Providing Breast Augmentation (Enlargement) in New Hampshire, near Boston and Manchester

There are numerous breast augmentation websites, each containing dizzying numbers of preoperative and postoperative results.

What is most important for the patient to understand is what breast augmentation can do and what its imperfections are.

Breast augmentation provides both enlargement and lift to the breasts. At my New Hampshire practice, between Manchester and Boston, we can enlarge breasts that have never developed fully, or enlarge breasts that have lost volume after pregnancy or weight loss.  In the later cases, some skin tightening (mastopexy or “breast lift”) may also be necessary.

Breast implants can be put behind the pectoralis muscle or in front of it; I use both methods, depending upon the patient’s activities, skin type, and breast contour.

Potential Complications

Breast augmentation has the two most common potential complications of all surgical operations: infection or unusual bleeding (hematoma).  In my experience, both are very rare.  If infection is severe enough, the implant would have to be removed temporarily and then replaced some months later because the patient’s body cannot fight infection around a foreign material.

Hematoma occasionally occurs, and is largely an aggravation to the patient and surgeon, because it usually means a second trip to the operating room (for which there is no additional surgical fee) to remove any blood collections.  Hematoma does not ordinarily change the likelihood of postoperative success and a good result.

Nipple sensation theoretically could change with any breast operation, but is relatively rare and minor following breast enlargement.  I warn each patient before surgery that a partial or complete, temporary or permanent loss of sensation on one or both sides is possible after surgery.  However, I have never heard of a total, permanent loss of sensation on both sides.  Furthermore, if sensory change does routinely occur, it must be so slight that patients do not care because almost no patient ever mentions sensation to me postoperatively, even though each one has been informed before surgery that it could change.

The major aggravations with breast implantations are related to the fact that it is an artificial material.  They are: so called “capsular contracture” and deflation.

Simultaneous Breast Augmentation and Breast Lift (Mastopexy)

Breast augmentation and breast lift have conflicting goals: the augmentation makes the breast larger and heavier, whereas the lift makes it higher.  Therefore, while a breast implant lifts the breast, it will also tend to drag down the correction achieved by the mastopexy itself.

I therefore look at augmentation/mastopexy as a compromise operation.  The augmentation improves breast shape while the lift improves breast position.  However, if the implant is too large, it will invalidate the lift.  Once again, the proper decision can only be made by a good consultation between patient and surgeon.

Secondary Revision after Breast Augmentation or Breast Lift (Mastopexy)

A variety of problems can occur after breast augmentation or lift: asymmetry, distorted or excessively hard results, unequal folds beneath the breasts, implants that are too large or too small, synmastia (the breasts touching in the midline), or rippling.  We encourage patients to return to their plastic surgeons for revision. But, if for some reason any patients do not wish to do so, Dr. Constantian would be happy to see them in consultation because many of these problems can be improved.

Questions about Breast Enlargement

These are some of the frequently asked breast enlargement/augmentation questions we are asked at our New Hampshire practice, between Boston and Manchester.

“What is capsular contracture and why does it occur?”
“What are the deflation rates?”
“How common is deflation?”
“Do you use gel or saline implants?”

One Final Thought

For all of the potential imperfections of breast augmentation, and the fact that some patients will develop a firm result despite everything the surgeon and patient does, most breast augmentation patients are extremely happy.  In fact, in twenty-nine years of practice I have never had a patient in whom I placed the original implants asked to have them removed, even when the result was not as perfect as I would have wished.  Even with a result that is “good” but not “wonderful”, most women did not want to return to the way they were prior to the augmentation.  It is that characteristic that makes breast augmentation, for all of its inherent imperfections, such a satisfying operation for patient and surgeon.


The consultation fee for Breast Augmentation surgery is $250.00. Dr. Constantian’s surgical fee for Breast Augmentation surgery is $4,565.00.

Because Dr. Constantian operates in a hospital setting, the hospital and anesthesia fees are not within his control and may change from time to time. If you would like more information regarding the hospital and anesthesia fees, please call our New Hampshire office.

Contact Our Practice

If you would like to schedule a consultation, or if you have additional questions about breast augmentation (enlargement) surgery, please contact our New Hampshire practice, convenient to both Boston and Manchester.
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