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Choosing a Breast Augmentation Surgeon

Dr. James MurphyBreast augmentation  is one of the most popular cosmetic procedures, giving women the opportunity to reshape or enlarge their breasts. This safe procedure allows women to feel more feminine and to improve their confidence.

Here are a few questions you should ask a breast augmentation surgeon if you are considering this procedure:

  • Are you board certified with the American Board of Plastic Surgery?
  • How long have you been certified? 
  • What are the risks and complications associated with having breast implants?
  • Do you have before-and-after photos I can look at for each procedure? Look at the doctor’s results, which show his ability.
  • What results and size are reasonable for me?

Let your doctor help guide you on this one. Each body is very different, and your surgeon can help you choose what is best for you, to achieve the desired result.

Will my ability to breast feed be affected?

Make sure you are comfortable with the personal rapport between you and your physician.  In addition, you should feel at ease and comfortable with the staff. Are they addressing your concerns?

For a very limited time we are offering one underarm or upper lip hair removal treatment to all of our cosmetic surgery patients.

Red Flags

A doctor who is impatient and rushes you to make a decision.

A doctor who is willing to combine multiple major procedures into one surgery. Your safety should be the priority, not to save money on facility fees, and anesthesia. Your doctor is not at his very best into the 6th hour of surgery. Remember, this is your health we are talking about.

A doctor who refuses to answer questions, or provide you with the necessary time to provide information.

Your Surgery

Breast implant augmentation surgery with Murphy Plastic Surgery,  plastic surgeon Dr. James E. Murphy  is usually performed in an outpatient basis, either in a hospital operating room or in a surgery center, using general anesthesia. Normally, you must arrive at the surgery facility one to two hours prior to the procedure, and you will be monitored in the recovery unit for one to two hours before being sent home. These times can vary, so be sure to inform your caregiver so he or she can be available when you’ll need transportation.

Your Recovery

During the first three days following surgery, you’ll experience the most discomfort.  Your breasts can be sore and swollen. They may feel very tight as well. It takes some time for the tissues to stretch to accommodate your new breast size. Don’t worry; it is a very temporary condition. Most women can return to work in five to seven days – sooner in some cases.

You will have a post-surgery appointment one or two days after the surgery, but if you have any concerns immediately after surgery, don’t wait to contact your surgeon.  Dr. Murphy will call you the evening of your surgery to make sure everything is going well, and answer any questions you may have.

How is a Breast Implant Augmentation Surgery Performed?

What is a basic description of the breast augmentation procedure?

Once anesthesia has taken effect, Dr. Murphy will make an incision in the decided location, and then create a “pocket” – a space within your breast tissues – for each breast implant. The breast implants will then be placed in the pockets and positioned for optimal appearance and symmetry. After comparing both breasts to ensure proper implant placement, size, and symmetry,  Dr. Murphy will close the incisions with stitches and then steri-strip bandages over the incision. You may have a guaze dressing over the site, or also be wrapped with ace bandages to hold position.

Where is the breast augmentation surgery performed?

Breast augmentation is most frequently performed on an outpatient basis in a hospital operating room, or outpatient surgery center.  At Murphy Plastic Surgery, Dr. James Murphy will most often take his patients to Renown South Meadows, to the outpatient surgery center.

How long does the breast implant procedure take?

Cases may differ, but on average the surgery lasts one to two hours.

What anesthesia will be used?

General anesthesia is most commonly used. Dr. Murphy will always use a board certified anesthesiologist.

Where will my incisions be located?

There are several different surgical approaches to the incision for breast implants. The most popular include Periareolar (around the nipple), Inframammary (beneath the fold of the breast), and Axillary ( in the crease of the arm-pit). A small incision is made in the chosen location, and the implant is placed either under the breast tissue or under the muscle. You and your surgeon, Dr.  James Murphy, will decide which incision is best for you.

What are my breast augmentation incision site options?

There are four incision sites used for breast augmentation: around the nipple (periareolar), within the breast fold (inframammary), and under the arm (transaxillary). Dr. Murphy will help you choose an incision site that best suits your frame and implant choice with the goal of resulting in minimal scarring. Get the details about each incision site now and then talk to Dr. Murphy about the pros and cons of each.

