Breast Augmentation in Fredericksburg, VA

Breast augmentation is the most commonly performed cosmetic surgery, helping women achieve fuller, shapelier breasts to enhance their appearance. At Surgical Arts of Virginia, we offer breast augmentation and other breast surgeries to women living in Washington DC, Fredericksburg, Stafford, Richmond, Charlottesville, and the surrounding communities of Virginia. 

What is Breast Augmentation?

Breast augmentation refers to breast implant placement. Breast enhancements are popular among women because the surgery allows for changes to breast shape and size via breast implants. Modern implants are of better quality and are safer than previous generation implants.

What Kind Of Implant Are Available?

Surgical Arts of Virginia offers MENTOR® saline-filled smooth round breast implants and new cohesive gel smooth round implants for breast augmentation.

How Are Breast Implants Chosen?

There are several different breast implant variables.

  1. Size of the implants: diameter and projection resulting in a volume
  2. Shape of the implants: round or anatomical
  3. Texture of the implants: smooth or textured
  4. Composition of the implants: saline or silicone gel

Dr. Palmer uses both silicone gel and saline-filled implants. Silicone is a more natural feeling product, but is more expensive. Saline is significantly cheaper, but tends to be more easily felt when touching the breasts, especially in women who are thinner or begin with small breasts. There are other pros and cons for each that will be discussed during consultation. Dr. Palmer has obtained excellent results using smooth round implants, avoiding the risks associated with other types of implants.

Surgeons use their own individual criteria to select implant size, making this an important topic for discussion. Patients tend to come to the consultation with a volume in mind without understanding the parameters that are used to select an appropriate volume for a particular body size that will then equate to the final cup size the patient desires to obtain. Dr. Palmer has been very successful meeting patient expectations by using two key patient parameters: breast diameter and nipple to fold distance. With these measurements the implant diameter is selected. Once the patient specific implant diameter is selected it is matched with Mentor’s available projections (low, medium, high, or extra-high profile) such that the patient’s cup size expectation is met. Dr Palmer uses Mentor’s smooth round saline-filled or smooth round silicone gel implants.

View Breast Augmentation Before and After Photos

How is a Breast Augmentation Performed?

Like most surgical procedures, breast implantation can be accomplished in a variety of ways, some of which are patient specific and some which are surgeon specific. Breast implant position placement is an important decision for your surgeon. Breast implants are placed either beneath the breast gland (subglandular), beneath the muscle (submuscular), or both (dual plane). Dr. Palmer has found that most patients are best served with a dual plane placement. This positions the implant beneath the pectoralis muscle superiorly and the breast gland inferiorly, hence dual plane. This has the advantage of providing adequate coverage by soft tissue above such that a gentle curve to the breast in obtained in the superior pole, while, at the same time, letting the implant settle into the natural inframammory fold, avoiding a “high riding” implant. Dual plane implants also have a much lower incidence of “bottoming out” over time (implant migration towards the abdomen) than implants placed beneath the gland alone. There are other pros and cons of placement to be considered that will be discussed during consultation.

Another decision for the patient is skin incision site. Most commonly, skin incisions are placed at the junction of the darker areola skin with the lighter colored breast skin (periareolar incision) or at the inframammary fold (inframammary incision). Dr. Palmer prefers the periareolar skin incision because it is well camouflaged, has a low incidence of implant migration, and is almost imperceptible when healed. The inframammary incision site is also very common and is acceptable to most patients.

What type of Anesthesia is used for Breast Augmentation?

Dr. Palmer performs breast implantation surgery in our office surgical suite using conscious sedation and tumescent local anesthesia. Advantages include patient convenience, avoidance of general anesthesia risks, lower cost, easier recovery, and excellent tolerance. The patient is fully monitored throughout surgery by Dr. Palmer’s registered nurse who is qualified and experienced with these type of procedures. This is the anesthesia most used in our office and we are proud of our 100% safety track record since its inception in 2008. No patient has ever required transfer to a hospital, although this is an option if an anesthesia complication were to be encountered.

What is Recovery Like After Breast Augmentation?

