Natural, Proportional Breast Augmentation in NYC: Implant Choice and Placement Matched to You

Who breast augmentation is for

You may be considering breast augmentation to increase volume, restore fullness after pregnancy or weight change, or improve a difference between your breasts. You may want a subtle change or a fuller shape. Our goal is to understand the result you want and evaluate how your anatomy affects our decision-making.

What we are trying to achieve

Breast augmentation, when done well, produces a breast that is in proportion to the chest and the rest of the body, with a natural slope, a soft feel, and a shape that holds up over years rather than months. How it functions is equally important. The pectoralis muscle is involved in almost everything the upper body does, and an augmentation that pulls or distorts with movement is not an optimal result. Appearance and function need to be planned together.

Deciding where the implant goes

For those who have spent time researching breast augmentation, implant placement can seem overwhelming. The truth is that there is no single best placement for every patient. Your surgeon should be making the decision based on what is best for your situation.

Above the muscle, beneath the breast tissue (subglandular). This avoids placing the implant beneath the pectoralis muscle, which eliminates the risk of animation issues. It requires adequate tissue coverage, because implant edges and rippling may be more noticeable in thin patients.

Above the muscle, beneath its fascia (subfascial). The implant sits under the thin connective tissue covering the pectoralis. This also avoids placement beneath the muscle, and the animation issues that can occur. It can help alleviate some of the coverage issues seen with subglandular placement, and it is often an excellent approach.

Partly beneath the muscle (subpectoral, typically dual-plane). The muscle provides additional coverage over the upper implant, which can be useful when breast tissue is limited or when a patient's skin is thin or does not provide good support. The tradeoff is muscle involvement and the possibility of implant movement with contraction.

The first two approaches are both above the muscle, sometimes described as prepectoral. Each approach can produce a good outcome in a suitable patient. Our assessment determines which balance of coverage, appearance, and movement best fits you.

Implant choice and surgical technique

We use implants from multiple manufacturers, including FDA-approved Motiva SmoothSilk implants. Implant dimensions, gel characteristics, and your tissue coverage inform the choice. We explain why we recommend a particular implant and how it fits the overall plan.

What your consultation involves

A breast augmentation consultation assesses your chest and breast measurements, tissue thickness, skin quality, and existing asymmetry. We also discuss your goals, work, hobbies, exercise, and any plans for pregnancy or significant weight change.

You receive a recommendation for implant size, type, and placement, with the reasoning explained. We discuss the incision, scars, recovery, risks, and longer-term follow-up, so you can make an informed decision.

What a realistic outcome looks like

Breast augmentation produces a visible change soon after surgery, but swelling and implant settling affect the early appearance. Shape continues to evolve over the following months. Your return to work and exercise depends on the operation, and in general recovery periods are relatively short. Motiva describes recovery after its Preservé technique as a matter of days, and both of our surgeons are certified in it.

Augmentation can improve volume and proportion, but it cannot guarantee perfect symmetry or prevent future changes from aging, pregnancy, or weight fluctuations. Risks include bleeding, infection, altered sensation, capsular contracture, implant rupture, and the possibility of further surgery. We review the implant-specific safety information and monitoring recommendations with you.

Breast implants are not lifetime devices, although their durability has improved with current-generation implants. The likelihood of complications increases with time, and some require another operation. Long-term care is part of the decision from the beginning.

If you already have implants and want to address a change in appearance or comfort, visit our revision and restoration breast augmentation page.

If you would like to discuss your goals and the options that fit your body, a clinical opinion is a reasonable first step.

‍

References

1. U.S. Food and Drug Administration. Risks and Complications of Breast Implants. https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants (implants are not lifetime devices; complications increase with time).
2. Establishment Labs. Establishment Labs Receives U.S. FDA Approval for Motiva Implants. Business Wire, 26 September 2024. https://www.businesswire.com/news/home/20240926359459/en/ (supports "FDA-approved Motiva SmoothSilk implants").
3. Motiva. Preservé for patients. https://motiva.health/patients-preserve/ and https://drupal.motivausa.com/patient/preserve (manufacturer's recovery claim, attributed as such on the page).

‍