Breast augmentation, done well, is not about chasing a trend. It is about balance, proportion, and how a person feels in their own skin. I have seen patients light up when a top finally fits the way they always wanted, and I have seen others happiest with subtle changes that only they notice. The common thread is customization. Every decision, from implant type to incision placement, shapes both the result and the experience. With thoughtful planning and clear expectations, breast augmentation can be a precise, personal procedure rather than a one‑size‑fits‑all operation.
Michael Bain MD, a board‑certified plastic surgeon in Newport Beach, approaches breast surgery with this philosophy. He blends surgical technique with candid conversations about lifestyle, body mechanics, and long‑term maintenance. What follows is a deep look at how a customized approach works in practice, including choices around implants, incision patterns, combination procedures such as a breast lift or tummy tuck, and what matters most in recovery and longevity.
What customization really means in breast augmentation
Customization starts with anatomy. Chest width, ribcage shape, nipple position, breast footprint, and skin elasticity set the parameters. Two patients with the same bra cup size can require very different implants to achieve a similar look, simply because their chest diameters and soft tissue envelopes differ. The goal is to select an implant and a surgical plan that respect those limits while building toward the patient’s aesthetic priorities.
Customization also includes the lifestyle filter. A marathon runner with thin soft tissue and low body fat might prioritize implants that look athletic and settle quickly with minimal lateral movement. A patient who loves structured dresses and wants upper‑pole fullness may feel differently about projection and firmness. Patients with a strong yoga practice, mothers navigating future pregnancies, and those planning weight changes all benefit from a plan that anticipates change rather than ignores it.
There is a third layer, often overlooked: the psychological component. Augmentation can correct deflation after breastfeeding, bring balance to asymmetric breasts, or align one’s external appearance with how they have always felt inside. A skilled plastic surgeon listens for that core motivation and uses it to guide trade‑offs. Bigger is not always better. Rounder is not always more youthful. Natural is not a size; it is a proportion.
The consultation: measuring, modeling, and managing trade‑offs
A detailed consultation with Dr. Bain typically includes precise measurements of chest width, sternal notch to nipple distance, inframammary fold position, and skin pinch thickness. These numbers aren’t just for the chart. They determine the safe implant base width, the likely pocket placement, and whether an internal bra or fold modification is advised.
Sizing uses more than a mirror and a guess. In‑office sizers, 3D imaging, and external implant trials under a fitted top help patients visualize how different volumes and profiles change their silhouette. The process is interactive. Patients often try a range, then step down or up after walking around, sitting, and seeing themselves from multiple angles. A common pattern emerges: when someone wears a conservative sizer for several minutes and then switches to a larger one, they often realize the bigger option overshoots their goals. Taking time in this phase prevents regret later.
Expect frank talk during this stage. For example, if a patient with mild ptosis wants a perky, lifted look without a breast lift, Dr. Bain will demonstrate why an implant alone cannot reliably raise the nipple or tighten lax lower‑pole skin. He may show how a moderate implant could camouflage a small degree of droop, but beyond that, the result risks a top‑heavy, “bottomed‑out” appearance. These trade‑offs are clearer when shown on your own frame rather than in abstract terms.
Choosing the implant: saline, silicone, profile, and gel behavior
There is no single best implant. There is a best match for a particular body and aesthetic.
Saline implants appeal to some patients for peace of mind. If a saline implant deflates, the body absorbs the salt water and the change is obvious. They require a slightly smaller incision because they are filled after insertion. Saline can feel a touch firmer and cause more rippling in thin patients, especially along the outer breast where coverage is minimal.
Silicone gel implants come in different cohesivities, from soft gels that mimic natural breast tissue to highly cohesive gels that hold shape better and resist rippling. The firmer the gel, the more stable the upper pole and the less likely a fold or wrinkle will show, but they may feel less compressible. Modern cohesive gels, when paired with proper pocket control, deliver a soft, natural feel in most patients. MRI or high‑resolution ultrasound screening is recommended at intervals to monitor implant integrity over time.
Profile is often misunderstood. It does not measure how far the implant sticks out on the body; it describes the relationship of projection to base width. A high‑profile implant has more projection for a given base diameter. If your chest is narrow, a higher profile may be necessary to achieve volume without spilling laterally. If your chest is wide, a moderate profile that fills the base width can look more natural and avoid a cone‑like silhouette. Dr. Bain aligns profile choice with chest width, tissue thickness, and desired upper‑pole shape.