You will awaken with adhesives on your incisions and wearing a support bra. Once you have met discharge criteria, we will will once again discuss postoperative instructions with you and your caregiver. You will need a driver to take you home and a caregiver with you for at least the first 24 hours. We like to see patients in follow up on the first post-operative day for safety reasons and you will need a driver for this as well. The first week involves significant discomfort for many, especially with manipulation of the pectoralis muscle, so you should expect to need your pain medication (hydrocodone and/or Toradol) for the first few days. You will also be asked to take an antibiotic for 5 days afterward. Wound care should be minimal, but you will need to be restrictive in your activity level to prevent increases in heart rate and blood pressure for the first week to prevent bleeding around the implants. Much of the discomfort and swelling will have resolved by the end of the first week, but experience has shown this to be quite variable between patients despite similar procedures. Larger implants are associated with more and longer discomfort. Full activity can be resumed in four weeks.

Dr. Palmer likes to follow patients out to at least one year to allow final results to be adequately assessed. We are available 24/7 via text or phone to answer questions and address postoperative concerns.

Are There Any Risks Involved with Breast Augmentation?

All surgery carries risk, but you can take steps to minimize the chances of experiencing complications resulting from your breast augmentation. The most important aspect is to work with a board-certified surgeon who is experienced with breast augmentation, including more complex cases, such as tuberous breast surgery and revision breast surgery. It is also important to understand and follow all postoperative instructions, especially limiting your activity in the first week.

Capsular contracture used to be a common complication that could occur any time after the procedure. Newer implant design and placement techniques have greatly decreased the incidence of capsular contracture, but if it develops it requires revisional surgery to correct.

Recently, implant placement has been associated with anaplastic large cell carcinoma. It is exceedingly rare and associated with textured implants that Dr. Palmer does not use, however patients should be aware of it. If it were to develop it is cured by implant and implant capsule removal. We have never seen this complication in our practice. Other possible complications such as hematoma, infection, wound break down, or malposition are very rare in our practice. If complications should arise, Dr. Palmer is qualified and experienced in their care. There is no additional fee for follow up care.

When Are Breast Implants Combined with a Breast Lift?

A breast lift with an implant is known as an augmentation mammoplasty. If a patient has significant breast sagging, then a breast implant alone will not result in an aesthetic breast. Mild sagging, however, can sometimes be addressed with an implant of proper size placed in a dual plane position. After Dr. Palmer examines the breasts and discusses with the patient the result they would like to obtain, he can make a recommendation that is most likely to result in aesthetic appearing breasts for that particular individual.

View Breast Augmentation Before and After Photos

What is the Cost of Breast Augmentation?

Breast augmentation starts at $4,840 for saline and $6,490 for silicone gel implants. There are no additional facility fees because we perform the procedure in our office surgical suite. Conscious sedation anesthesia used for breast implant placement is $900. We also recommend that you purchase silicone wound adhesives (Silagen) to diminish scar visibility. Follow up care is included in the surgical fee.

If breast implants alone will not result in an aesthetic breast and you need additional procedures concurrently to reach this goal (such as a breast lift), then this will be explained up front and included in your personalized itemized fee breakdown. The fee quoted at consultation for the surgery is the total fee and there will be no additional fees after the operation is completed.
You can pay for your breast enhancement with cash, personal check, money order, or credit card. If you would like to make payments, our financing options are CareCredit®, United Medical Credit and Prosper™ Healthcare Lending.

How Are Breast Implants Used In Tuberous Breast Surgery?

Tuberous breasts are breasts in which the lower pole (the portion below the nipple and areola) has developed poorly or abnormally. There is constricting tissue present that has prevented expansion of the lower pole of the breast and shifted the nipple towards the midline, or center of the chest. Often, there is associated herniation (protrusion) of the nipple areola complex.

To address tuberous breasts, Dr. Palmer surgically releases the constricting tissue in the lower pole and places an implant in the dual plane position (partially below the pectoralis muscle) so that the implant acts as a tissue expander. There is often some residual constriction where the old inframammary fold was, but this improves over time secondary to the implant stretching the skin. The herniation of the nipple often needs to be corrected at the same time. To visualize the tuberous before and after results, take a look at some of our Tuberous Breast patients here.


The decision to undergo breast augmentation is a big one, and the staff at Surgical Arts of Virginia and Dr. Palmer are here to help you every step of the way. To learn more about the procedure or to schedule a complimentary consultation, contact us today. We welcome patients from Fredericksburg, Charlottesville, Richmond and Stafford, VA, as well as Washington DC and the surrounding Virginia communities.