PLASTIC AND RECONSTRUCTIVE SURGERY
HIGH DEFINITION LIPOSCULPTURE
ISAPS MEMBER 
Mexico City and Oaxaca

DR Marcos Salazar 

Breast Augmentation

Rhinoplasty

Facelift

Hello,
You are very well informed about your procedure. Based on the information you’ve shared, in my opinion there are not many options to consider &mdash; a properly performed dual-plane approach would be the most appropriate choice, and I’ll explain why.
In your specific case, a subfascial plane would likely not provide sufficient soft tissue coverage. This can increase the risk of visible or palpable rippling (where implant edges can be seen or felt) as well as bottoming out (downward displacement of the implant over time).
A correctly executed dual-plane technique allows controlled release of the lower muscle fibers, enabling the implant to settle naturally into the lower pole. This expands the lower breast, improves shape, and creates a more natural slope and contour.
Regarding implant selection, I always recommend choosing a device with a strong safety record and long-term reliability. Some implant types may have higher reports of rotation or positional issues depending on patient anatomy and surgical technique, so careful selection is important to minimize risks.
I would be happy to review your case in detail and clarify all of your questions during a consultation, so we can design the safest and most natural-looking plan for you.
Warm regards, Dr. Marcos Salazar

Hi doctors, I’m 166 cm tall, 55 kg, with a breast base width of approximately 11–11.5 cm. I have very minimal natural breast tissue and low body fat. I am considering Motiva Ergonomix 2 implants in the 235–250 cc range (mini size), aiming for a small, natural-looking result. My surgeon is currently deciding between dual plane and subfascial placement because I have very little natural breast tissue. However, he mentioned that he may not prefer dual plane in my case because Motiva Ergonomix 2 implants are lightweight and highly cohesive, and he is concerned that under the muscle they might not settle or “drop” in a way that creates a soft, natural slope. He suggested that the implant could potentially stay too high or not create the desired lower pole fullness. At the same time, I am concerned about soft tissue coverage due to my low body fat. Given my anatomy and the relatively small implant size (235–250 cc), would subfascial placement provide enough upper pole coverage and long-term aesthetic stability? Or would dual plane still be considered the more predictable option in a thin patient like me? I would greatly appreciate your professional opinions.

Low tissue patient (55 kg) – 235–250cc Motiva Ergonomix 2: Dual plane or subfascial? (Photos)

Hello,
Yes, it is absolutely possible to achieve a very natural result with a smaller implant. During your consultation, we would take detailed measurements of your breasts and perform implant sizing in front of a mirror so you can see how different volumes would look on your body before making a decision.
Since you currently have limited upper pole volume, a dual-plane technique is often an excellent option. This approach allows the implant to be partially covered by the muscle in the upper portion of the breast, helping to create a softer and more natural contour.
A round implant can help maintain a natural-looking cleavage, while the dual-plane placement contributes to a more natural slope and breast shape.
Additionally, transferring a small amount of fat to the cleavage area is always an option to further soften transitions and enhance natural definition.
I would be happy to discuss all of your questions in detail during a consultation and design a plan that aligns with your goals.
Warm regards, Dr. Marcos Salazar

Hi! I am 5’7 and I work out 6 days a week weight training at the gym. I wanted fat transfer to breasts for I am not a big fan of implants and just having plastic in my body in general. I have gone to various surgeons and the mentioned that fat transfer would be difficult (it is not common in Mexico) and all recommended breast implants. I am currently a 32A and would like to go up to a 32B, would 180cc tear drop over the muscle be ideal as recommended to me?

Would I be able to achieve my goal size from a 180 cc implant? Currently 32 A, goal is 32 B (photos)

Hello,
What is happening is that the implant appears to be positioned too far beneath the muscle and is not settling into a natural position. This commonly occurs when the dual-plane pocket is not adequately released.
This condition is often referred to as a “waterfall deformity,” where the implant remains positioned higher on the chest while the natural breast tissue descends over it, creating a cascade-like appearance.
The most effective solution in this situation is to properly release and adjust the muscle to allow the implant to settle into a more natural position. In many cases, combining this with a periareolar mastopexy (breast lift) helps reposition the breast tissue and improve overall shape and balance.
A detailed in-person evaluation would allow for a precise surgical plan tailored to your anatomy and goals.
Warm regards, Dr. Marcos Salazar

I am not satisfied with the result of the surgery. The breast is not filled in at the bottom and the skin is loose. My doctor said that a lift was not necessary, but now he is suggesting a lift to correct it. Are there any other possible options to fix this? Before the surgery, this was a 375 ml Motiva Ergonomix implant planned to be placed using the dual plane technique.

