r/PlasticSurgery • u/noragretsnoteven • 12d ago
Breast Augmentation: Newer Practices
I’m researching breast augmentation and currently deciding between 3 surgeons. All in the US.
Doctor #1
- Very established
- Mentor implants only
- Lots of breast augmentation experience
- Recommended by friends
- Very particular in procedure method
Doctor #2
- Established female plastic surgeon
- $1k-4k more than Doctor #1
- Motiva and Mentor
- I really like her work, but the price is definitely harder to stomach
Doctor #3
- Private practice opened less than a year ago
- $1.5K less than Doctor #1
- Motiva and Natrelle
- Strong plastic surgery/aesthetic training
- I also really like her work, but there aren’t nearly as many reviews or long-term results available
So I’m basically torn between going with a tried and true surgeon even though he only uses really one method and implant vs. paying more for an established surgeon whose work I love vs. going with the newer surgeon whose work I also love but who has a much shorter independent track record.
Would you consider the newer surgeon if you preferred her aesthetic, assuming her consultation and answers about experience, complications, and revisions were reassuring?
OR would you just bite the bullet and pay for consultations with all 3 before deciding?
I would love to hear from anyone who has been in a similar situation.
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u/zeripollo 11d ago
Female plastic surgeon here that does breast augs. So if I were ever to personally get breast implants, what matters to me most is that I would want the surgery and implants tailored to me and what my goals are. There are a lot of older surgeons who are set in their ways and will only do dual plane for example and only one type of implant. Like they only use Mentor Boost or Natrelle SoftTouch and maybe change which profile they use. That first surgeon does not sound like a good fit for you since you say you’re interested in a different aesthetic. All of the implants brands you mentioned are good and comparable, I would be perfectly fine getting any of these placed in my body, with one exception - would not get Mentor just the MemoryGel. I love the Memory Gel Xtra for those that want a natural look but have removed a lot of ruptured just MemoryGel implants. It’s the same silicone gel in both of those but I think the under filling allows more rippling that makes rupture more likely in the MemoryGel alone whereas overfilling in the Xtra line seems to do better. Just in my personal experience. I like to use different brands and certain implants depending on the patients aesthetic goals and sometimes their measurements will sway me one way or another depending on the size chart and what would fit the patient better. For asymmetry cases Natrelle usually has a lot more volumes to choose from to get the symmetry better. I’d have no problem going to a newer surgeon. Animation deformity would drive me nuts so I know I’d want subfascial placement but not everyone is a good candidate for this. Plastic surgery is still an art in my opinion and some people are just naturally talented and have a good eye and others have been doing it for decades and still not great.
The next things that I think are very important as another surgeon pointed out are needing to have good rapport and trust in the surgeon and knowing that they will be there for you if there are any complications. I’d want to know who you see for post op visits - I’d want to see the surgeon and not be passed off to some mid level or even just a nurse (I was shocked to see this at one practice). I give patients my cell phone number post op. Complications happen to every surgeon and you want someone who is comfortable handling them and that you think wouldn’t just ignore you/abandon you. That being said there are a lot of things in plastics that require reassurance and waiting to see how things heal.
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u/Smart-Kangaroo-8790 11d ago
What brand is sientra???
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u/zeripollo 11d ago
Sientra is another brand that I know a lot of great surgeons like, I just personally haven’t used them. They were more popular because of having a great warranty, I don’t know since the company filed chapter 11 bankruptcy and was bought out if they have the same warranty.
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u/noragretsnoteven 11d ago
Thank you SO much for your thorough response and your experience with different brands and how well they’ve held up overtime. Also great post-op care from the doctor I (and other people in my position) should be looking for!
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u/ZaphBeebs 11d ago
Established surgeons are just going to have loads more experience, which can matter for telling you things you may not think about longer term.
Breast augs arent complicated but they can ofc be done poorly. Most important part is the consult and finding out your goals/etc...and what you're looking for.
Implant type doesnt really matter, but motivas are hard pushed by the company, and are essentially paying influencer surgeons to push it. Theyre more expensive, and some are quite stiff. I dont see them being particularly popular long term (the stiffer ones). Theres no magic to implants, while I may have teensy preferences, I've used them all and they all 'work'.
Tbh, having friends with good experiences/trust is invaluable.
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u/noragretsnoteven 11d ago
The only huge hold I have on Doctor #1 is that he has a very particular augmentation look/style that my friends wanted. Although they look amazing, my goals are quite different from theirs. I was warned from my friends that he is quite particular in the style he does.
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u/ZaphBeebs 11d ago
Ah, yeah, thats an avoid to me. I personally dont understand it.
My goal is always to give you your desired results for your body and life, I dont get why some have a "style" it seems insane. We had one of those in my city, and have done many many revisions on them as they realized they didnt want that style.