Size ranges are discussed in cubic centimeters, but it is more productive to think in millimeters. An extra 25 to 50 cc might barely change your look, while a 1 to 2 mm difference in base width or projection can alter cleavage and implant edge visibility. Many excellent outcomes land in the 250 to 375 cc range for petite frames and 300 to 450 cc for medium builds, with outliers on either side depending on goals. Each step up carries incremental weight, which affects activity and support needs long term.
Incision options and what they mean for healing and maintenance
Incisions are small, but their placement matters. Dr. Bain commonly uses three approaches, selected to balance scar quality, pocket control, and future maintenance.
Inframammary fold incisions sit in the crease under the breast. They provide direct access to create a precise pocket, especially helpful when adjustments to the fold position or internal support are needed. Scar quality here is usually excellent, and the incision stays hidden in most bras and swimsuits. For patients who may need revision work in the future, this approach simplifies re‑entry.
Periareolar incisions hug the border of the areola. They can heal discreetly when there is strong pigment contrast and a larger areolar diameter to accommodate the incision. This route is useful when combining augmentation with minor areolar adjustments, but it is not ideal for all patients, especially when the areola is small. There can be a slightly higher chance of temporary nipple sensation changes.
Transaxillary incisions place the scar in the armpit. Some patients prefer the absence of a breast scar, especially those who tan or wear minimal clothing at the beach. The trade‑off is more indirect pocket creation, which can be challenging for complex adjustments or revisions. This approach is less common when combining augmentation with a lift.
Scar quality depends on biology, technique, and aftercare. Patients who form thicker scars elsewhere on the body can do so with breast incisions as well. Silicone sheeting, sun protection, and gentle scar massage after the wound is sealed all improve the final result. Dr. Bain reviews a plan for scar care before surgery so patients can prepare supplies in advance.
Pocket placement: above or below the muscle, or a split‑plane approach
Where the implant sits relative to the pectoralis major muscle influences contour, animation, and rippling. Three concepts guide this choice.
Subglandular placement positions the implant above the muscle. It offers more direct control of lower‑pole projection and avoids animation deformity when the pectoral muscle contracts. It can be an option for patients with thicker tissue and good coverage, or those with specific athletic goals. The trade‑offs include a higher chance of visible rippling in thin patients and slightly less softening of the upper pole.
Submuscular placement, sometimes called dual‑plane, tucks the upper portion of the implant under the muscle while allowing the lower pole to expand naturally beneath the breast tissue. This can soften the upper edge, reduce rippling, and often provides a very natural slope, especially in slender patients. The muscle can cause some implant movement during heavy chest exercise, which is acceptable for many but not all athletes.
Refined dual‑plane techniques, adjusted to the degree of breast tissue laxity, let a surgeon like Dr. Bain fine‑tune how much of the implant sits under muscle versus under gland. This is particularly useful when mild ptosis exists. The right plane reduces the need for aggressive lifting while shaping the lower pole.
When a breast lift belongs in the plan
Augmentation adds volume. A breast lift changes position and shape. If the nipple sits well below the fold or points downward, adding an implant alone will not create a youthful contour. In those situations, a breast lift realigns the nipple areolar complex and tightens stretched skin. The lift can be completed in the same surgery as the augmentation, using limited incisions when only moderate correction is needed.
Patients sometimes resist the idea of additional scars. The key question is what the eye notices at conversational distance. A perky shape with faint, well‑healed lines often looks more natural than a larger, droopy breast with no lift scars. Dr. Bain reviews scar patterns honestly, explains how tension and closure methods influence scar quality, and helps patients choose the least invasive approach that still achieves symmetry and position.
Pairing augmentation with body contouring
Many patients interested in breast augmentation are also considering other procedures that restore proportion after pregnancy or weight loss. Combining operations can make sense when it is safe and strategic.
A tummy tuck addresses skin laxity, stretch marks, and abdominal muscle separation. When paired with augmentation or a breast lift, the combined change can restore a balanced hourglass line. Dr. Bain plans combined procedures to minimize anesthesia time and manage postoperative discomfort intelligently. For example, adding liposuction to the flanks can refine the waist and reduce the heaviness that sometimes makes augmented breasts feel larger than intended.
Liposuction alone is a versatile tool. In select patients, contouring the lateral chest and bra roll yields a cleaner frame and lets the breast sit in a more defined pocket, enhancing cleavage and reducing the impression of bulk near the armpit. Small adjustments here can make a standard augmentation look bespoke.
The quiet variables: tissue quality, fold control, and internal support
Results that look great at six weeks can drift if the underlying support is not addressed. This is where technique and judgment matter more than implant brand.
