Breast Augmentation 101

Breast Augmentation 101

Breast augmentation is one of the fastest-growing and most popular procedures I do at Mountain Lake Plastic Surgery, so here’s a primer on breast augmentation to get you started.

There are 4 primary decisions to make when planning a great breast augmentation:

  • Implant size
  • Implant type
  • Incision location
  • Implant pocket- under vs over the muscle


This is the big question for many women and I spend a lot of time working with my patients to find the size that will achieve their goals. Breast implants are manufactured in a wide range of sizes from 100 cc all the way up to 800cc. Size choice depends on each woman’s goals, as well as many factors such as her body shape and existing breast size, the thickness and elasticity of her tissues, and the position of her breasts on her chest wall. The most commonly used breast implant sizes are in the 275-425 range, but some women choose larger and some smaller – my goal is a personalized plan for each woman.


Implant Type

You’ve probably heard about saline and silicone gel implants, but did you know that breast implants are also made with different surfaces as well as different shapes? Implant manufacturers make textured surface implants that are designed to “stick” in place, and they also make teardrop shaped implants that are designed to lend a slope to the upper pole of the breast. The modern implants that I use most frequently are round, smooth surfaced, silicone gel or saline implants.


Incision Location

Surgeons can make an incision in the crease under the breast, around the edge of the areola, in the armpit, or even in the bellybutton! As you can imagine, the farther away from the breast the incision is, the harder it is to be precise with creating the pocket for the implant. In addition, if revision surgery needs to be done in the future, it’s harder to do that through incisions in the armpit or bellybutton. There’s now some scientific evidence that there are higher complication rates with the periareolar (around the areola) incision. In the majority of cases, I use a small incision hidden in the crease under the breast; this allows me to create the implant pocket precisely and avoid some of the problems that can be associated with other incisions.


Implant Pocket- Over or Under the Muscle

During breast augmentation surgery, I create a space for the implant that is either directly under the breast tissue (subglandular/over the muscle), or partially under the chest muscle (subpectoral/under the muscle/dual plane). Each approach has its pros and cons. Many of my patients prefer over the muscle with smooth round cohesive gel implants, but it’s great to have so many options available for customizing the approach.

For more information about breast augmentation surgery, contact Mountain Lake Plastic Surgery today!