Overview
Breast augmentation is one of the most commonly performed cosmetic procedures in the United States, and one that demands exceptional surgical judgment to produce results that look natural, feel natural, and last. At The Ferguson Clinic in Honolulu, Dr. John C. Ferguson, MD, FACS, performs breast augmentation using the latest generation of silicone, saline, and cohesive gel (“gummy bear”) implants, with placement techniques, including dual-plane positioning and transaxillary approach, refined over more than 25 years of cosmetic surgery practice.
As a quintuple board-certified cosmetic surgeon, Dr. Ferguson’s approach to breast augmentation goes beyond simply choosing an implant size. He considers each patient’s chest wall anatomy, breast tissue characteristics, skin elasticity, body proportions, and aesthetic goals to design a surgical plan that produces a balanced, proportionate result. Whether you are seeking a subtle enhancement or a more dramatic change, Dr. Ferguson’s experience and credentials, including certification by the American Board of Cosmetic Surgery, the only board dedicated exclusively to cosmetic surgery of the body, ensure that your breast augmentation in Honolulu is performed by one of the most qualified surgeons in the Pacific.
Am I a Good Candidate?
You may be a good candidate for breast augmentation if you desire larger or more proportionate breasts; have asymmetry in breast size or shape that you would like to correct; have experienced a loss of breast volume following pregnancy, breastfeeding, or weight loss; or simply want to feel more confident in your body.
The best candidates are in good overall health, are not currently pregnant or breastfeeding, and have realistic expectations about what implants can achieve. Patients should have fully developed breasts, which typically means being at least 18 years old for saline implants and at least 22 for silicone implants (per FDA guidelines).
During your consultation, Dr. Ferguson will discuss implant options, placement techniques, incision choices, and sizing in detail, using imaging and sizers to help you visualize your potential results.
The Procedure — What to Expect
Dr. Ferguson performs breast augmentation at his AAAHC-accredited surgical facility in Honolulu, typically under general anesthesia. The procedure takes approximately one to two hours.
Implant Types
Silicone gel implants are filled with a cohesive silicone gel that closely mimics the feel of natural breast tissue. They are the most popular choice among Dr. Ferguson’s patients for their natural look and feel.
Cohesive gel (“gummy bear”) implants use a more highly cross-linked silicone gel that holds its shape even if the shell is compromised. These form-stable implants offer a natural teardrop contour and are particularly well-suited for patients requiring breast reconstruction.
Saline implants are filled with sterile saltwater after placement, allowing for minor size adjustments during surgery.
Implant Placement
Below the muscle and Dual-plane placement is Dr. Ferguson’s preferred technique for most patients. This approach positions the upper portion of the implant beneath the pectoralis major muscle while the lower pole sits beneath the lower edge of the muscle or the breast tissue. Dual-plane placement combines the benefits of submuscular positioning, reduced capsular contracture risk, more natural upper pole contour, improved mammographic imaging, with a natural lower pole drape that avoids the “ball on the chest” look that results from not releasing the lower edge of the muscle.
Subfacial (over the muscle) placement may be appropriate for specific patients, particularly those with heavy breast tissue or certain athletic considerations.
Incision Options
Inframammary fold: A short incision in the crease beneath the breast. This is the most common approach and provides excellent access for precise implant positioning.
Periareolar: An incision along the lower border of the areola. Dr. Ferguson rarely uses this, as it can produce scarring of breast tissue and problems with mammograms.
Transaxillary: An incision in the armpit, leaving no scar on the breast itself. This approach is suitable for most patient anatomies.
Dr. Ferguson will discuss the advantages and considerations of each incision option during your consultation.
Recovery and Results
Breast augmentation recovery is generally well-tolerated, with most patients returning to their normal routines faster than they anticipate.
Days 1–3: You will see Dr. Ferguson the next day. Mild to moderate soreness and tightness across the chest. Most patients manage comfortably with prescribed pain medication. A bandeau or surgical bra is worn for support.
Week 1: Most patients feel well enough to return to desk work and light activities within five to seven days. Swelling is present but manageable. Dr. Ferguson sees patients for a follow-up visit during this first week.
Weeks 2–4: Soreness diminishes significantly. Returning to normal activities is encouraged. The implants begin to settle into their final position — a process called “dropping and fluffing” — as the tissue around them relaxes. Sometimes we will perform ultrasound treatment to speed up the process.
Weeks 4–6: Patients should be back to all normal activities by now. Swelling continues to resolve.
Months 3–6: The implants usually reach their final position and the breast shape softens to its definitive result. This is when patients see the full outcome of their breast augmentation. natural-looking, proportionate enhancement that complements their body.
Follow-up: Dr. Ferguson believes in frequent follow-up. You will always see him the day after surgery, 1 week later, and 2 weeks later. After that it depends on how you are healing. But you will always see him frequently during the first year after surgery and then yearly afterwards.
Frequently Asked Questions
How do I choose the right implant size?
Dr. Ferguson takes a dimension-based approach to implant selection, considering your chest width, breast tissue, and body frame rather than simply picking a cup size. During your consultation in Honolulu, he uses measurements, sizers, and imaging to help you understand how different implant sizes will look on your specific body. The goal is a result that looks proportionate and natural.
How long do breast implants last?
Modern breast implants are durable medical devices, but they are not considered lifetime devices. Most patients can expect their implants to last ten to twenty years or longer before replacement may be considered. Dr. Ferguson monitors his patients with regular follow-up and imaging as needed.
Will breast augmentation affect breastfeeding?
Most women are able to breastfeed after breast augmentation, particularly with submuscular placement and inframammary incisions. Dr. Ferguson discusses this consideration in detail with patients who plan future pregnancies.
What is capsular contracture?
Capsular contracture occurs when the scar tissue that naturally forms around an implant tightens and compresses the implant, potentially causing firmness, discomfort, or distortion. Dr. Ferguson’s use of dual-plane placement and meticulous surgical technique helps minimize this risk. His experience in Honolulu managing non-surgically and revising capsular contracture cases is extensive.
Will I have visible scars?
Breast augmentation scars are small and strategically placed to be as inconspicuous as possible, in the breast crease, around the areola, or in the armpit. Scars fade significantly over the first year and are typically very difficult to see in their mature state.
How soon can I fly after breast augmentation?
Since many of Dr. Ferguson’s patients in Hawaii travel from neighboring islands or the mainland, this is a common question. Most patients can fly day after surgery, though Dr. Ferguson provides individualized guidance based on your recovery.
Why Choose Dr. Ferguson for Breast Augmentation
Breast augmentation may seem straightforward, but the difference between a good result and a great result lies in the surgeon’s judgment, implant selection, pocket creation, placement precision, and the ability to anticipate how results will evolve over time. Dr. Ferguson’s certification by the American Board of Cosmetic Surgery, the only board exclusively dedicated to cosmetic surgery of the face, breast, and body, reflects specialized expertise in exactly this kind of aesthetic decision-making. His dual-plane technique, refined over thousands of cases, consistently produces the kind of natural, proportionate enhancement that patients want but fear they will not get. With his AAAHC-accredited facility, five board certifications, and more than 25 years of experience, Dr. Ferguson offers breast augmentation patients in Honolulu a level of qualification and surgical artistry that is unmatched in Hawaii.
Schedule a consultation with Dr. Ferguson at The Ferguson Clinic in Honolulu. Call (808) 521-1999 or book online.