The inframammary fold should be respected or intentionally adjusted, not accidentally stretched. If the fold is lowered too far for the tissue quality, the implant can settle lengthwise, creating a long lower pole and a high‑riding nipple. Dr. Bain uses measurements and intraoperative sizers to set the fold at a stable level, often with sutures that reinforce the fold position.
Some patients benefit from an internal bra, which uses sutures or a mesh scaffold to distribute weight and support the implant from the chest wall. This is particularly helpful in patients with thin tissues, previous pregnancies, or revision cases where the pocket has stretched. The goal is longevity, not tightness. Properly used, internal support feels invisible but preserves shape over years rather than months.
Sensation, breastfeeding, and the reality of aging
Changes in nipple sensation after breast augmentation are usually temporary, resolving as swelling decreases and nerve fibers adapt. The risk of persistent changes is small but not zero, and higher in very large augmentations or when periareolar incisions are used in patients with limited areolar diameter. Patients who prioritize sensation should discuss incision and pocket choices accordingly.
Breastfeeding is often still possible after augmentation. The procedure does not remove glandular tissue or sever ducts in most approaches. That said, individual anatomy varies, and there is no surgery that can guarantee future milk supply. If breastfeeding is a high priority and pregnancy is planned soon, many patients choose to wait, or they choose a conservative augmentation that respects the natural breast footprint.
Aging does not stop after surgery. Skin stretches, gravity acts, and weight fluctuations change the envelope. Most well‑planned augmentations keep their shape for many years, especially with good support garments and stable body weight. If the breast drops over time, a minor lift in the future may restore position without changing implants.
What recovery really feels like
Experienced patients often describe a pattern rather than a moment. Day one feels tight, as if you did too many push‑ups. By day three, most are comfortable with oral medication and gentle mobility. Many return to desk work within a week, with restrictions on lifting and upper‑body strain. Full return to high‑impact cardio or heavy chest workouts typically waits four to six weeks, sometimes longer for submuscular placements.
Anecdotally, patients who walk several short laps around the house the day after surgery report less stiffness and better sleep by night two. Staying ahead of swelling with scheduled anti‑inflammatories, wearing a supportive surgical bra, and using a small pillow to keep the arms close at rest all help. Dr. Bain provides a detailed plan that anticipates common speed bumps, from managing bruising to recognizing normal shifting as the implants settle.
Safety first: how Michael Bain MD manages risk
Any plastic surgery, even straightforward breast augmentation, carries risk. A methodical approach reduces it.
Capsular contracture, the pathologic tightening of the scar tissue around an implant, occurs in a small percentage of patients. Minimizing bacterial contamination during surgery, placing the implant in a clean pocket, and choosing submuscular placement when appropriate can lower the risk. When contracture occurs, options include capsulotomy or capsulectomy and pocket change, sometimes with a switch in implant type.
Implant malposition, such as lateral drift or symmastia, usually reflects pocket dynamics, tissue quality, or unrealistic sizing relative to chest width. Preoperative measurements help prevent this. If it occurs, early intervention with taping and support can help; established malpositions may require surgical pocket repair.
Thromboembolic events are rare in healthy augmentation patients, but risk screening still matters. Dr. Bain reviews personal and family history, plans anesthesia to minimize time under, and encourages early mobilization. Smoking cessation is mandatory well ahead of surgery due to its effects on healing and blood flow.
Realistic timelines and maintenance
Augmentation is not a once and done promise. Implants are devices. They are durable, but not immortal. Modern silicone implants can last well over a decade, with many patients enjoying stable results for 15 years or longer. That said, plan on periodic check‑ins. The FDA recommends imaging to monitor for silent rupture in silicone implants at intervals after surgery. High‑resolution ultrasound has emerged as a convenient, radiation‑free option for many.
Patients sometimes ask whether they will need replacement at a set year mark. There is no expiration date by calendar. Replace for a problem, a change in preference, or if imaging suggests a rupture. Otherwise, let good results continue.
Subtle choices that make a big difference
Two patients of similar build met with Dr. Bain in the same week. Both wanted a natural look that fit their active life. Patient A, a distance swimmer with very low body fat, had a narrow chest and tight, elastic skin. Her plan used a modest volume, high‑profile silicone implant in a refined dual‑plane pocket. She returned to light pool work after four weeks and was back to full training by week eight, with minimal visible rippling and a soft slope.
Patient B, a mother of two with mild lower‑pole laxity and wider chest diameter, prioritized cleavage in fitted dresses. She chose a moderate profile implant sized to her base width, paired with a small, skin‑tightening mastopexy to control the lower pole. Her incision sat in the fold with a short vertical component. At three months, she had a rounder upper pole and a lifted nipple position, which would not have been possible by volume alone.
