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Breast Augmentation

Breast Augmentation (Mammoplasty) is a surgical procedure designed to improve the shape and appearance and increase the size of a woman’s breasts through the use of breast implants. Dr. Crabtree’s patients typically undergo this procedure to achieve a greater proportional balance, address asymmetrical concerns, or restore volume lost over time.

In the initial consultation, Dr. Crabtree will use the time to get to know you, learn about your expectations and discuss a plan to achieve your goals. He will discuss the variables of the surgery: implant type, volume, and surgical technique. Prior to surgery you will have a good understanding of the procedure, plan and recovery. If you decide you are ready to proceed you will set a date for surgery and be given instructions on how to prepare. You will also schedule a pre-operative appointment to review your medical history, take pre-operative photographs, and confirm your size choice.

Since every woman’s body is unique and each patient has different surgical goals. There is no such thing as a “one-size-fits-all” breast implant. During your initial breast augmentation consultation, our experienced plastic surgeon, Dr. Crabtree, will talk with you about your goals, answer your questions, and show you a number of different breast implant options so that you can get a firsthand look at the differences. Dr. Crabtree will review all of your options, including:

  • Implant type
  • Size
  • Shape/Profile
  • Incision technique

Dr. Crabtree outlines all of the information you need to make an informed decision about your implant selection.

Saline and Silicone Breast Implants
There are two types of implants that are currently used for breast augmentation procedures: saline and silicone. These implants are made of a salt-water solution encased in a silicone outer shell. They have been used in breast augmentation procedures for decades with great success. However, saline implants may look and feel less natural than silicone implants because they are heavier and firmer.
Silicone breast implants offer a more natural look and feel, and are not known to cause a “rippling” effect that can sometimes occur with saline implants. The gels have become even more cohesive. This means that they are thicker, hold their shape better, and if they were to leak, the gel wouldn’t go anywhere. These are commonly referred to as “gummy bear” implants and when you cut the implants in half, the gel is firm like a gummy bear. The outer shells on these implants have also been improved, further reducing the rupture rate to single digit percentages. Recent studies also show a significantly decreased capsular contracture (internal firm scar) rate than was seen with older generation implants. Though silicone implants have a lower deflation rate, a ruptured silicone implant can be more difficult to detect. This makes it necessary for all women who have breast implants, either saline or silicone, to do routine self-exams, follow their physicians recommended mammogram schedule and let their doctor know of any concerns they may have.

Your breast augmentation procedure generally takes about an hour and a half to two hours and will be performed under general anesthesia administered by a Board-Certified Anesthesiologist or a Board-Certified Nurse Anesthetist at Windward Surgical Facility in Kailua, Hawaii. Dr. Crabtree typically performs the surgery using the Inframammary (under the breast) incision to increase the control and precision of the breast implant placement. Dr. Crabtree also uses the “no touch” technique for breast implantation using the Keller Funnel.

Dr. Crabtree uses the Keller Funnel™ for the implantation of silicone gel breast implants via a no-touch technique. This technique allows the breast implant to never be handled by the surgeon, nor does the implant ever rub against the skin during insertion. No matter how sterile the surgeon or operating room is, there is always the small risk for a minute amount of bacteria to get on the shell of the implant, particularly when the implant is inserted in the pocket. The Keller Funnel™ eliminates this risk and also lessens the risk of capsular contracture.

The Keller Funnel™ also allows for shorter incision lengths for placing the implant. The funnel also facilitates a shorter operating time by making it easier to insert the implant. Lastly, the funnel lessens the trauma at the incision site. Since the implants are not being worked in manually through the incision there is less trauma which means less soreness post-operatively.

(Keller Funnel™ Photo courtesy of Keller Medical, Inc.)

Advancements in technology and a clear expectation of post-surgery results can all aid in a smooth breast augmentation. Dr. Thomas Crabtree shares his techniques and process for an ideal procedure that results in minimal complications. Among these techniques are:

  • Minimally traumatic surgical technique
  • Long acting local anesthetic
  • Keller funnel
  • No external sutures

Using all these techniques, Dr. Crabtree offers his patients a Weekend Recovery Breast Augmentation. He typically performs the surgery on Friday, allowing patients to recover over the weekend and be up and about on Monday. Pain management can usually be done with over the counter pain relief medication.


  • Clinic Procedure or Operating Room: Operating Room
  • Hospital Status: Outpatient
  • Length of Surgery: 1-1.5 hours
  • Anesthesia: General Anesthesia performed under the care of a board certified Anesthesiologist
  • Types of Enhancements: Silicone or Saline Implants, Fat Grafting
  • Post-Operative: A special bra may be worn for up to two weeks to help with swelling and recovery. Mild soreness, swelling, and bruising are all normal
  • Recovery Time: Return to normal daily routine in one week, two to three weeks avoiding strenuous activity and several months for scars to fade and normal sensation.
  • Results: The results will be evident immediately but will continue to improve and “settle” over the course of several months.


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