A breast augmentation is a procedure in which either a silicone or saline implant, or a patient’s own fat, is used to augment the breast. This procedure usually takes anywhere from one to two hours to perform and is generally done under general anesthesia. Dr. Cabbabe, an expert breast augmentation surgeon, utilizes “Rapid Recovery” or “Flash recovery” techniques to minimize pain and downtime after surgery.

These involve using anti-inflammatories and local anesthetics around the time of surgery, careful surgical technique to minimize bleeding, and early range of motion after surgery to allow the fastest recovery possible.

What is Breast Augmentation?

A breast augmentation, also known as augmentation mammoplasty, is a surgical procedure that increases the size, changes the shape, or alters the texture of the breasts. This is typically done by placing breast implants under the breast tissue or chest muscles. The implants can be filled with either silicone gel or saline (sterile salt water). The procedure is commonly performed for cosmetic reasons, to reconstruct the breast after mastectomy or injury, or to correct genetic deformities.

Implant Placement

The implant can be placed through one of three different incisions: The incision can be around the areola, which is the pigmented area near the nipple, in the natural breast fold, or occasionally through the armpit. Under the breast is the most common location recommended unless a breast lift is also being performed.

When placing a larger implant, the breast crease may be intentionally lowered. This

allows the scar to sit in the new breast crease for the implant instead of on the lower half of the breast in the old breast crease. Placing the implants through the areola carries a higher risk of developing a capsular contracture, which can affect a woman’s ability to have a breast lift safely later. If a breast lift is done, the incisions used to make the breast lift will be utilized to insert the implant.

If fat is being injected, very small incisions are made, through which fat is injected after liposuction is done. Implants may be placed above or below the muscle. Implants placed above the muscle may carry a higher risk of capsular contracture, or encapsulation, than below the muscle. This risk is also higher in nicotine users or if a lift is being done.

For this reason, below the muscle has typically been recommended. Motiva implant company received FDA approval for their smooth implants in the U.S market in 2025. These implants have lower rates of capsular contracture above the muscle than prior U.S. implants] manufacturers, including Allergan, Mentor and Sientra.

Most implants placed in this manner are done in a “dual plane,” below the muscle in the upper half of the breast and the breast gland in the lower half. This allows the implant to sit more naturally under the muscle and breast with an ideal nipple position. Exceptions may include bodybuilders or patients not desiring implant movement with muscle tightening.

Dr. Cabbabe performs hundreds of implant surgeries each year and uses only FDA-approved breast implants. These come with various warranties in case of rupture/leaking or capsular contracture.

Types of Implants

The current choices for a breast implant are silicone and saline. A silicone implant has a silicone shell with silicone material inside, while a saline implant comprises a silicone shell with saline or salt water inside. Silicone implants are available as round or “shaped”/gummy bear implants.

Round implants may be smooth or textured, whereas shaped implants are always textured to prevent implant rotation. Allergan textured implants have been recalled due to concern for ALCL. The concern for ALCL is that the textured implant surface allows bacteria to adhere more easily. For this reason, Dr. Cabbabe typically only uses smooth round implants in his practice.

Newer round implants incorporate thicker/more cohesive silicone to provide better form stability in the breast, less rippling, and more upper pole fullness. Each implant choice is customized to a patient’s desire and Dr. Cabbabe’s aesthetic recommendation. In Dr. Cabbabe’s opinion, a silicone implant provides a more natural look and natural feel with less rippling and more upper pole fullness than a saline implant.

Current FDA recommendations state that women less than twenty-two (22) years of age should receive saline implants; otherwise, any woman can choose which implant they prefer. FDA recommendations are for MRI screening 2 years after augmentation then every 3 years thereafter.

This is to detect silent ruptures of the implant which may require further surgery. These are recommendations, not requirements, and Dr. Cabbabe will review his opinion on this

recommendation with you at the time of your consultation. Dr. Cabbabe utilizes ultrasound in the office to look for silicone implant rupture and recommends this every 2 – 3 years.

The expected life of an implant is approximately 15 years. If a saline implant ruptures, it will generally deflate the breast, and one would be able to tell immediately. This will require immediate attention due to asymmetry. Saline implants can be deflated in the office.

Implant Ruptures

If a silicone implant ruptures, the patient may not know, or they may feel a small bubble, some other contour change, or some local irritation or discomfort. An examination and ultrasound is normally done to determine likelihood of rupture. A rupture may produce a capsular contracture of the breast, resulting in a hard or misshapen breast.

Either way, it is recommended that the implants be replaced if ruptured and if the implants are

several years old, both implants will be replaced at the same time. We purchase our implants with lifetime warranties so that if this occurs, the company may pick up the cost for the implants themselves for the lifetime of the implants.

They may even give money towards surgical fees if this occurs in the first 10 years after placement. Implant companies now warranty for capsular contracture for the first 2 years. Each company carries different warranties.

