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Breast Augmentation

Breast augmentation is a breast enlargement surgery with implants, fat transfer or flaps.

Breast implants are saline or silicone and are placed through a small incision hidden in the armpit, under the breast or around the areola. We offer TUBA (Transumbilical Breast augmentation) which involves placing saline implants into the breast through a small incision hidden inside the belly button.

Fat transfer involves liposuction, harvesting of the fat from other areas of the body (e.g. belly or thighs) then injecting the fat into the breast.

Before and After Gallery

Breast Augmentation: Patient #1 (w/ Implant)

Breast Augmentation: Patient #2 (w/ Implant)

Breast Augmentation: Patient #3 (w/ Fat Transfer)

Breast Augmentation: Patient #4 (Implant Revision)

Breast Augmentation: Patient #5 (w/ Implant)

All before and after photos are of actual Akkary Surgery Center patients and are shown with permission. Please remember: these pictures are courtesy of patients who kindly agreed to share their experience on our website. The pictures are to be viewed only and not to be downloaded, copied, captured or used for any other purpose. Individual results may vary.

Additional Facts

Who is a good candidate for Breast Augmentation?

Breast augmentation is designed to enhance the breast contour of a woman who is either not happy with her breast size or who wants to improve a loss of breast volume after nursing or pregnancy. The procedure involves fat transfer to the breast or surgically implanting FDA approved saline filled or silicone gel implants either above or below the chest muscle.

What are Breast Augmentation contraindications?

Severe or uncontrolled systemic diseases, connective tissue disease, malignancy, unrealistic expectations, local skin pathology and pregnancy.

Note: A contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient.

How is this procedure performed?

The procedure is done under tumescence anesthesia with monitored sedation.Tumescence anesthesia consists of diluted Lidocaine with epinephrine in a crystalloid solution that is infiltrated into the operative area in calculated amounts based on patient’s body weight. This is then followed making an incision as described above then creating a pocket for the implant above or below the chest muscle, placing the implant then closing the incision.

How long does the effect last?

  • Saline or silicone Implants are permanent yet reversible and can be removed if needed.
  • For breast augmentation using AFT, It is reasonable to plan for overcorrection as part of the fat graft might "not take" meaning some of the injected fat will be lost, the effect is long term but varies per patient.

What should I expect during recovery?

  • Since the area is numb after the procedure, we routinely do not use narcotics for pain control and the pain is easily controlled on acetaminophen (Tylenol).
  • Also, since general anesthesia and narcotics are usually avoided, nausea and vomiting are very rare after the procedure.
  • A soft bra or compression garment is usually worn postoperatively for 2-4 weeks or longer.
  • Patients are usually discharged to the care of a responsible adult and recover at home.
  • Light activity and early ambulation are encouraged after the surgery but we recommend avoid upper body exercise and arm lifting above the head.
  • Activities are advanced gradually based on your healing.
  • The body forms a capsule around the implant. It is important to manipulate and move the implants when instructed and avoid smoking to keep the capsule soft and decrease the risk of capsular contracture.

Where is the scar?

  • “One of the key differences in the procedures is the surgical approach,” explains Dr. Ehab Akkary, MD FACS FASMBS FAACS. “This is where the surgical incision is made and where the implant is initially introduced on its route to be properly placed. The site of this incision is where the scar will be.”
  • There are different routes:
    • 1- Periareolar (around the areola), incisions are made along the curve of the areola, where darker colored skin meets lighter colored skin, also disguising the scar.
    • 2- Inframammary (Under the breast) incisions are made in or close to the crease where the breast meets the rib cage. Under normal circumstances, these scars can be easily hidden by a bra or bikini or even the contour of the breast itself
    • 3- Transaxillary (arm pit). the incision is made in the natural fold of the armpit and there are no visible incisions anywhere near the breast
    • 4- TUBA: One innovative technique that we offer is TUBA (Trans-Umbilical Breast Augmentation). This procedure allows empty saline implants to be inserted via an incision in the navel (belly button) and then filled with saline. This procedure leaves no scars anywhere on or near the breasts. Only a handful of highly skilled surgeons in the U.S. and worldwide offer the procedure, and we are, to the best of our knowledge at the time of this writing, the only surgical practice in West Virginia to offer TUBA to patients". The very small incision is hidden inside the belly button.

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Dr. Akkary

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I have been seeing Dr. Akkary since 2014. The first day I was given his cell number...that has NEVER happened before at any other doctor's office. He is genuine and compassionate and really only wants to help you succeed. I have called him so many times and he has ALWAYS answered my questions. He has performed 2 surgeries on me and I wouldn't go anywhere else! I trust him and his staff completely. They will listen to all of your concerns and explain everything completely!

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Great for anything in his speciality

If you are looking for a doctor who will listen to you and explain what & why he’s going to do something, you have found him. He has the added benefit of a wonderful bedside manner minus the arrogance found in doctors ( just because they are doctors, you have met a few if you’re reading this I’m sure). In all he’s a wonderful person who if you’re lucky enough to find him, give him a call. You will have an amazing doctor who is there for you without dodging your call’s no matter how silly you think the question or thought may be ( this isn’t a paid ad I promise, you have his cellphone number incase of anything no matter the time. Sorry, but I’ve never been able to reach a doctor 24-7 without going through a answering service and even then how many times do you get to talk to them? Not many from my experience and I’ve seen more doctors than I care to think about.) he’s always able to answer it or calm your pre surgery nerves. He’s great if you’re looking for anything in his specialty and if I could, he’d be my doctor for everything, but he’s only one person so I will settle for his specific fields.

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