Dr. Rian A Maercks: In my practice I simply do not offer the
augmentative look. The augmented look is very accepted in the community and even celebrities. In newspapers and magazines we see people flaunting a very augmentative look. An augmented look means to me a high, round projecting, and separated breast. In my opinion, this is a predictable result of the most commonly used breast augmentation technique, the Dual Plane or Sub-muscular approach. Because we're relying on superior muscular coverage of the implant the
implant simply can't go medial enough to look natural, and that's just one of the problems.

I was never will to create this kind of appearance on a woman because I'm more focused on natural results. So I designed something called the Cold-Subfascial Breast Augmentation. There are many things that are different including just the aesthetic perspective, the aesthetic goal. I'm not trying to create a round, separated, high breast. I'm trying to create something that could pass for natural. I don't put scars on the breast unless I'm doing a lift, so I use a Trans-Axillar or armpit approach. And I lift the fascia of the strong layer on top of the pectoralis major muscle off of the muscle. And I design a custom pocket to put the implant in.

And the custom pocketed design creates the formed implant. So another change is I don't need high profile implants to create a profile. I always use low profile implants or the nice anatomically shaped Hourgan 410 or Sientra shaped implants. So I create this custom breast customizing every detail, from width, height, and nipple projection. Customized to the patient's body. Using what's based on an internal bra or brassiere made of the strong living tissue called fascia. The other advantages are long term support with a Dual Plane type of approach you have pressure pressing down the implant above and nothing holding it below.

So within three months to a year you can usually feel an implant directly underneath the skin and inferior pull. On the contrary on the Subfascial approach were you preserve the entire fascia, the fascia hold the brunt of the pressure and weight of the implant protecting the overlying tissues for a longer lasting result. My patients and myself believe that my results can easily pass for natural. And when my patients want to look extra busty or more cleavage they can easily just use a push-up bra or tighter clothing just like anyone else.

Options for a Natural Looking Breast Augmentation

Doctor Maercks discusses options for a natural looking breast augmentation.