Benefits of Breast Augmentation

This breast enhancement procedure can offer the following physical, psychological, and reconstructive benefits.

Physical Benefits Include:

• Enhanced breast size and shape
• Firming of breast
• Filling of upper half of deflated breast
• Improved body proportions
• Better fit in clothing
• Restoration of breast volume lost after pregnancy or weight loss
• Correction of asymmetrical breasts

Psychological Benefits Include:

• Increased self-confidence
• Improved self-image
• Enhanced body image
• Greater sense of femininity
• Better social confidence

Reconstructive Benefits Include:

• Breast restoration after mastectomy
• Correction of congenital defects
• Repair of breast tissue damage

Remember that the decision to undergo breast augmentation should be personal and

well-informed, with realistic expectations about the outcomes. 

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, Plavix, Coumadin, ibuprofen, or any other type of blood thinner before surgery. Patients should also hold any weight loss medications for up to 2 weeks prior. If you are older than 40, a mammogram within

one year before the procedure is recommended as part of regular health screening.

You will have an opportunity to “size,” try implants of various sizes inside a bra which will help you determine which size implant is best for you. Dr. Cabbabe may also measure your chest width and other distances to help you determine the best fit and shape for you.

Dr. Cabbabe may recommend a breast lift or mesh internal bra to help provide optimal shape and long term results and to minimize your chances of needing a revision. Dr. Cabbabe makes recommendations based on a patient’s desires and tissue characteristics. He is not a “one size fits all” surgeon and may recommend various types of implants to provide the best result possible.

Candidates

Anyone who desires breast enlargement is a good candidate for a breast augmentation

procedure. A breast lift may also be recommended if the breast is significantly ptotic or droopy. If a patient is large-breasted, a breast reduction may be done at the type of implant placement.

Dr. Cabbabe does not hesitate to recommend a breast lift for any patient with excess skin or droopiness of the breast. He feels strongly that doing a breast lift helps to reshape the breast, allows the implant to sit higher on the chest wall with a better shape, and positions the nipple-areola better over the implant.

If no lift is done, the implant will settle to the lowest point of the breast, and there will be no

upper pole fullness: the implant will start to fall into the armpits when lying down. These present challenging revision cases as new pockets must be made, and a lift will be needed. An unreasonable expectation would be to place a larger implant to avoid a breast lift.

This exacerbates the situation because the heavier implant will stretch the skin further and

accelerate the abovementioned changes.

Dr. Cabbabe also uses (absorbable) mesh liberally and has learned advanced techniques of breast augmentation and revision surgery through thousands of implant surgeries. Mesh may be recommended to reduce bottoming out or from displacement of the implants into the armpit area.

This allows the implants to sit in a higher and more natural position. Dr. Cabbabe has extensive experience with these products and feels they are safe even though many of their use may be “off-label.” If mesh is recommended a patient chooses to not use mesh, revisions may be needed with mesh at a later date for better shape.

Breast Augmentation Procedure

Breast augmentation surgery is done under general anesthesia and takes around one to

one-and-a-half hours to complete. Doing a breast lift adds an additional one to one – and a – a half hours or so. Using the “Rapid Recovery” or “Flash Recovery” Techniques, Dr. Cabbabe provides patients with anti-inflammatories, Gabapentin, long acting numbing medication and Tylenol to “block pain before it starts” before surgery.

During surgery, local anesthetics/numbing medicine is used in the skin and muscle to reduce pain after surgery. Generally, no drains are used, and massaging is recommended for most patients. Patients can shower the next day and go home in a bra. Use of anti-inflammatories is encouraged after surgery as the primary pain medication. Early range of motion is done with the arms. Patients will generally follow up within 1 day to 1 week and then approximately 3-4 weeks later and then in several months.

The implants will sit higher on the chest immediately after surgery and will then settle into the breast over the course of 3 months to 1 year. A bandeau may be provided to help accelerate the natural settling of the implants that occurs after surgery. Nipple sensation and the ability to lactate are usually preserved in these procedures. Women are able to get mammograms after surgery and implants do not interfere with breast cancer detection.

Dr. Cabbabe may recommend implant placement above or below the muscle. There is no one best option for everyone and every patient has unique characteristics and desires and Dr. Cabbabe excels at helping to meet and exceed patient expectations. Dr. Cabbabe will review the options, make a recommendation, and explain his rationale with you during your consultation.

Recovery

Recovery is approximately 1-2 weeks from a breast augmentation procedure depending on the size of the implant used and the type of work one does. Most women who have this procedure done will be up and about the next day, moving around. However, they may need pain medication occasionally, but most women state it was not as bad as they anticipated. Ibuprofen is the primary pain reliever, although narcotics may be prescribed.