Periareolar Incision

Illustration of a periareolar incision and resultsThis incision site is typically the most concealed. It is associated with a higher likelihood of breast feeding difficulties than the other incision options because periareolar incision involves cutting through the breast tissue. This may also increase the chance that there will be a change in nipple sensation.

Inframammary Incision

This is the most commonly used incision for silicone implants at the present time, and is made below the breast fold. This incision is generally less concealed and may cause fewer breastfeeding difficulties than the periareolar incision option.

Transaxillary Incision

This incision is made under the arm. A pocket is created by tunneling thru tissue to behind the breast. This incision site is used primarily to place unfilled saline breast implants.

What are my options for breast implant placement?

Sub-Muscular vs. Sub-Glandular

Illustration of a breast implant above and below muscle tissueYou may have heard that there are options for the placement of breast implants within your breast tissue. In fact, there are two choices for breast implant placement: sub-glandular (under your breast tissue and over your chest muscle) or sub-muscular (under or partially under your chest muscle). Each placement type has benefits that may be right for you. Discuss your desired outcome with your plastic surgeon to select the best option for your figure.

Sub-Glandular Breast Implant Placement

With sub-glandular placement the implant location is between your chest muscle and your breast tissue (under the glands). This placement may help reduce your surgery and recovery time. It may be less painful than sub-muscular placement and may make your breast implants easier to access if re-operation is necessary. Implants that are sub-glandular may be easier to see and feel through your skin.

Sub-Muscular Breast Implant Placement

Sub-muscular placement means that your breast implants are placed partially or wholly under the pectoralis major chest muscle. Sub-muscular implants may result in a longer, more painful recovery than sub-glandular implants. Sub-muscular placement may result in less palpable implants and may reduce the risk of developing capsular contracture (Capsular Contracture: A tightening of the scar tissue surrounding an implant. May require an additional surgery to correct), as well as offer easier mammographic imaging of the breast.

What type of implant is used?

There are two main types of implants used in breast  implant augmentation surgery.  Those filled with saline and those filled with a silicone gel.  Saline implants are filled with a solution that is similar to the fluid in the human body. In 2006 the FDA approved silicone breast implants, after two decades of research and testing all over the world. Silicone gel implants are filled with a cohesive substance that is more like a solid than a liquid. Implants can be round or tear-drop shaped, smooth or textured.  During your personal consultation with Dr. James Murphy he will determine which implant is best for you.

Are Breast Implants safe?

After reviewing years of evidence and research concerning silicone gel-filled breast implants, the Institute of Medicine found that “evidence suggests diseases or conditions such as connective tissue diseases, cancer, neurological diseases or other systemic complaints or conditions are no more common in women with breast implants than in women without implants.”

How will I feel after surgery?

Immediately after surgery you will have some swelling, soreness, and bruising. Dr. Murphy will prescribe pain medications for the discomfort.  You will be up and about the next day, but very conservatively. You are not allowed to lift your arms above your head, or lift any heavy objects.  Stitches are generally removed a week later.

You will experience some swelling and bruising for a few weeks, but reducing over time.  Incisions will be red to pink, but fade out to light pink or white over time. We do have a Icon laser, that can minimize the discoloration of the scars quicker, if the patient chooses.  You will continue to wear a good support bra, 23 hours a day.

You will notice an immediate result and increase in breast size, but keep in mind, you have some swelling at this point. You will need to do some massage exercises to the breasts, to help get the surgical pocket where your implants were placed to relax. New implants tend to “ride high” at first, then relax into a natural placement over time.  You will probably have more realistic results after about 3 months.

After 4-6 weeks you may resume more vigorous exercise and full range of motion with your arms.   Follow-up care will occur within a week after surgery, and approximately every 3 months for the first year.

Dr. Murphy will call you the first night or following day after surgery, to make sure you are doing well. We are on-call for you 24 hours a day, if necessary.

Reno Office

10401 Double R Blvd
Reno, NV 89521

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Hours & Info


(775) 322-3446