Does Surgery Technique Make a Big Difference in a Breast Augmentation?

I will be having a breast augmentation in one month and I'm still debating on which certified and well qualified doctor to go to. Looking at both of their before and after pictures, one doctor's pictures looks very "natural" looking - a little better than the other doctor but he's farther away from me. Is there a big difference between a doctor's technique in his/her surgery to make the implants look more natural? For example the placement or the opening for the implant makes a big diffence in the surgeons' surgery technique to make them more natural looking?

Doctor Answers 17

Travel for the best

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The photos are telling you what to do. They reflect what each surgeon believes to be their best work. Yes - there are no 2 surgeons who are the same and neither are their results. Differences in talent, training, experience, patient management, personality, staff quality, and medical and aesthetic judgement separate one from another. ALWAYS go to the one whom you believe will give you the result you are looking for, regardless of location or price. Good luck!

Heck Yes!

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Every doctor meets minimum standards of excellence to achieve Board Certification in plastic surgery. Beyond that, each doctor over the years develops his own way to do things, and his results will be slightly different from another doctors. Both may be excellent, but you should judge which you like better.

Here is the thing.You like both doctors, that is great. Take a look at the results, and look for trends. If you like one more than the other, it is worth the drive, as you want to be happy with the result for a long time.

By the way, another woman my like the other doctor's results better. So look carefully at the results, and choose the ones you like the best. A few miles seems like an unreasonable compromise to your long term happiness.


It makes a huge difference.

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Hi! Results vary a lot from one surgeon to another. There are differences in talent, time and attention spent examining you and understanding what you want, having a good eye, making a good plan, caring, and not quitting in the operating room until the best possible result has been obtained.

Here's just one example: Before the end of the operation, I sit the patient up (you are still asleep, of course) and put in disposable implant SIZERS to decide what implants will give you the nicest, most natural result. Only then do we open the permanent implants. This way I can also check that the shape and symmetry of the breasts is just right. It takes the guess work out.

But many surgeons don't take the trouble to go through these extra steps which take only a few minutes. And a sizer costs only $45.

So travel a little further, and go to the surgeon who makes the natural breasts. And let him or her decide what's the best technique for you.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Breast Enhancement Surgery

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Surgeons are individuals and you should go with the surgeon you feel most comfortable with. Remember pictures online are not standardized and can be photoshoped

Breast Augmentation: Best Results from Experienced Plastic Surgeons

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See the below link on how I would choose the best plastic surgeon for a BA.
Breast Augmentation prices vary greatly because the surgery itself encompasses a wide range of techniques that can be performed to different extents. It might be possible to meet your price point but be careful that this does not mean a less experience surgeon and therefore less quality surgery. My recommendation is to first find qualified surgeons that are board certified by the American Board of Plastic Surgery you trust, then compare prices between them. Factors that influence the price include:
1. Location - Will it be performed in a hospital with an overnight stay, an independent out- patient facility or a doctors office? Geographical location also has a significant influence.

2. Type of Anesthesia - IV sedation or General Anesthesia? Will a board certified anesthesiologist or a nurse anesthetist be used, or an RN?

3. Experience and training of your surgeon. The best trained (and longest) would be a surgeon board certified by the American Board of Plastic Surgery

4. Length and Complexity of Surgery - how difficult will your surgery be and how long, etc . Will other procedures also be done like a breast lift, lipo on the sides of your breast/chest wall, etc be also performed?

Doctor selection for breast augmentation

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Find the best doctor to get the best results. Do not settle for someone just because they are closer to you. It is important to find a good surgeon.

Technique & philosophy can make a big difference.

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Plastic surgery varies with the doctors who perform it without a doubt. We all have different philosophies as to what makes a difference. Some surgeons try to put three operations into the time others put in one. Often they are much cheaper and their results show it.

Some of the really cheap doctors were not even trained as plastic surgeons. They are "re-invented" general surgeons or gynecologists who never took plastic surgery residency training.

Technique and practice philosophy both can make a difference.

John P. Di Saia, MD
Orange Plastic Surgeon

Natural-looking Breast Augmentation

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Surgical technique is not the same from surgeon to surgeon. Breast implant placement and size will determine whether or not a result looks natural. The issue of ‘over’ or ‘under’ the pectoralis major muscle receives a great deal of attention, even more important than implant position relative to this muscle is implant position vertically and horizontally on the chest wall. In many patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola, and in order to prevent the appearance of excessive upper pole fullness.

In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that an implant sits below the skin. Likewise, if the inframammary fold is lowered too far, the augmented breast will appear ‘bottomed out’, with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast – another situation with a distinctly unnatural appearance.

The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Breast implant pockets that extend too fat laterally will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. If the pockets do not extend far enough laterally, however, the result is an augmentation with an abnormal ‘side by side’ appearance. As it is the lateral projection of the breasts beyond the lateral limit of the chest wall (in frontal view) that, along with the concavity of the waist profile and the convexity of the hip profile, produces the appearance of an ‘hourglass figure’, careful attention must be paid to ensure that lateral breast projection is adequate and appropriate.

Another consideration is that the implant base diameter must match the existing anatomic limits of the breast preoperatively and the breadth of the anterior chest in general. Obviously, a given implant volume and diameter that works well for a small-framed patient who is 5’2” will be inadequate for a large-framed patient who is 5’10”. Careful evaluation of all of these issues is necessary if the ultimate goal of the surgery is a natural-appearing breast enhancement.

I urge all propective patients to take time, do a lot of research and view many many before and after photographs before selecting a plastic surgeon to perform breast augmentation. surgery. When viewing photos be sure that you see three positions of each patient, front, side and oblique. The photos should be uniform in all respects, similar lighting and background and shot from the same perspective and cropped so they are equal in size. Be sure that your plastic surgeon has a lot of experience with the incision site you'd like whether it be through the underarm, around the areola or under the breast. Taking some time to speak to several former patients who have had the same surgery you are considering can also be helpful.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

The surgeon you chose makes a big difference; more than other factors

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We're glad to see that you have done research to evaluate the two surgeons you mentioned. Hopefully both are board-certified plastic surgeons. You sound like you like the results of one more than the other. That seems like a good reason to pick him or her, if all other factors are equal.

Two or more surgeons, using the same implant, same incision, same plane of dissection, same anesthesia, and same pre- and post-op care routines will obtain different results for their patients. The surgeon is the most important decision you make.

Sutton Graham II, MD
Greenville Plastic Surgeon

Technique, experience, and results

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The most important decision is your choice of doctors. Your surgeon should be certifiied by The American Board of Surgery. You should see as many before and after photos as possible and trust your instincts as you see these photos. Do not be persuaded by "scarless" claims or gimmicks. In the end the vast majority of patients have a great scar and what they have concerns about are hardness, placement, and symmetry.

Technique is important in that the surgery should be perfomed with the least trauma and bleeding possible, with attention to placement and symmetry. The actual location of the scar is less important.

In general, it is worth traveling the extra distance for something that is only going to happen once in your life.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.