Who Is A Candidate For Breast Augmentation?

Our breast augmentation in Seattle surgery is for:

  • Women who desire larger, firmer, or fuller breasts
  • Women who have a moderate sagging of the breasts, which can be resolved by adding volume rather than by lifting the skin of the chest
  • Women who have lost the firm fullness in breast tissue after pregnancy, breastfeeding, or significant fluctuations in weight
  • Women who have breast asymmetry (one breast that is noticeably larger or smaller than the other)

Intended Results

With our breast augmentation in Bellevue surgery, you will have larger, shapelier breasts.

The goal is to deliver more attractive proportions for breasts and body.

Breast augmentation before & after

Implant Selection

Dr. Egrari uses the most advanced surgical procedures and an artistic method to recommend a custom-selected size and shape of the latest generation of breast implants in Seattle in saline or silicone for a perfect balance with your natural build.

Vectra® 3D imaging allows you to see a digital simulation of the implant sizes suggested by Dr. Egrari.

Implant profile and size is determined by your body proportions, including diameter of chest, weight, height, and the level of enhancement you envision.

We offer a variety of the most advanced breast implants in Bellevue — in all styles and dimensions for an individualized breast enhancement, including cohesive (gummy bear) implants. We also offer the IDEAL Implant, an innovative saline implant with a significantly improved feel and look.

Dr. Egrari employs a unique method of intra-operative sizing to evaluate the patient and to give her the most appropriate size and shape of breasts.

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Breast Augmentation Procedure Description

The procedure is done on an outpatient basis under general anesthesia at our Bellevue, WA facility. A small incision is made under the breasts, under the nipple, or under the armpit (endoscopic approach). A saline or silicone implant is then inserted under the breast tissue, or more commonly under the breast tissue and the underlying muscles. The most common incision over the past few years has become the inframammary incision (under the breast). Dr. Egrari uses the Keller Funnel™ to simplify the insertion of the implant. This serves to protect the implant from affecting the surface of your skin. Click here to watch how the Keller Funnel is used.

Click here to watch a video of how our team at The Egrari Plastic Surgery Center performs arguably the best breast augmentation Seattle has to offer.


No Touch Technique | Egrari Plastic Surgery Center

Breast Augmentation Surgery | Egrari Plastic Surgery Center

Recuperation And Healing After Breast Augmentation

You will return home wearing a surgical bra. It provides comfort and support for your new breasts while simultaneously holding the new implants in a secure position during the healing process. Initial discomfort can be controlled with medication. We feel that our meticulous “no touch” technique creates a more comfortable post-operative experience. Most patients take off one week from work. For great results from the best breast augmentation Seattle has to offer, aerobic activities must wait for about four weeks.

Light activities can be resumed as tolerated, but limit any motions that put stress on the upper chest area, including lifting or stretching.

Patients can opt for EXPAREL®, a long-acting injectable pain reliever. We call this procedure an “ouchless” breast augmentation. Generally, no sutures are used on the outer skin. The sutures placed beneath the skin are dissolvable.

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Other Procedures With Breast Augmentation

An additional procedure may be necessary. Our Bellevue breast augmentation surgeon, Dr. Egrari, can restore sagging breasts with a procedure called a mastopexy (breast lift).

After pregnancy, breastfeeding or dramatic weight loss can cause drooping of the breasts (ptosis). This condition cannot be resolved with the placement of implants; rather, it must be combined with a breast lift to create the firm, high, plump look associated with youthful breasts.

Fat injection into the breasts (fat transfer breast augmentation) has gained significant popularity. Not every patient is a candidate for this, and most of the time if a breast lift is needed as well. Fat injection cannot be done at the same time, except for certain candidates. There is a unique breast shape that might be amenable to a lift and fat injection at the same time. Fat injection is not for an individual who wants significant volume. Instead, it’s ideal for patients with youthful breasts and available fat who want a more subtle enhancement.

