Breast Augmentation in Puyallup & Tacoma, WA

Breast augmentation increases breast size and refines shape, using either implants or a transfer of your own fat. At our Puyallup office, Dr. Rajiv Iyengar performs augmentation for patients seeking greater fullness, improved symmetry, or volume restored after pregnancy or weight loss.

Contact us today to schedule a consultation.

What Is Breast Augmentation?

Breast augmentation, also called augmentation mammoplasty, is an outpatient procedure that adds volume to the breasts through one of two approaches.

‍Implants are the more common route. A silicone or saline implant is placed through a small incision, positioned either behind the breast tissue or beneath the chest muscle, producing a predictable increase in size and fullness across the upper breast.

‍Fat transfer uses your own tissue instead. Dr. Iyengar harvests it through liposuction of the abdomen, flanks, or thighs, then injects it in small, carefully layered amounts. The result is a more modest increase, generally half a cup to one cup size.

One distinction deserves emphasis: augmentation adds volume but does not lift sagging tissue. If your nipple sits at or below the crease beneath the breast, an implant alone will make you fuller without making you higher. A breast lift is the procedure that corrects position.

Am I a Good Candidate for Breast Augmentation?

You may be a strong candidate if several of the following apply:

• Dissatisfaction with your breast size or fullness
• Noticeable asymmetry between the two sides
• Volume lost following pregnancy or weight loss
• Breasts that never developed as fully as you had hoped
• A stable weight maintained for at least six months
• Non-smoking status, or a willingness to stop before surgery
• Realistic expectations of the outcome

The FDA also sets age minimums: 18 or older for saline implants, 22 or older for silicone. Fat transfer carries no federal minimum, though Dr. Iyengar still requires a stable weight and completed development.

Augmentation is not the right answer for everyone. When heaviness or back pain is the primary concern, a breast reduction addresses it directly. Men with excess breast tissue are better served by gynecomastia surgery.

Types of Breast Augmentation

Silicone implants are filled with a cohesive gel that behaves much like natural breast tissue, and most patients find them softer than saline. Because the gel holds its form, rupture is often silent, which is why periodic imaging is recommended.

Saline implants are filled with sterile saltwater after placement, allowing them to be inserted through a smaller incision. Rupture is unmistakable: the breast deflates, and the saline is absorbed harmlessly. Saline feels firmer and shows rippling more readily in thin patients.

Profile matters as much as volume. Implants are manufactured in low, moderate, high, and extra-high profiles, each describing how far the implant projects relative to its base width. Two implants of identical volume can look entirely different on the same patient, which is why base width is the first measurement Dr. Iyengar takes.

Fat transfer suits patients who want a subtle change and have sufficient donor fat. Roughly 60 to 80 percent of the transferred volume survives long term.

Incision and Placement Options

Three incisions are available, and the choice depends on your anatomy, your implant, and where you would prefer the scar to sit.

• Inframammary (breast crease). The most common approach, offering the best access and the greatest control over the implant pocket. The scar conceals itself within the fold.
• Periareolar (around the areola). Follows the lower border of the areola, where the change in color camouflages it.
• Transaxillary (armpit). Leaves no scar on the breast itself. Best suited to saline implants and first-time augmentation.

Placing the implant beneath the pectoralis muscle softens the upper edge, reduces visible rippling, and interferes less with mammogram imaging, though you should always inform the technologist that you have implants. Placement above the muscle avoids the flex distortion some very active patients notice, but it requires more of your own tissue to look natural.

Scars remain pink and slightly raised for two to three months, then continue to fade over 12 to 18 months.

How Dr. Iyengar Helps You Choose a Size

Sizing is measured rather than guessed. Dr. Iyengar records chest and breast measurements, including base width and nipple position, evaluates your skin quality and existing tissue, and has you try sizers in a fitted bra.

Volume alone is a misleading guide. The same 350cc implant appears different on a narrow chest than on a broad one, and it settles differently depending on tissue coverage and skin elasticity. Two women may receive identical implants and wear different bra sizes.

