5 Questions?

So you’ve decided to seriously consider breast augmentation. Now what? You just know that you want great looking breasts, but you might be confused about what else to ask. Start with these 5 questions, and you’ll be well on your way to a successful surgery.

1. Are the doctor and the facility properly certified for breast augmentation surgery?

You hear a lot about board certification, but what does it mean exactly? Doctors who are board certified by the American Board of Plastic Surgery ( are also generally members of the American Society of Aesthetic Plastic Surgery ( This is the only group that is a member of the American Board of Medical Specialties (, the nation’s most prestigious group of medical specialties. It takes a minimum of 10 years after college to become one of these elite surgeons!

Equally important is having your breast augmentation performed at a certified facility. Every state has different regulations, but generally all hospitals are certified by the Federal and State government. There are some independent agencies that certify and ensure facility safety as well. I only operate in approved facilities. As a member of ASAPS, I must operate in a surgical facility that is approved by the State of California. If your doctor is offering an out-patient surgery at his office, buyer beware.

2. What are the differences between saline and silicone implants?

First, I want to assure you that silicone implants are safe. The FDA put a moratorium on silicone implants in 1992 after the media had a publishing frenzy telling stories of women who claimed that their silicone implants ruptured and made them ill. The FDA conducted extensive clinical trials, which found no increased risk of breast cancer, connective tissue diseases, neurological diseases or other illnesses in women with silicone breast implants. As a result, the 14-year moratorium on silicone implants ended in November 2006. Now that we’ve cleared that up, let’s look at a few differences between saline and silicone implants.

Saline implants offer the advantage of a smaller incision because they are inserted into the breast empty and filled with saline through a small tube. Silicone implants come pre-filled, and therefore require an incision that is about one inch longer than a saline implant incision. However, saline implants are more firm in texture and don’t not feel as real as silicone implants. For this reason, saline implants may also be at higher risk for creating a rippling effect. Silicone implants create a more natural feel but are slightly more expensive

3. What kind of incision is used for breast implants?

There are three incision techniques for breast augmentation, and in my opinion, they are viable options for virtually all patients. By design, they all leave scars that should end up thin, white and nearly iinvisible. The three incision types are:

IMF/Inframammory/Breast Fold incision – This is the most popular incision technique. It is placed under the breast where it meets the flat skin, and the volume of the implant hides the scar. IMF incisions are only 1.5-2 inches long.

Areolar Incision – This is also very common because the incision is curved inside the darker skin of the areola so it is difficult to see. But because the milk ducts are just behind the areola, there is an increased risk of bacterial interaction during the surgery, which in rare cases can lead to excessive scar formation.

Axillary/Underarm Incision – This incision is placed in the underarm skin folds but is slightly longer because a tunnel must be made under the muscle from the underarm to the breast. This involves more surgery, more swelling and more recovery time. But is it the most hidden incision.

4. What size breast implant should I choose?

For most women, this is the fun part! While women think in terms of cup sizes, those are often subjective and inconsistent. Plastic surgeons think in terms of cc measurements and profiles.

Breast implant volume is measured in cubic centimeters, or cc, which is equal to one milliliter. 30cc = 1 ounce, so a 300cc implant = 10 ounces. Implants range from 120cc to 850cc. I show my patients plenty of samples in the office based on their body type and aesthetic desires. Now that you know how cc measurements compare to ounces, you can also go home and fill a bag with rice in the equivalent number of ounces for a sizing experiment. Put the bags in an unpadded bra, and take several days to decide what works best for you. You might even try going up one size (only 2 ounces more) because the most common reason for breast implant revision surgery is that the patient feels they did not go big enough.

Profile sizes refer to the width of the implant. This is just as critical as volume selection because the size of your frame should be measured to ensure that your implants are not too close together or too far apart.

5. How can I reduce my pain after breast augmentation?

The simple answer is to find a plastic surgeon who specializes in pain reduction and follow that doctor’s instructions. For example, I provide my patients with an awesome device called a “pain pump” that utilizes two small tubes to deliver numbing medication directly to the implant pocket for 3-5 days after surgery. You should also walk around and move your arms as much as possible. Drinking plenty of water and keeping your upper body elevated will help reduce swelling and pain. Finally, using a support bra and consistently icing your breasts for the first 72 hours will do wonders to reduce pain and swelling.

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at or (415)362-1846.


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