We continue to educate our patients about their choices and about the safety of implants. For more information, visit: http://www.breastimplantsafety.org.

The American Society of Plastic Surgeons offers additional information on breast augmentation at www.plasticsurgery.org/.

Before & After


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Breast AugmentationFAQs

What are the incision options for breast augmentation?

What are the implant placement options?

What implants does Dr. Egrari use?

Is it possible to inject fat for breast augmentation?

Will I have cleavage? Can my breast be placed higher on my chest?

What is the recovery like? When can I start exercising?

What is the "no touch technique"?

How painful is breast augmentation?

What are the most common complications of breast augmentation?

What is Dr. Egrari’s philosophy on breast augmentation?

How do I make sure that I get the size that I want?

What are the incision options for breast augmentation?

There are three main types of incisions used in our Bellevue breast augmentation procedure. Inframammary (under the fold of breast), peri-areolar (around areola), and trans-axillary (through armpit). All three are possible, but the latest research and our own personal experience has taught us that the inframammary incision is the safest and produces the least scarring. The TUBA technique (through the navel) is a highly controversial technique that is effectively shunned by most qualified plastic surgeons. It has also lost its popularity due to some dismal complications.

What are the implant placement options?

The general options for placement include subpectoral (under the muscle), and subglandular (above the muscle). There is slight variation in how these placements are used based upon the unique physiology of the patient. The subpectoral placement is partially beneath the chest muscle. The subglandular technique can be performed using the subfascial technique, a recent development in breast augmentation surgery. The most popular technique is subpectoral, in which the implants are placed beneath the muscle. We believe there are at least five powerful advantages of this surgical technique:

  • Looks better
  • Feels better
  • Less chance of capsular contracture (the most common complication of breast augmentation)
  • Less chance of infection
  • Mammograms are more accurate

The only disadvantage of breast implant placement with muscular coverage is that for some patients, the new breast may appear temporarily misshapen when the chest muscle is flexed. Most patients do not find this effect troublesome.

What implants does Dr. Egrari use?

Dr. Egrari has access to the three FDA-approved lines of implants: Allergan Natrelle®, Mentor®, and Sientra®. Dr. Egrari is one of the largest users of implants in the United States and finds the Allergan Natrelle line of implants to be of highest quality. He is partial to this brand, as the metrics, profiles, and the type of cohesivity that they have is second to none. The implants are either saline or silicone. Almost 98% of the breast implant procedures involve silicone implants due to the natural feel and weight. With five different profiles and many sizes, these implants can be custom-tailored to create the most natural look and feel. Gummy bear implants are created out of a more cohesive gel, more form-stable, and are known for keeping their shape due to the thicker quality of silicone gel. Recently we have introduced the IDEAL Implant®, an innovative saline implant with very good feel and look. What’s right for you? The first step is an initial consultation in which all options will be fully explained to you. During this meeting, you will have the opportunity to see how the various sizes and shapes will appear on our digital imaging system.

Is it possible to inject fat for breast augmentation?

Autologous fat transfer (AFT) has become a popular treatment in plastic surgery and over the past decade, there has been a renewed interest in AFT in breast augmentation. This procedure may be appropriate for a select group of patients who have excess fatty deposits from which fat can be extracted, and who do not want a significant increase in breast size.

Will I have cleavage? Can my breast be placed higher on my chest?

One of the most important concepts that must be clearly explained is “footplate”. All patients have a pre-determined footplate. This is where the breasts are located on the chest wall, and its placement is the result of genetics — although it can be impacted by loss of flexibility, strength of aging skin, or weight loss. If a patient has a low footplate, she will have low breasts after breast augmentation; therefore, a breast lift may be needed to produce the look wanted. A wide cleavage due to a wider breast position may not create a tight cleavage line. All of these issues will be discussed during your consultation so that you can get the look you envision, including cleavage appearance.

What is the recovery like? When can I start exercising?

