Plastic Surgeon Daniel Ronel, M.D.

I take precise anatomical measurements to determine the safest range of implants from which the patient can choose. I like to put most implants behind the pectoralis muscle because I think it is safer there. My favorite approach is through the armpit because the muscle is lifted up and the implant can be slid underneath, instead of cutting through the muscle. Even those women requiring a breast lift can take advantage of this approach. The choice of silicone or saline implants is an individual one and depends on several factors, including body size, cost and personal preference. I think the difference comes down to only a few things.

• 1) Silicone implants cost about $1,000 more than saline implants.
• 2) The incision used to place silicone implants is slightly larger than the one used to place saline implants. If someone is having a breast lift, it does not matter because the implants are generally placed through the open breast incisions.
• 3) Silicone implants feel a little more natural than saline implants. Because I place my implants under the pectoralis muscle, this is somewhat less apparent than you'd think. In a thin woman with large implants, there is a noticeable difference, but in a woman with some subcutaneous fat and breast tissue, who is not choosing a large implant, I think the difference in feel between silicone and saline implants is small. Women 35 years or older should have a mammogram before their breast augmentation.