Breast Augmentation

The women considering breast augmentation who come to our Rochester practice from Buffalo and Syracuse, NY and other areas are often self-conscious about breasts they feel are too small or lacking in shape. You may believe your breasts aren't proportional to the rest of your body, or may be uncomfortable wearing a swimsuit or form-fitting clothes. Breast augmentation can also restore volume lost after having children. Dr. William J. Koenig and Dr. Emese Kalnoki specialize in breast enhancement. Dr. Koenig's extensive experience includes performing more than 3,000 breast augmentation procedures since joining the Quatela Center for Plastic Surgery in 2003.

Women who want a renowned breast augmentation surgeon and the latest and best breast implants come to our practice in Rochester, NY. Request a consultation with Dr. Koenig or Dr. Kalnoki using the online form, or call our office at (585) 244-1000 to schedule an appointment.

Before & After Photos

Photo Gallery

Individual results may vary.

Before photo Before
After photo After

WARNING: This feature contains nudity. Please click OK to confirm you are at least 18 years of age and are not offended by such material.


Dr. William J. Koenig Dr. William J. Koenig

William J. Koenig, M.D.

Specializes in Breast & Body Procedures

A board-certified plastic surgeon, Dr. Koenig's experience and gentle bedside manner help put patients at ease and build an uncommon level of trust. He meticulously customizes each procedure, and sculpts beautiful results that consistently exceed his patients' expectations.

Read On

Dr. Emese Kalnoki Dr. Emese Kalnoki

Emese Kalnoki, M.D.

Specializes in Body Contouring & Breast Procedures

A talented artist and board-certified plastic surgeon, Dr. Kalnoki specializes in plastic surgery after weight loss or pregnancy and other body contouring procedures. As a woman, Dr. Kalnoki brings a unique perspective to the Quatela Center for Plastic Surgery.

Read On

What Is Breast Augmentation?

Breast augmentation can improve breast volume and size, give proportion, and enhance the feminine shape of the body. To provide flexibility and meet the unique needs of each patient, we offer 3 types of breast implants. Those include saline, silicone gel and form-stable silicone (often called "gummy bear" implants). Our surgeons perform breast augmentation procedures at the Quatela Center's state-of-the-art, accredited surgical center. To ensure long-lasting, beautiful results, Dr. Koenig and Dr. Kalnoki offer a comprehensive follow-up care schedule.

Your Consultation

During the consultation, your surgeon reviews your medical history, including past medical conditions, current allergies and medications, as well as your personal or family history of breast cancer and any other breast issues. After a brief examination, the surgeon discusses your current breast size, and listens to your goals and desired changes. Your surgeon offers breast implant sizers to try on and helps you choose the right implant size and type. Dr. Koenig or Dr. Kalnoki then takes measurements of your chest to ensure that the chosen implants are proportionate for your body type and will meet your desired cosmetic goals.

Your surgeon additionally discusses any limitations for the breast augmentation procedure, and all potential risks or complications. If breast augmentation is right for you, the surgeon creates an individualized surgical plan. Before the consultation is finished, our patient consultant meets with you to discuss cost, payment options, and scheduling the procedure.

Ideal Breast Augmentation Candidates

Any woman who wants larger, shapelier breasts may be a good candidate for breast augmentation. Breast implants can help women who have natural breast tissue that is out of proportion with their build and body size, or who have experienced a decrease in breast volume after having children or aging. An ideal breast augmentation patient is:

  • In good overall health
  • Wants fuller breasts and enhanced cleavage
  • Has realistic goals and expectations about the results

Dr. Koenig or Dr. Kalnoki can help determine after the consultation if breast augmentation is the right procedure to meet your unique needs.

Before Your Procedure

Once your breast augmentation has been scheduled, there are a few things that you can do to prepare for the surgery and recovery period. By taking time several days before your procedure to prepare, you can be assured of the best results and a smooth recovery.

  • Your breast augmentation will be performed as an outpatient procedure, so you must have a ride home from the surgery center, or if you spend the night at our Carriage House, you must have a ride the next morning.
  • Fill all prescriptions prior to surgery.
  • Plan to take off about a week from school or work after the procedure to heal and rest at home.
  • Arrange for assistance during the first few days after your breast augmentation.
  • Carefully review the post-surgical instructions. Contact our office immediately if you have questions.
  • Keep important phone numbers and all emergency contact information in an easy to reach location.
  • Put all follow-up appointments on your calendar — these are very important to attend, even if you don't have any questions.
  • Stop aspirin and any specified herbal supplements two weeks before your breast augmentation.

