, however saline implants are used less often than silicone nowadays. Silicone implants are considered to be softer, feel more natural, look less round, weigh less, and perhaps last longer. In the past, there were just two types of silicone implants - regular round silicone implants and gummy bear teardrop implants. Nowadays there exists a wide array of “gumminess” in both round and teardrop implants. Round silicone breast implants vary from the very softest and squishiest to the firmest and most ripple resistant. Teardrop implants are now available in less cohesive and softer versions, in addition to the traditional teardrop implants, which though firmer, hold their shape better.

How is the size chosen?

Making sure that your implant procedure will make your breasts big enough – but not too big – is probably one of the most common concerns. Dr. Romita will use every available method to help you envision your outcome, and provide his recommendation on what will look the most natural and appropriate for your unique body type and breast profile, so there will be no surprises after your surgery


How long will it take?

Most breast augmentation procedures take at least one to two hours and potentially 1-2 hours longer if a breast lifting is also being performed.



In advance of your procedure, Dr. Romita may ask you to:

  • Stop smoking at least six weeks before undergoing cosmetic surgery to better promote healing.

  • Avoid taking aspirin and certain anti-inflammatory drugs that can increase bleeding.

  • Drink lots of water; hydration is very important before and after surgery for an enhanced and safe recovery.

  • Patients with a history of cysts may be required to have a mammography.

  • Get a physical and a chest x-ray with your Primary Care Doctor.

  • Patients should not be obese.


After your breast augmentation procedure, you should be able to walk without assistance immediately after surgery, and it is very important that you walk a few minutes every few hours to reduce the risk of blood clot formation in your legs.

You will be placed in a post-surgical dressing garment that includes a support bra that must be worn for at least five days following the surgery. Underwire bras should not be worn for an additional six to eight weeks. Sutures will dissolve naturally.


Breast augmentation surgery stretches the breast tissue and can be painful—especially when implants have been placed under the chest muscle. Typically, the most pain is experienced within the first 48 hours after surgery. Your level of pain will typically decrease each day and can be effectively treated with various pain medications. Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy. You may experience difficulty raising your arms. Your implants may sit higher on your chest, but they will settle into place within a few weeks. Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month. 


When you will feel ready to return back to work is highly individualized. Some patients are able to be back to work after three or four days, others may need a week or more, but most are able to work from home the very next day. As long as your work doesn’t involve straining and heavy lifting, you are encouraged to listen to your body and return to work as soon as you feel you are able. 


Avoid picking up children, heavy objects, and any strenuous arm lifting or sports, like tennis or golf, for four weeks. Always wear some type of support garment when you are active.


Under normal circumstances, the results of your breast augmentation surgery will be long-lasting, however, it’s important to know that breast implants may need to be replaced at some point. Routine follow-up with your surgeon is important. Fat transfer surgery has different expectations, including losing some volume over time. 

Your breasts augmentation can also change due to:

  • Childbirth

  • Aging

  • Weight gain or loss

  • Hormonal factors

  • Gravity

Click photo to enlarge

Why Dr. Romita chooses Sientra  Implants:

Only Sientra implants are available exclusively through board-certified plastic surgeons who are required to complete 14 years of formalized training and experience. You can trust if a surgeon offers Sientra, they are board-certified. Because Sientra believes in the safety and performance of their implants, they offer the industry’s best warranty. Sientra’s Platinum20™ Product Replacement and Limited Warranty Program provides the most comprehensive protection, longest length of coverage, most financial assistance, and least amount of warranty restrictions amongst all implant brands.


Breast Augmentation Procedure 

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