Breast Augmentation

Breast augmentation with silicone, saline, or cohesive gel (gummy bear) implants. Incision options include inframammary, periareolar, and transaxillary; placement options include submuscular, subglandular, and dual-plane. The Keller Funnel technique enables minimal-incision silicone insertion with reduced contamination risk. Duration is 90–120 minutes under general anesthesia. Return to non-strenuous activity within days.

Dr. Kolker's approach to breast augmentation emphasises individualised implant and technique selection to achieve a result proportionate to each patient's body frame, existing breast tissue, and aesthetic goals — with a strong preference for outcomes that age naturally and avoid an overdone appearance. Implant options include conventional saline-filled (adjustable volume, smallest incision, firm feel), silicone cohesive gel (more natural feel and appearance, requires a slightly longer incision), and highly cohesive 'gummy bear' form-stable gel implants (anatomical teardrop shape that maintains its form if the shell is disrupted). Dr. Kolker uses the Keller Funnel — a sterile funnel device that allows silicone implants to be squeezed through a substantially smaller incision than manual insertion, reducing implant contamination risk and minimising incision length. Three incision positions are available: inframammary (in the breast crease — allows greatest surgical precision and hides the scar below the breast), periareolar (around the areola edge — camouflages the scar in the pigment transition zone), and transaxillary (in the armpit — leaves no scar on the breast at all, using an endoscope to guide implant placement). Placement planes include subglandular (above the pectoralis muscle — more natural movement for patients with adequate overlying tissue, reduced animation deformity), submuscular (beneath the pectoralis — extra tissue coverage, preferred for slimmer patients), and dual-plane (partial subpectoral, releasing the inferior muscle attachment — a hybrid that reduces animation while providing upper-pole coverage). Surgery is performed under general anesthesia in the accredited on-site suite; duration is 90–120 minutes. Recovery involves restricted upper-body activity for six weeks, with most patients returning to desk work within several days.