BREAST IMPLANTS Procedure Pictures

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For many women, breast size and fullness is an important part of their self-confidence and femininity. If you have always wanted larger breasts, or if life changes such as aging, pregnancy, or weight loss have reduced your size, a breast augmentation procedure can help. Dr. Matthew Steele can give you a full, feminine, proportional, and natural looking enhancement with breast augmentation surgery.

If you are ready to learn more about how breast augmentation can improve your look, request a consultation online with Dr. Steele, or call my office at 712-224-8677. He serves patients in Sioux City, IA and surrounding communities and he welcomes patients who wish to travel from Sioux Falls, SD and Omaha, NE.

Benefits of Breast Augmentation:

Every woman has her own personal reasons for pursuing breast enhancement surgery. These reasons typically include:

  • Restoring breast volume after pregnancy or weight loss
  • Increasing the size of naturally small breasts
  • Balancing the size of uneven breasts
  • Enhancing self-esteem and femininity

Dr. Steele takes great pride in helping his breast augmentation patients achieve their desired aesthetic goals and an improved self esteem. He provides an unhurried, comfortable setting for your initial breast augmentation consultation in which you can talk openly about your body and feel comfortable asking questions. Dr. Steele takes the time to understand your goals and help you develop realistic expectations for your results.


Your Unique Enhancement:

During your consultation, Dr. Steele will guide you through your breast implant options and surgical techniques to help determine the right combination for you. These decisions will include:

Implant Type:

Saline vs. Silicone

Saline implants are filled with sterile saltwater solution. These implants may be appealing to some patients because they are cheaper than silicone implants and can be placed through a smaller incision. Disadvantages include increased firmness and more visible wrinkling/rippling compared to silicone implants. Silicone gel implants are very popular due to their more natural look and feel. Modern silicone gel implants are very safe and are filled with a sticky silicone gel (cohesive gel) that will not migrate even if the surface (shell) of the implant is cracked or ruptured. The FDA recommends the cosmetic use of silicone gel implants in patients over the age of 22 and recommends periodic MRI screening to rule out silent implant rupture (rare). Silicone gel implants require a slightly longer incision compared to saline and are more expensive. There is no perfect implant for every woman, and Dr. Steele will help you make the best implant decision for you based on your anatomy, personal preferences, and desired goals.

Implant Size:

This decision is highly personal and should be based on your underlying anatomy, as well as your desired goals. It is important to pick an implant that is proportional to your body, while delivering a size that is comfortable for you. Implants that are too small, will not deliver a proportional result, while implants that are too large can cause complications and accelerated breast sagging. During your consultation, you will the opportunity to try on breast sizers to help you decide the optimal implant size for you.

Implant Location:

Over or under the muscle

Submuscular (under the muscle) implant placement is the more commonly used location for both saline and silicone gel implants. This location tends to produce a more natural result with less risk of implant visibility. Recent studies have also confirmed that submuscular placement decreases the risk of capsular contracture, a complication in which excess scar tissue tightens around the implant. Recovery time is longer with submuscular placement due to the muscular incision, which can increase muscle spasm and tightness. This location is especially recommended for very thin patients with little breast tissue. Subglandular (over the muscle) implant placement may be used in certain situations. These include replacement augmentation in patients with existing subglandular implants, patients with borderline sagging (ptosis) in which a breast lift can be avoided with subglandular implants, and patients with adequate breast tissue who request a more augmented, fuller look. Subglandular placement results in a quicker recovery, but the implants may be more visible and may look less natural.

Incision location: The inframammary incision (under the breast) is the most commonly used incision by Dr. Steele. A small incision is made in the breast crease on the underside of the breast. It heals very well, and is not visible when looking at the chest. This incision allows for the best access to the breast/chest anatomy and allows for optimal implant placement. Additionally, there is a lower rate of breast encapsulation (hardening of the breast implant) with this incision location.
The peri-areolar incision is made along the bottom half of the areola. This incision allows direct access to the chest wall and can be useful in patients with an indistinct breast crease, patients with tuberous breasts, and patients undergoing a circum-areolar breast lift. When performed properly, the incision generally heals well, but is still visible when looking directly at the breast. There is also evidence to suggest that this technique increases the risk of capsule contracture.