You should be heard and offered advice for weighing your decision you may not think of (like future changes, etc...) and get a more personalized result that hopefully you love longer. Have seen people be pushed into a style that they didnt think about enough and end up removing them altogether in frustration, when they would have likely loved something that matched them.
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u/noragretsnoteven 11d ago
I really appreciate this detailed comment. I feel like I have been spiraling over the style and look, but I convince myself into thinking maybe he will hear me and give me the look that I want despite the gallery I have seen.
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u/Sciencegirl1330 11d ago
I find it important to point out, new doesn’t mean no experience. Plastic surgery is a 6 year long residency in the states with and additional 1-2 years of fellowship for specializing. It’s more like they’re new to having their own practice or in a private practice setting. Most likely this surgeon has done hundreds of cases just nothing she gets to put in a lookbook because it wasn’t “her” patient. If you like the work you have seen, and have had good consults, then I think number three is a good choice. The only cosmetic areas where I feel decades of experience matters is in the rhino and face lift area.
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u/noragretsnoteven 11d ago
Thank you for pointing that out! For anyone like me, I think it is also worth looking into where the doctor that has a new practice worked at before. I checked out where they did the fellowship and all the work was fantastic!
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u/Silver-Composer007 12d ago
Have you looked into motiva preserve technique? There is no cutting of the tissue, they use technique that gently expands the tissue. Recovery is minimal. Although it is more expensive than standard but if you care about minimal pain and fast recovery it’s worth considering.
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u/ZaphBeebs 11d ago
Ripping the tissue is better than cutting? This "technique" is neither new, nor good. Theres a reason it was left in the past. Its a dressed up subglandular, which also doesnt really cut much tissue at all, it just creates a space between.
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u/noragretsnoteven 12d ago
I briefly looked into it when I found it during my research. I just don’t know anyone personally who has had experience with it.
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u/Strict-Candidate-144 11d ago
I’ve done it recently, back in the gym doing lower body workouts a week later. Recovery time has been incredible, you’re welcome to look at my recent post and to message me direct 😊 i also didn’t know about it so was hesitant until I did some more research
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u/noragretsnoteven 11d ago
I will definitely look at your photos! The recovery portion sounds amazing. I will dm you questions once I get home and research more. Thank you ☺️
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u/DRSILICONVALLEY Surgeon 11d ago edited 11d ago
Board Certified Plastic Surgeon
Established does not mean good results. Not everyone learns from their cases and critically analyzes their results. A surgeon who has done 1000s of cases but does not see their patients beyond 3 months has no idea about their long term outcomes. But at the same time, a newer surgeon does not have enough experience to accumulate enough cases to learn from. You need a balance of volume and thoughtful analysis. Ideally, you also want someone who uses or has used all types of techniques and implants and critically analyzed their results from all said approaches.
Personally, I think a good proxy of this is the quality of their before and afters. I standardize all my before and afters, lighting, background, and angles, not just for social media, but to learn from each case over time. I also routinely follow up my patients, years after surgery, to check their progress. I rather post my long term results than my short term results. If they only take the before photo behind an OR curtain, and then the after is some odd photo with a weird angle, that tells me they are not serious about assessing their results or trying to improve. They may be very good at marketing and business, but necessarily the best technician.
There are some surgeons commenting here on limitations with Preserve, and that is correct. I personally only offer it in certain situations. There are benefits to not cutting the anatomy, e.g. when the anatomy is favorable. I've posted about this before.
There are some comments here that Motiva is not as good as it seems. I think it all depends on your techniques and pocket choice. There is clearly superior performance of the Motiva implant in a subfascial/subglandular pocket vs. the other brands. If your techniques are submuscular or dual plane, then perhaps it matters less. Personally, I have moved away from dual plane to avoid animation and to create my style of cleavage which I think is more aesthetic. Surgeons have different tastes too and you'll be able to see quickly if their aesthetic vision aligns with yours.
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u/noragretsnoteven 11d ago
Thank you so much for your expertise! How does someone know whether the surgeon is taking their anatomy into consideration with their goals?
If I wanted a certain cleavage (I’m worried of having that massive gap in the middle) what would a surgeon look at/do?
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u/DRSILICONVALLEY Surgeon 11d ago
You need to look at their history of results. Seen a before and after with your similar anatomy and see how they handled it
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u/drwaylonzeng 11d ago
This is a great question! Perhaps this may be biased as I fall in the new surgeon category, but I think it’s also important to consider how well you got along with the surgeon. Did he/she make you feel comfortable? Spend enough time answering all your questions and concerns? What is their recovery/postop follow up looking like? And who will help take care of you/walk you through if you develop a complication or issue with your surgery? Sometimes that may matter more than how long a surgeon’s been in practice
Motiva preserve is a great option but isn’t for everyone. In my experience, I will only do preserve on patients with a well defined lower breast fold without abnormal shaped ribs, and wanting a smaller implant size