What to Expect: Surgery Day and Recovery Timeline

Surgery is performed at an accredited surgery center under general anesthesia, administered by a licensed anesthesia provider. The procedure generally takes one to two hours, or longer when combined with a lift. You return home the same day and will need a driver.

First 48 hours. Expect tightness and pressure across the chest, some grogginess, and soreness that peaks around day two. Rest, walk briefly every hour or two, and sleep propped upright. No driving.

Days 3 to 7. Soreness eases, and most patients discontinue prescription pain medication between days three and five. Shower according to your instructions and manage light desk work from home.

Weeks 2 to 4. Swelling recedes visibly, though the implants still sit high. Most patients return to desk work at seven to ten days and resume driving at roughly a week. Nothing heavier than 10 pounds.

Weeks 6 to 8. Cardio and most lifting are cleared at six weeks, with chest and upper body training at approximately eight.

Three to six months. Full activity resumes, scars continue to fade, and the implants settle into their final position. Early photographs do not represent your result.

Review how to prepare for surgery beforehand, and follow the post-operative care instructions closely afterward.

Combining Breast Augmentation with Other Procedures

Augmentation with a breast lift is the most common pairing: the implant restores volume while the lift repositions the nipple and removes loose skin, which is precisely what most post-pregnancy patients need. The mommy makeover combination pairs augmentation with a tummy tuck, frequently with liposuction of the flanks. Following significant weight loss, augmentation is often combined with a lift and occasionally an arm lift.

Combining procedures means one anesthetic, one facility fee, and one recovery, which reduces total anesthesia exposure and proves far less disruptive than staging the operations separately.

Risks, Safety, and Long-Term Implant Care

Every surgery carries risk, and implants carry several of their own.

• Capsular contracture. Scar tissue forms around every implant. In a minority of patients, it tightens, leaving the breast firm to the touch or distorted in appearance. It remains the most common reason for revision.
• Rupture. Evident with saline, frequently silent with silicone.
• Rippling. Visible wrinkling at the implant edge, more likely with saline and with thin tissue coverage.
• Changes in nipple sensation. Usually temporary, occasionally permanent.
• Asymmetry. Breasts are never perfectly matched before surgery, and they will not be afterward.
• BIA-ALCL. A rare and treatable lymphoma of the scar capsule, associated almost entirely with textured implants.

The FDA recommends that patients with silicone implants undergo an ultrasound or MRI at five to six years, then every two to three years thereafter, to screen for silent rupture. Saline implants require no such monitoring.

Implants are not lifetime devices. Many are replaced at 10 to 15 years. Revision is a normal part of the process, not an indication that something went wrong.

Breast Augmentation Cost and Financing in Puyallup

The cost of breast augmentation varies from patient to patient. Implant type, the decision to include fat transfer, the addition of a lift, and total operating time all influence the final figure.

Following your consultation, a patient coordinator prepares a written quote built around your specific surgical plan, covering the surgical fee, anesthesia, facility fees, implants, and your follow-up visits.

We also partner with CareCredit and Cherry for monthly payment plans, subject to credit approval. Contact us to schedule a consultation and receive your personalized quote.

Why Patients Choose Dr. Rajiv Iyengar

Dr. Iyengar performs breast reconstruction alongside cosmetic breast surgery, and the significance of that is easy to underestimate. Reconstruction involves rebuilding a breast from tissue that has been operated on or removed entirely, and achieving symmetry between two sides under difficult conditions. That work develops a deeper command of breast anatomy, blood supply, and pocket control than placing implants into healthy tissue alone.

He completed a combined BS/MD program at Brown, a six-year plastic surgery residency at Yale, and a fellowship at Vanderbilt. He grew up in Puyallup and returned to practice in his hometown.

Schedule Your Breast Augmentation Consultation in Puyallup

Your consultation lasts approximately an hour. Dr. Iyengar reviews your history, examines and measures you, discusses implant type and placement, and has you try sizers. Afterward, a coordinator provides a written quote, with no pressure to decide.

Ready to take the first step? Call 253-840-5397 or request a consultation online today.