Breast implants must be placed through an incision in the skin. There are generally four options for scar placement – the arm pit (axilla), the area around the areola (peri or circum-areolar), under the breast crease (inframammary fold), and the belly button or umbilicus. The placement of implants from the abdomen has been largely abandoned by most plastic surgeons. Most common today is the inframammary fold incision under the breast fold. This remains well hidden, even in bikini bathing suits or nude. It also provides direct access to the placement of the implant and is usually limited to around 3cm (just over an inch). Dr. Marion uses the Keller Funnel to aid placing the implant and this has many advantages, one of which is requiring a smaller incision or scar.

There are many types of implants to choose from when considering a breast augmentation. Options include the shape, implant surface texture and the implant filling such as saline and several types of silicone gel (cohesive gel, gummy bear breast implants). All of these breast implant materials will do a great job enlarging the breast and all are FDA approved. But there are subtle differences between these material types that can affect how they feel, what incision is needed for their placement, how long they will last and their costs. It is important that each patient be aware of these breast implant differences so they can make the best choice.

Dr. Marion has used all brands and types of implants and is satisfied with the safety and results of the newest generation of implants that are called form-stable or highly cohesive silicone gels.

The breast implant size has two main variables- size (volume) and shape (projection). The choice depends on what the patients goals are. When considering volume it is best to limit the range of size to the footprint of the breast. This means taking careful measurements of where the implant is going to be placed on the chest then based on those measurements determining the volume of implant the manufactorers make for that measurement. This is sometimes called tissue based sizing.

The second consideration is profile. This also has an important role in implant sizing. One can choose between moderate, moderate plus, high and utra-high profiles. Basically this relates to the projection of the implant from the chest wall- ultra-high being the greatest take-off which gives a more augmented or enhanced look. The different profiles can affect choice of volume as well. Because the decision on implant size/shape has many variables and is of high concern to patients, the decision should be made carefully.

Dr. Marion feels that the most important part of breast augmentation consultation is for him to have a good understanding of the patients goals. To help with this he utilizes a breast sizing system.

This has been show to closely resemble the final result patients receive in surgery and helps Dr. Marion to better envision what the patient hopes for as an end result. Seen here, the sizing system allows patients to place different size implants over their own breasts to similate what the different sizes would represent on them. Once the patient finds a size or two that they prefer, Dr. Marion will review their choice with them and develop the plan for surgery.