Plan to take at least one week off work and social activities. During this time you will not be bedridden — but you should allow yourself to rest, relax, and heal. Most of our patients return to work after one week and are ready to operate a vehicle again at this time. We recommend avoiding exercise and other vigorous activities for two weeks. At four weeks, you can return to an exercise program that is less strenuous, slowly increasing your actions. Always listen to your body. After six weeks you should be fully healed and can return to all your normal activities, including vigorous exercise, hiking, running, biking, yoga, and other activities.

What is the "no touch technique"?

The no touch technique is a series of surgical techniques designed to reduce trauma to the tissue and reduce the risk of contamination of implants. We strongly feel that contamination of the implants is a likely reason for hardening of the shell around the implant — a condition known as capsular contracture. Dr. Egrari uses the latest and most innovative techniques, including the no touch techniques. These techniques include:

  • The actual implants are never used to choose size. Instead, Dr. Egrari uses specific implants to determine the proper size that are dedicated solely for that purpose.
  • The pockets are irrigated with three different antibiotic solutions.
  • The dissection is done essentially “bloodless”.
  • Drains are not necessary.
  • Perhaps one of the most important components of the no touch technique is the use of the Keller Funnel®, which allows for a rapid, accurate, and non-contaminating technique for placement of implants in the pocket created in the procedure.

The combination of these surgical techniques makes the procedure safer, cleaner, and far less prone to contamination in placing implants. Patient safety is always a priority for Dr. Egrari.

How painful is breast augmentation?

Our tremendous knowledge in using meticulous surgical techniques, our rapid operating time, and our extensive experience have made breast augmentation a fast and comfortable operation. Most patients require only two to three days in which they need pain medication, and many patients use only over-the-counter products or none at all. Today, we also offer Exparel, a long-acting medication that blocks pain with up to 72 hours of comfort. Recently there have been some claims of “rapid recovery breast augmentation”. Be careful with such frivolous claims. This is a real operation with real recovery. All qualified plastic surgeons try hard to use techniques to improve the recovery. Unfortunately, some are using the suboptimal above the muscle (subglandular) technique to expedite recovery. Dr. Egrari believes this is a compromise in long-term outcome just to have one to two days of recovery.

What are the most common complications of breast augmentation?

Capsular contracture, asymmetry, wrinkling and rippling, deflation, dissatisfaction with size, nipple insensitivity, under-breast insensitivity, and the common risks of anesthetic are all theoretically possible. However, all of these are rare and some almost nonexistent. The two that are worth further discussion are capsular contracture and the commitment a patient makes to a specific size or shape, which they sometimes later feel is unsatisfactory (too large or too small).

What is Dr. Egrari’s philosophy on breast augmentation?

Dr. Egrari’s philosophy is based on body size, and shape, and the artistry in achieving the ideal proportion. He does not feel that extremely large implants are a good decision, as they tend to look fake. He feels that by using the artistic eye he has developed over almost a quarter of century of practice, he can help guide his patients to the most beautiful final look. Beauty is proportion, and proportion is beauty. Never is this so true as it is with breast augmentation.

How do I make sure that I get the size that I want?

Dr. Egrari spends a considerable amount of time talking to patients about the mathematical dimensions their unique body. He has an artistic sensibility that can only be developed through experience and natural talent. He will guide you to the size and shape that will create the most beautiful outcome for you. He listens closely to your vision and helps you discover the most effective size and shape for your body contour. His digital Vectra visualization system makes it possible for you to see how the implants will look. This is a significant advantage. He reserves the right to adjust size in the operating room. The entire procedure is performed with the utmost of professionalism and a process that aids in ensuring you get the perfectly sized, even, and natural-looking breasts you want.

Breast Implant Safety

We are always in search of information and safety, and we want our patients to do the same. This link will provide some frequently asked questions about BIA-ALCL (breast implant associated anaplastic large cell lymphoma) and BII (breast implant associated illness). We know that there has been a lot of news and hype about this, so we wanted to make sure that we convey to you the latest. Our objective is always guided by science.

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