The difference was not simply implant size. It was the relationship between implant, tissue, and support, tailored to the body and lifestyle. This is where experience counts.
Is a “natural” look possible with implants?
Yes, when the breast footprint is respected and the upper pole is shaped rather than inflated. Natural often means a gentle slope from the clavicle, visible but not dramatic upper fullness, and a lower pole that fills softly without a hard edge. That outcome relies on pocket precision, gel choice, and implant width matching the chest.
Conversely, a sculpted, high‑fashion look with pronounced upper‑pole fullness is achievable and can still be elegant. It simply requires different choices: firmer gel, slightly narrower base, and intentional upper‑pole fill. Neither is wrong. The mistake is mismatching the aesthetic to the frame.
Costs, value, and how to think about budget
Prices vary by region, facility, anesthesia, and the complexity of the plan. In Orange County, straightforward augmentation commonly falls within a mid‑four to low‑five figure range. Adding a breast lift, tummy tuck, or liposuction alters operative time and can change facility needs. A rock‑bottom quote may omit essential elements like postoperative garments, imaging, or revision policies. On the other hand, the highest price does not guarantee the best result.
Value lives in preoperative planning, surgical execution, and follow‑through. An experienced plastic surgeon like Michael Bain MD spends significant time on the front end, measuring, modeling, and aligning expectations. That investment pays off in smoother recoveries and fewer revisions.
Preparation that improves outcomes
A few simple choices weeks before surgery can materially improve healing. Prioritize sleep, hydration, and protein intake. Pause nicotine and vaping completely, not just on the day of surgery. Review medications and supplements with the surgical team, as some increase bleeding risk. Arrange help at home for the first few days, particularly if you have young children or pets. Most importantly, confirm your support garments and scar care plan so you do not scramble after the procedure.
The right postoperative bra provides gentle compression without pushing implants unnaturally high. Underwire is typically avoided early on. If you lift weights, plan a staged return that respects pocket stability. Your future self will thank you for not rushing push‑ups or heavy bench work.
How to choose your surgeon
Experience, board certification, and a portfolio of results that match your taste matter. So does how the consultation feels. If you feel rushed, or if every question gets the same generic answer, keep looking. Dr. Bain’s patients often comment on the clarity of his explanations and the thoroughness of his measurements. You want a plastic surgeon who is as comfortable saying no to an unsafe size as they are saying yes to a plan that fits your vision.
Two quick cues to assess during a visit: first, does the surgeon discuss millimeters and tissue quality, not only cc volumes? Second, do they describe how your result will age, not just how it will look at six weeks? Those are signs you are in experienced hands.
When revision is the right answer
Life happens. Breast shape changes with time, pregnancy, and weight shifts. A well‑done augmentation from a decade ago can still call for refresh. Revision can address capsular contracture, asymmetry, implant rupture, or a desire for a different look. The best revisions start with a plainspoken analysis of what is working and what is not. Sometimes the fix is as simple as a pocket adjustment and a small size change. Other times, liposuction surgeon drbain.com an internal bra and a mastopexy create a much more stable, aesthetic foundation. There is no shame in revising. It is part of the lifecycle of implant‑based breast surgery.
Final thoughts from a customization lens
Breast augmentation builds confidence when it is precise, proportionate, and honest about trade‑offs. The technical pieces, from gel cohesivity to fold control, are tools. The art lies in listening closely and shaping a plan that fits a particular life. Michael Bain MD brings that balance to his plastic surgery practice in Newport Beach, whether the goal is subtle enhancement, a combined breast lift for a perky contour, or a coordinated approach with liposuction or a tummy tuck for comprehensive change. Patients who invest in careful planning tend to love their results more, and for longer.
If you are considering augmentation, start with the right questions. What look do you want at a glance? How should it feel in motion? How will it age with your lifestyle? Then bring those answers to a consultation where measurements, modeling, and experience translate them into a sensible, safe plan tailored to you.
2001 Westcliff Dr Unit 201,
Newport Beach, CA 92660
949-720-0270
https://www.drbain.com
Top Plastic Surgeon
Board-Certified Plastic Surgeon Plastic Surgery in Newport Beach
Newport Beach Plastic Surgeon
Michael A. Bain MD
2001 Westcliff Dr Unit 201,
Newport Beach, CA 92660
949-720-0270
https://www.drbain.com
Newport Beach Plastic Surgeon
Plastic Surgery Newport Beach
Board-Certified Plastic Surgeon
Michael Bain MD - Plastic Surgeon
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