The Surgeon Minute

Five Questions That Guide Every Breast Aug

Five Questions That Guide Every Breast Aug

Breast augmentation is the most popular plastic surgery procedure in the United States with hundreds of thousands of procedures done each year. If you find yourself searching for information on the Internet about breast augmentation, you can easily get confused by the multitude of opinions and options floating around online. Miami plastic surgeon Dr. Constantino Mendieta recently took the time to explain the basic five questions that guide the decision making process for every breast augmentation.

by Anne Meyer
and Constantino Mendieta, MD

Question #1: Do You Need A Breast Lift?

During the consultation Dr. Mendieta does a physical examination to determine if a patient is a candidate for a breast augmentation alone or if the breasts also require a lift.  He examines the nipple position and the amount of extra, or droopy, skin that exists. If you fall into the category that you doesn’t require a lift, you are ready for question number two.

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Question #2: Where Am I Going to Place the Scars?

Breast implants are inserted through incisions that can be hidden in several different locations on the body with trade-offs to be considered for each option. Together with your surgeon you will determine which incision is the best option for you, based on your anatomy. Most commonly, incisions are placed around the areola or hidden under the fold of the breast. Other options include the armpit and the belly button.

Question #3: Will the Implant be Placed Above or Below the Muscle?

“Once we’ve decided on the scar,” continues Dr. Mendieta, “I need to know, do we want to go underneath the muscle or do we want to go above the muscle?” When patients have very little breast tissue, surgeons often recommend placing an implant beneath the muscle in order to provide more natural coverage.  If a patient begins with a fair amount of breast tissue before they add an implant, it may be an option to place the implant above the muscle. “Now there’s a new plane, called the fascia,” adds Mendieta. “The fascia is a thin layer that exists between the muscle and the breast tissue. Some people feel that going underneath that fascia gives you the benefit of both, without having to go underneath the muscle.”

Question #4: What Size Implants?

During the surgery planning process, Mendieta measures his patient’s breasts to help determine the proper implant size. “We measure your breast width, we measure your breast height, and we decide what implant we will put in based on what your body will accommodate.” Once the measurements determine a ballpark range of sizes, he uses other methods of determining the size each patient desires for their new breasts. Often patients will bring pictures of breasts they have seen in magazines or on his website that they like.  

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Question #5: Saline or Silicone?

Another decision all breast augmentation patients must decide is what type of implant they will have. The two basic choices are saline or silicone gel filled implants. Silicone gel is the most popular implant around the world, due to its natural feel and longevity. “Silicone gel has been approved by the FDA, and it is safe,” assures Mendieta.  It is a more expensive option, so if cost is a concern, patients may decide to opt for saline.

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