How can this be fixed? The lower part of the breast is not round and feels loose. Will I need a lift? (Photos)

Hello,
I completely understand your hesitation about undergoing a breast lift due to concerns about scars or surgery. That is a very common and valid concern.
However, based on the degree of laxity and breast drooping you have, a lift would likely be necessary to achieve a natural and well-proportioned result. Placing implants without performing a lift is generally not recommended in this situation, as the additional weight could worsen the sagging and negatively affect the overall shape of the breasts.
In your case, restoring fullness to the upper pole is especially important to create a natural, balanced cleavage. If you prefer to avoid implants, this can often be achieved with fat transfer using your own tissue, which provides subtle volume and a softer, more natural contour.
A personalized consultation would allow us to evaluate your anatomy in detail and discuss the option that best aligns with your goals and comfort level.
Warm regards, Dr. Marcos Salazar

Hi, I’m currently trying to see if this is even possible. I am a deflated 38C. I would love to avoid a lift if possible. I am 100% ok with my nipple not moving I just want to be full on the bottom and natural. My priority is a natural sloped look with rounded lower fullness. I prefer implants only if possible and I do NOT want a high round upper pole. Thank you!

My priority is a natural sloped look with rounded lower fullness - Can I avoid a lift? (Photos)

Hello!
Rhinoplasty can be an excellent option to refine your nose and create better overall facial balance. By improving nasal proportions, we can enhance harmony between your facial features in a very natural way.
If there is underdevelopment of the midface or lack of cheek projection, this can often be improved with fat transfer to restore volume and create better contour and balance. Small adjustments in the midface can make a significant difference in overall facial harmony.
I would be happy to discuss the different options with you during a consultation, evaluate your facial structure, and recommend the approach that best aligns with your goals.
Warm regards, Dr. Marcos Salazar

I have a big nose and pretty flat cheekbones. I’m not sure if it’s due to a recessed maxilla or just poor nose development. I used to have an underbite that was fixed with orthodontic treatment but feel it only masks the issue now then fully correcting it like it might have with jaw surgery. All they did was pull my lower jaw back to fix it. And now that I consider a rhinoplasty, am wondering if that is even the right thing to tackle.

Rhinoplasty or recessed maxilla? (Photos)

Hello, this is Dr. Marcos Salazar from Mexico.
In many cases, the term “mid facelift” is often used for marketing purposes to make the procedure sound less invasive. However, for patients who present moderate to significant skin laxity, a Deep Plane Facelift is usually the more comprehensive and effective option.
This technique allows us to reposition the deeper facial structures, correct muscle laxity, and restore long-lasting firmness and definition to the face and neck &mdash; often with results that can last 10 years or more.
There is no need to be afraid of this procedure. When performed by a board-certified plastic surgeon, it is very safe. Most patients experience minimal discomfort, and recovery is generally smoother than many expect.
If you would like to schedule a consultation, I would be happy to evaluate you in person, explain the procedure in detail, and answer all of your questions so you can feel fully informed and confident in your decision.
Warm regards, Dr. Marcos Salazar

I'm almost 72, and I understand that a midlift is appropriate for much younger women, but I had a lowerlift in 2018, which I think is still doing well. Could i be a candidate for a midlift?

Midlift - could I be a candidate at almost 72? (Photos)

Marcos Salazar, MD

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Plastic surgeons specialize in the full spectrum of cosmetic and reconstructive surgeries for the face, eyes, nose, breasts, and body.

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Meet Marcos Salazar, MD, a trusted Plastic Surgeon. See 6 expert answers, 29 before-and-after photos, credentials, treatments, and 0 real patient reviews. Book a consultation today!

Total Definer Liposuction Expert

General Surgery Residency — Hospital Pemex Norte, accredited by Universidad Nacional Autónoma de México (License No. 12169105).

Subspecialty in Plastic &amp; Reconstructive Surgery — CMN 20 de Noviembre ISSSTE, accredited by Universidad Nacional Autónoma de México (License No. 13764523).

Board Certified — Consejo Mexicano de Cirugía Plástica, Estética y Reconstructiva (No. 2468).

Member — Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva ,  International Society of Aesthetic Plastic Surgery (ISAPS).

Advanced international training in high-definition body contouring (Total Definer with Alfredo Hoyos), rhinoplasty, breast, and facial surgery across the United States, Europe, and Latin America.

MD — Universidad Anáhuac Mayab (License No. 8879665).

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