Dr. Cabbabe strives to make the procedure as easy and comfortable as possible for his

patients. He does not believe in the use of pain pumps for breast augmentation because newer local anesthetics are long-acting and have eliminated the need for these pumps. Studies have shown mixed results with pain pumps: they are costly, and they can increase the risk of infections. He has removed breast implants on patients from other practices that use pain pumps due to infection.

Complications

The complications that can occur are implant infections, bleeding after surgery, capsular

contracture, and asymmetries. Infections are rare after augmentation alone and could require implant removal to treat. This is slightly more common in the scenario of a breast lift with implants.

Any significant bleeding requires additional surgery to remove the blood. Otherwise, capsular contractures may occur which may require additional surgery. Most women have some asymmetry to their breasts, and most of the time, the same-sized implant is used on both sides.

Occasionally, a different-size implant will be used if needed. More significant asymmetries need to be addressed through further incisions on the breast, such as a breast lift.

Capsular contracture is a known risk that can be reduced, but not eliminated, by placing the implant below the muscle. This will be discussed during your consultation as some of the newer implants (Motiva), may have lower rates of capsular contracture above the muscle.

Massaging helps reduce the risk of this occurring, and it is often recommended after surgery. Every implant eventually ruptures, and further surgery will be needed during its lifetime. For this reason, lifetime warranties are usually purchased; the implants will be replaced, but the patient may have additional surgical costs, depending on when the rupture occurs.

Rare Implant Complication: ALCL

There is a rare form of breast implant-associated lymphoma which all patients need to be aware of. This is believed to be related to bacteria/biofilm on the implants. It is now understood that most of these cases involve “textured” implants, with Allergan being the predominant implant associated with them. There are no cases when only smooth implants have been utilized.

As a result, Dr. Cabbabe rarely recommends the use of textured implants. Also, Allergan recalled all of their textured implants off the shelves in 2019. Allergan and the FDA do not recommend preventative implant replacement or capsulectomy because ALCL may still occur despite these measures.

ALCL becomes visible 5-10 years after surgery, most commonly with fluid collecting acutely around the implant. Although fluid can accumulate for non–cancerous reasons, fluid collecting around the implant may need to be tested for cancer cells before performing implant replacement surgery, particularly if it falls within this time range.

If ALCL is detected, implant removal and capsulectomy are recommended. If ALCL is caught early, this surgery may be curative. If it is caught late, an oncologist may recommend more aggressive treatment, such as chemotherapy or radiation. Dr. Cabbabe recommends routine follow-ups to examine the implants for abnormalities and to contact him immediately if any changes or concerns occur.

Breast Augmentation Cost

The cost of breast augmentation can vary depending on several factors, including the type of implants chosen (silicone or saline), the complexity of the procedure, anesthesia fees, and surgical facility costs. While a general range for breast augmentation in the St. Louis area is typically between $7,000 and $10,000, it is important to note that each patient’s needs and goals are unique, which may influence the final price. The use of mesh and higher quality implants will carry higher fees.

At Cabbabe Plastic Surgery, Dr. Cabbabe ensures complete transparency by discussing all

aspects of the procedure, including the total costs, during your initial consultation. This

A personalized approach allows patients to fully understand their options and make informed decisions based on their needs and desired outcomes. Financing options may also be available to assist in making the procedure more accessible.

Why Choose Dr. Cabbabe

Dr. Samer Cabbabe is regarded as one of the best plastic surgeons in St. Louis and the U.S.

As a double board-certified plastic surgeon, he is internationally recognized for his precise and advanced surgical techniques, especially in breast and body contouring. Dr. Cabbabe has performed thousands of breast implant surgeries and is a master of breast implant surgery, including complex revisions that many of his peers are not able to take on.

His techniques are not known by other plastic surgeons as they are self-taught through his extensive experience. Approximately half of his implant patients are revisions from other plastic surgeons. His approach ensures that each result is natural, balanced, and tailored to the individual patient. Dr. Cabbabe is a sought – after speaker at major plastic surgery societies, such as ASPS, ASAPS and ISAPS, where he shares his expertise with other surgeons and emphasizes patient safety and comfort, which remain his top priorities.

Moreover, patients worldwide travel to St. Louis to benefit from his unique skill set, and plastic surgeons regularly observe his practice to learn from his advanced methods. Beyond his technical abilities, Dr. Cabbabe is known for his friendly demeanor and personalized care, ensuring every patient feels supported and confident throughout their surgical journey. For those seeking a premier plastic surgery experience, his combination of expertise, artistry, and compassionate care makes him an exceptional choice.

FAQs: Breast Augmentation in St. Louis

Consult with Dr. Cabbabe Today

If you’re ready to enhance your confidence and achieve the look you’ve always desired, trust Dr. Cabbabe and his team to guide you through your breast augmentation procedure. Dr. Cabbabe has helped countless patients feel more comfortable and empowered in their bodies. Don’t wait to take the next step toward the transformation you deserve—schedule your consultation today to discuss your goals and explore the possibilities!