Most patients can get back to an office job within 2-3 days. We advise patients to avoid strenuous activity that increases blood pressure or heart rate for 3-4 weeks, at which time it is safe to resume cardio exercise. No lifting more than 15 lbs. is advised for the first 6 weeks. In submuscular implants, no pectoral (chest) muscle exercise are advised for at least 8 weeks to minimize the risk of implant displacement. Patients are able to drive as soon as they are no longer taking any sedative medications (pain pills and muscle relaxants).


Dr. Steele is frequently asked many similar questions from patients considering breast augmentation in the Siouxland area.

Common Questions:

How much does breast augmentation cost?

Few cosmetic procedures have set price tags. That’s because each procedure is customized to each patient and may be affected by implant type and need for other procedures. A typical price for straightforward breast augmentation will range between $4000-$5200. During your consultation, you will be given a quote that reflects your specific surgery.

Are silicone implants safe?

Patients sometimes ask about the safety of silicone gel implants due to lingering concerns generated by poor, biased reporting in the early 1990’s. Silicone gel breast implants are the most studied medical device in history, and the FDA has repeatedly confirmed their safety. There has never been evidence linking silicone gel to cancer, autoimmune diseases (like lupus), or any other illness. Our practice uses silicone gel implants almost exclusively for cosmetic augmentation and universally in breast reconstruction patients after mastectomy.

What is the difference between silicone and saline implants?

Both are FDA approved for use in breast augmentation.

  • Both add volume to the breast
  • Both are available in various sizes, shapes, and textures
  • Both have a silicone shell
  • Surgical risks are similar


Saline implants

  • Cost less
  • Tend to be more firm, palpable
  • Have more visible rippling/wrinkling, especially in thin patients
  • Rupture is easy to identify (the saline is absorbed and the breast looks flat/smaller)

Silicone implants

  • Cost more
  • Feel more natural
  • Have less rippling/wrinkling
  • FDA label suggests use in patients 22 and older (although they are safe in younger patients)
  • FDA label recommends periodic MRI exams to check for implant rupture (rare)

How will I decide what implant size will give me the desired result?

Patients often focus on cup size when determining their desired result. However, breast implants are not sized by bra cup size. A breast implant with a given volume may give one woman a C cup and another woman a DD cup. This is because the final cup size depends on the starting breast volume, the implant size, and where the patient buys her bras. We encourage patients not to focus too much on a certain bra size, but rather look at the volume and the proportionate increase in size. Dr. Steele will take various breast measurements and have you try on breast implant sizers in the office to help determine the appropriate implant volume for each individual patient. Another good way to help pick an implant is to review your surgeon’s former cases and find patients with a similar height, weight, and preoperative breast size.

What is breast implant projection?

Breast implant projection is how far the implant sticks out from the body. Women tend naturally to choose an implant volume that is in proportion with body size and breast diameter. In a high profile implant, the volume is the same, but the diameter is narrower and the projection is greater. If the diameter of the implant size you select is about the same or smaller than your measured breast diameter, then a standard implant is appropriate. If the diameter of the desired breast implant is larger than your breast diameter, then you should consider high profile breast implants.

Will I have scars after breast augmentation?

Yes. All incisions leave scars. Plastic surgeons are especially trained to leave scars that heal very well and are almost imperceptible after one year. Additionally, Dr. Steele uses the Keller Funnel™ to insert his breast implants, allowing him to make a smaller incision during breast implant surgery.

How long is the surgery?

Typical breast implant surgery through an inframammary incision lasts between 45-75 minutes. The time variations are due to differences in patient size and anatomy.

What type of anesthesia is used during breast augmentation?

We recommend the use of general anesthesia when performing breast augmentation. This allows for greater patient comfort and allows the anesthesiologist to give a muscle relaxant which paralyzes the chest muscles making implant placement easier and reduces bleeding from the muscle. At the time of surgery, long lasting local anesthetic is placed along the chest wall and in the breast tissues to help with postoperative pain relief.

Can other procedures be performed simultaneously?

Absolutely. We often combine breast augmentation with body contouring procedures such as liposuction or a tummy tuck during a Mommy Makeover procedure. Facial procedures can sometimes be combined with a breast augmentation as well.