If you are a smoker, it's also important that you commit to stop smoking at least two weeks prior to your breast augmentation procedure.

The Breast Augmentation Procedure

Our surgeons offer breast augmentation with three types of breast implants: saline, silicone, and form-stable silicone (sometimes called highly cohesive silicone). All can improve your body's contours and bring proportion to your silhouette. The saline, silicone, and form-stable implants come in a wide variety of sizes (measured in cubic centimeters, or cc), shapes (round or teardrop), and textures (smooth or textured). Implants can be placed over or under the chest muscle (subglandular or submuscular), depending on your existing breast tissue. The best implant will depend on your aesthetic goals.

Saline Implants

Saline implants enjoy a long history of satisfaction and safety. This type of implant is constructed of a silicone shell, filled with saline or salt water. It has the lowest rate of capsular contracture, when compared to silicone implants. Saline implants are typically placed in the submuscular space. The best candidates will be those women with a large amount of their own natural breast tissue. The disadvantage for saline implants is how they feel. As there is little viscosity in the implant, filled with water, it can often be felt against the surrounding tissue. This can also result in rippling, which on a rare occasion can be seen.

Silicone Gel-Filled Implants

After returning to the market in 2006, silicone gel-filled implants have been hailed as safe for use in breast augmentation. They are very popular because of their natural feel, as they are difficult to distinguish from the surrounding breast tissue. They also can be placed above or below the muscle. Furthermore, current silicone implants have a thicker and more cohesive gel. The disadvantage is there is a higher rate of capsular contracture compared to saline implants.

Form Stable (Gummy Bear Implants)

Form Stable implants were introduced in 2013. Form stable means it is a true teardrop-shaped implant. As a result, they may offer a more natural shape to the breast in some patients. The gummy bear implants are firmer to the touch than other silicone implants and have a textured shell. To insert the implant, a larger incision is needed. Some patients will find more size and shape options resulting in a more customized result. The disadvantage of shaped cohesive gel implants is the slight chance of rotation, which may require surgical correction.

Natrelle INSPIRA™

INSPIRA is a revolutionary new line of silicone gel-filled implants with over 200 size and shape options for a fully-customizable result. Filled to be more round and full, these implants maintain optimal fullness in the upper half of the breast. Despite their soft feel, the implants hold their shape to lessen the occurrence of rippling and wrinkling. INSPIRA offers options to provide a tailored fit based on individual body type, size, and goals.

Recovery after Breast Augmentation

Patients should expect breast augmentation recovery to take around one week. There may be some soreness and mild pain immediately after surgery, which is well controlled through appropriately prescribed pain medications. The refined, advanced techniques used by our surgeons mean there is very little pain associated with his breast augmentation procedure. Their overall goal is to have no real down time and most patients are surprised how comfortable they are with minimal medication. There may be some burning around the nipples or incision sites, as well as minor bruising, but if these occur, they will resolve over the first five days. Swelling is normal, but may take up to four weeks to fully disappear. A sports bra can be worn for the weeks following the procedure, which provides support during the healing process. Some patients are more comfortable not wearing any bra for the first 3 weeks.

While there is little risk from today's breast augmentation procedure, problems do occasionally occur. These may include bleeding, infection, breast asymmetry, and numbness. Dr. Koenig and Dr. Kalnoki both pride themselves on their low complication rates with breast augmentation. Dr. Koenig presented a study at the Northeastern Society of Plastic Surgeons documenting those low rates.

Choosing the Right Breast Augmentation Surgeon

The key to a successful breast augmentation procedure is choosing the right surgeon. Dr. Koenig is a board-certified plastic surgeon with 25 years of experience. He specializes in breast and body procedures and has performed over 1,600 breast augmentations over the past 12 years in Rochester at the Quatela Center for Plastic Surgery. Breast augmentation is by far his most requested procedure. Dr. Kalnoki specializes in cosmetic and reconstructive breast surgery and brings a woman's unique perspective to the procedure.

Frequently Asked Questions

What types of implants are available?

Saline, silicone, and form stable silicone implants are available for breast augmentation at the Quatela Center for Plastic Surgery.

When can I return to work after my breast augmentation?

Depending on the nature of the job, patients without a physically demanding position may return to work or school within two to five days after their breast augmentation.

Are there risks involved in breast augmentation?

Breast augmentation is considered extremely safe, although with any surgical procedure there is a rare chance for bleeding, infection, asymmetry, capsular contracture, or loss of sensation to occur.

