Dr. Oldham is announcing that Covid-19 realities have led him to accelerate his timetable for retirement.  Dr. Michael Vincent, a widely respected local plastic surgeon, has agreed to be available to see Dr. Oldham's patients who need plastic surgery services. Rated as a "Top Plastic Surgeon" by Washingtonian Magazine, Dr. Vincent also served as Consultant to the White House and Congress and as surgeon for two past Presidents before starting his career in private practice in Rockville.  

Dr. Vincent's contact information is:

15245 Shady Grove Road #155

Rockville, MD 20850

240 912-4708

Thank you for your interest in our practice.

Selecting the Right Breast Implants

Breast augmentation with implants is a very popular way for women to enhance the size, projection, and proportion of their breasts. After choosing a reputable cosmetic surgeon, breast implant selection is the most important decision a woman will need to make before her procedure. There are a wide variety of implants on the market today, and each provides a unique set of advantages. Respected plastic surgeon Dr. Roger J. Oldham can help you determine the type of breast implants right for you during a consultation at his Bethesda, MD, practice. 

image of breast implant consultation

During your visit, we can help you select the size and shape of implants that will complement your body type and reflect your aesthetic goals.

Saline vs. Silicone

Silicone vs. saline implants - this is often the first question women have to consider regarding their implant type. Both saline and silicone breast implants consist of a silicone outer shell. Silicone implants are pre-filled with a silicone gel while saline implants are empty when they are inserted behind the breasts and then filled with sterile saltwater during surgery.

Many women choose saline implants for their simpler surgical placement and post-operative care. In addition, women who have concerns about long-term implant safety often select saline implants. In the unlikely occurrence of a rupture or leak, the body naturally absorbs the saline and the implant will deflate. Alternatively, women who seek the most natural texture and appearance generally choose silicone implants. After years of improvements in design, silicone implants are safer than ever before, and simply require occasional MRI (magnetic resonance imaging) scans to monitor their integrity. These check-ups are important, as silicone implants will not noticeably deflate in the event of a rupture. 

Shapes & Sizes

Silicone and saline implants are available in a variety of sizes, shapes, and projections. Round implants are the tried and true implant shape, and have helped women enhance their figure for decades. In recent years, teardrop-shaped implants have become popular, but they have the disadvantage of occasionally flipping upside down.

Teardrop-Shaped Implants

When viewed in profile, a natural breast has a teardrop-like shape. Gravity pulls most of the breast mass downward, making it slimmer near the collarbone. Teardrop shaped implants are designed to reflect this natural contour, while still augmenting the overall size of the breast. However, due to its shape, a teardrop implant that shifts out of place can distort the enhanced shape of the breast. In this case, patients may require further surgery to correct the issue. In addition, the unique shape means that this type of implant typically costs more than round options. 

Round Implants

Because of their shape, round implants help women maintain the bust line originally achieved through their surgery. These implants can shift without causing any concern of an irregular shape, and also provide added fullness to the upper portion of the breast. It is important to keep in mind that round implants may eventually adopt a contour similar to the teardrop shape under the effects of gravity. Generally, round implants cost less than their teardrop-shaped counterparts.  

Profiles and Size

Breast implants come in a range of sizes and profiles. The profile of the breast implant refers to how far it will project from the chest wall. A breast implant that has a wider base will lay closer to the chest, while an implant with a narrower base will create a more dramatic silhouette. Often, patients can receive smaller implant sizes but still achieve their desired results with a higher profile implant. 

Implant Placement

Dr. Oldham can place implants using various incision patterns so any scarring will be camouflaged around the nipple or concealed beneath the breast. It is important to remember that saline implants can be placed using smaller incisions. In most women, silicone implants will require slightly longer incisions. Depending on the size of the areola, an incision under the breast may be required. Breast implants can also be placed above or below the chest muscle, depending on your preference and your goals. The best way to determine which implantation method is suited to your needs is to schedule a consultation with Dr. Oldham to discuss your options. 


Subglandular implants are placed above the pectoral muscle, but below the breast tissue. This method produces a more dramatic enhancement and provides ample cleavage. If your breasts are naturally far apart, this placement option is a way to bring breasts closer together when wearing low-cut clothing. Women who are athletic or live an active lifestyle tend to prefer this method, because it will not affect their muscle and can offer a shorter recovery time

The downside of subglandular implants is that they are more likely to develop capsular contracture, a condition in which the scar tissue around the implant becomes excessively tight. This condition can cause the implant to take on an unnatural shape, or to rupture. 


Submuscular implants are placed below the pectoral muscle, and are preferred by patients hoping for more natural-looking results. In comparison to other implants, submuscular implants make mammograms easier and diagnostics more precise. This implantation method is particularly effective if you have naturally small breasts, or are especially thin and petite. It is possible that your submuscular implants will shift and look unnatural when pectoral muscles are flexed. 

Many patients who plan to have children in the future also prefer this method because it can lower the risk of complications with breastfeeding.

Breast Implant Revision Surgery

If you underwent a breast augmentation procedure and are unhappy with your results, revision surgery is an opportunity to provide you with the look you deserve. Common issues addressed by this procedure involve size, shape, and capsular contracture. Revision surgeries can also be performed for implants that require replacement due to age.

Dr. Oldham may recommend placing a different size of implant if you are unsatisfied with your results or have experienced complications. Sometimes altering the placement to subglandular or submuscular can provide a better outcome. Capsular contracture is treated by loosening or removing the constrictive scar tissue that is squeezing or distorting the breast shape. Typically, once the scar tissue is removed, the implant is replaced. 

Small changes can make a large difference in how you feel about your implants. An in-depth assessment of your current bust line and your goals can help Dr. Oldham decide whether breast implant revision surgery is the right option for you. 

Schedule Your Consultation Today

Other than taking the time to educate yourself on breast implant options, the most effective way to ensure your long-term satisfaction in your surgery is to choose a reputable board-certified plastic surgeon. Dr. Oldham serves as an associate clinical professor of surgery at Georgetown University, and has been selected among an exclusive group of surgeons for membership in the prestigious Aesthetic Society of Plastic Surgery and International Society of Aesthetic Plastic Surgery. Contact us online or call (301) 530-6100 today to schedule a consultation.

To: Roger J. Oldham, M.D.

Dear Dr. Oldham,
interested in scheduling an appointment with you
and would like to receive information about
. Please
at your earliest convenience.

Expand to Personalize Your Message

Roger J. Oldham, M.D.

Phone: (301) 530-6100
Fax: (301) 530-6104