In breast surgery, I believe that in addition to the desired breast size one needs to pay close attention to preserving a natural shape and improving long term results. I utilize both silicone and saline implants for augmentation. Individual characteristics and goals help determine the size and shape of the implant as well as the location of the pocket (over/under muscle) and the incision site.
For patients who have experienced a significant sagging of the breasts, particularly after childbearing or weight loss, a combination of breast lift and enlargement may be needed. In such cases, I make an effort to decrease the length of the scars when possible.