Do I need to have my breast implants replaced every 10 years?

No medical device is considered permanent; however breast implants do not need to be replaced every 10 years. If you are pleased with your implants and not experiencing any issues, we do not recommend replacing them. Each Natrelle implant is covered individually in the case of rupture or deflation and carries a lifetime warranty. If this occurs within the first 10 years after surgery, the manufacturer may offer financial assistance to have them replaced.

Is it mandatory that I have an MRI if I have breast implants?

No. While it is a recommendation from the FDA for patients with silicone implants to obtain an MRI every 3 years, it is not mandatory. The purpose of the MRI is to detect any evidence of a ruptured breast implant. Most women choose not to have an MRI done unless they are experiencing symptoms of a rupture.

Can I have regular mammograms if I have breast implants?

Yes, regular mammograms should not affect breast implants. It is important that women have yearly screenings, whether you have implants or not. All patients 35 and older will be required to have a current mammogram (within a year prior to their surgery date) prior to breast enhancement surgery.

What should I expect in terms of recovery after breast augmentation?

Our plastic surgeons use refined techniques for breast augmentation so there is very little pain associated with the procedure. Their overall goal is to have no real down time and most patients are surprised at how comfortable they are with minimal medication. Normal activity can be resumed quickly after breast augmentation surgery and most patients return to work in a week, although each patient's situation may be different depending on the nature of her work.

What is capsular contracture? What are the signs and symptoms?

Capsular contracture (or scar tissue) is an immune system's response to foreign materials in the human body. It occurs when the collagen-fiber capsule tightens and squeezes the breast implant. It can be very painful and discomforting and might distort the aesthetics of the breast implant and the breast, changing the shape and feel of the breast implant.

When can I exercise after breast surgery and are there any limits to what I can do?

It is recommended to refrain from all exercise for the first week following surgery. You may begin lower body exercises after the first week and resume full exercise after three weeks, within your comfort level. It is recommended that you refrain from doing any future pectoralis strength training (building muscle), however light muscle toning exercise is permissible.

Is the loss of nipple/breast sensation after breast augmentation surgery typical?

No, it is not typical. However, you may experience a diminished or loss of sensitivity of the nipples and the skin of your breasts which could be permanent or partial. All of the risks of breast implant surgery will be discussed with you during your consultation and pre-operative appointments.

What are the benefits of breast augmentation vs. breast lift?

Breast augmentation surgery is for patients who are self-conscious about the size and/or shape of their breasts, while a breast lift lifts the breasts by removing some excess skin and tightening the surrounding tissue. In most cases, it is safe to combine breast augmentation and breast lift surgery if both a lift and size change is desired.

How will breast augmentation surgery affect breastfeeding?

Patients cannot have breast augmentation surgery if they are currently pregnant, breastfeeding, or lactating. We recommend waiting 6 months after breastfeeding before having a breast procedure. Breastfeeding can typically be done after breast augmentation as the production of milk is not compromised. Sometimes patients experience the loss of sensation to the nipples, in which case breastfeeding can be affected. This will be discussed in your consultation appointment.

How can I improve scarring after breast augmentation surgery?

Excessive scarring is uncommon and our surgeons discuss your options for scar treatments. Keeping your incisions out of the sun for at least a year after breast implant surgery will decrease the potential for hyperpigmentation (redness).

When does swelling go down after breast augmentation surgery?

Immediately following surgery your breasts will be high and very swollen. Swelling peaks about the third or fourth day after the operation. Three weeks after getting breast implants you can expect to still have some swelling but this varies from patient to patient. By 3 months you can expect to be near your baseline.

How long do breast implants last?

It is not realistic to think breast implants will last forever. However, they do not need to be replaced if there isn't a problem with them.

Is it safe to combine an implant exchange with a breast lift?

Yes. It is quite common for women to have a breast lift with breast augmentation if there is some droopiness of the breast tissue. This is something that would be discussed in detail during your consultation.

Back to Top

Quatela Center
for Plastic Surgery

The Quatela Center's reputation as one of New York's finest cosmetic plastic surgery practices attracts patients to Rochester from throughout the state. Choose one of the locations below for driving directions to our practice.

Contact Us

The Lindsay House

973 East Avenue
Rochester, NY 14607
Phone: (585) 244-1000

Download Your
Q Beauty e-Book

Read about the latest news and advances in the cosmetic industry from experts you can trust.

get your e-book