How long is the recovery?

Most patients can get back to an office job within 2-3 days. We advise patients to avoid strenuous activity that increases blood pressure or heart rate for 3-4 weeks, at which time it is safe to resume cardio exercise. No lifting more than 15 lbs. is advised for the first 6 weeks. In submuscular implants, no pectoral (chest) muscle exercise are advised for at least 8 weeks to minimize the risk of implant displacement. Patients are able to drive as soon as they are no longer taking any sedative medications (pain pills and muscle relaxants).

Can I still breastfeed after breast augmentation?

Yes. Most patients can still breastfeed without any difficulty after breast augmentation, even when placed on top of the muscle. This is because the breast ducts connected to the nipple are not disturbed with routine breast augmentation. Some patients will have difficulty, however, after breast reduction or a breast lift (mastopexy) procedure.

Should I have a breast augmentation or breast lift? Or both?

Breast implant surgery will improve breast size and fullness, but will not correct breast sagging (ptosis). Breast implants will provide a slight elevation of the breasts and may be enough in patients with borderline breast ptosis. Patients who have significant breast sagging with loose skin, who also desire enhanced upper pole fullness, are great candidates for a breast lift with implants.

Will breast implants affect nipple sensation?

It is normal to have some altered nipple sensation for a temporary period after surgery. This is because the many nerves that run through the breast tissue are under significant stretch due to the volume of the implant and associated swelling caused by surgery. Some patients report increased sensitivity, while others note some level of numbness. These sensations will generally resolve by 2-4 months after surgery. It is quite rare to have permanent numbness after surgery.

How soon after child birth can I have implants?

The answer will actually depend on whether you are breast feeding or not. We generally recommend waiting 3-6 months after lactation has ceased. This will allow the breast to recover and finish shrinking back to their normal size.

Will smoking affect my surgery?

In addition to risks of cancer and heart disease, smoking can impair wound healing and increase your risk of infections. Smoking causes the blood vessels in skin to constrict down, thus reducing the blood flow. This can result in wounds that are slow to heal and scars that are wider and more visible. Additionally, chronic smoking will accelerate skin aging and loss of elasticity; which explains why smokers look much older than their age. For the breast tissue, this can result in more sagging and drooping with the implants “bottoming out.” It is best to stop smoking 4 weeks before and after surgery for optimal healing.

What about mammograms?

Implants placed above and below will block a small portion of the breast from being visualized on a mammogram. Placing the implant below the muscle will increase the amount of breast tissue visualized. With modern ultrasound and MRI technology, this is much less of an issue, but still a concern for many women. Patients over the age of 40 are usually advised to get a mammogram prior to proceeding with breast surgery if they have not had a previous mammogram within the last 12 months. Patients with a strong family history may need to start at age 30.

Will I ever need new implants?

While breast implant technology has improved over the last 30-40 years, they are not perfect and will not last forever (like any medical implant). Saline implants have a 1-2% chance of rupture each year and this adds up to a roughly 15-20% chance of rupture at 10 years. Silicone gel implants are sturdier with rupture rate of approximately 8-12% at ten years. Most patients will need to have some sort of revisionary surgery (for a variety of reasons) around the 15-20 year mark.

What is capsular contracture? Can it be prevented?

Capsular contracture describes hardening and distortion of the breast due to shrinking or contraction of the scar capsule around the implant. The scar capsule is important because an inadequate capsule will result in early stretching and
bottoming out of the implant (1-2% of patients). The opposite of this is encapsulation. In its mildest form, the breast feels more firm to the touch. More aggressive cases of capsule contracture will result in narrowing of the breast with implant malposition (generally moving superiorly). In the most severe form, the breast is distorted and painful. Early capsule contracture can sometimes be treated with the off-label use of montelukast (an asthma medication), breast massage, and the use of a breast band. If this does not work, revisionary surgery to remove the implant and scar capsule with placement of a new implant may be necessary. Symptomatic capsule contracture occurs in roughly 10-12% of patients at the 8-10 year mark. Placing the implant under the muscle through an inframammary (under the breast) incision seems to decrease the risk of encapsulation, as does the use of a textured implant.


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