Eric Mariotti M.D.

Breast Augmentation FAQ

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Many women visit Dr. Eric Mariotti for breast augmentation from Walnut Creek, Danville, and other cities around the East Bay. In fact, it's one of the most popular procedures he performs. During your consultation, he will reserve time especially to answer your questions and address your concerns. In the meantime, you can review the answers he has provided to some of the most common questions here.

If you have more questions about breast augmentation or want to see whether it's right for you, simply request a consultationrequest a consultation online with Dr. Mariotti, or call his office at (925) 685-4533.

Breast Augmentation
Before & After Photos

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Breast Augmentation
Before & After Photos

Keep in mind that each patient is unique and your results may vary.

How do I choose between saline and silicone implants?

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I believe in giving my breast augmentation patients choices, so I offer safe, FDA-approved breast implants filled with saline or silicone gel. The decision between the 2 types is usually a matter of personal preference. Saline implants are a little bit less expensive than silicone, are filled after they are placed so the size can be fine-tuned, and make it immediately noticeable when there's a leak; however, women may be able to feel if there is a ripple or wrinkle, and saline implants feel firmer than natural breasts. Silicone implants have a soft and doughy feel that is more like natural breast tissue and provide a more natural appearance for women who have little of their own breast tissue. In 2012, of the 130+ breast implant procedures I performed, about 90% of my patients ended up choosing silicone. With new implants entering the picture all the time, such as the new highly cohesive (gummy bear) implants, the best thing a woman can do is seek the advice of a board-certified plastic surgeon.

Where do you place the incisions?

Placement of the incisions during breast augmentation depends on the type of implants, your unique needs (some patients need a combination breast lift and augmentation), and personal preference. The most common options are along the breast crease (inframammary incision), along the lower edge of the areola (periareolar), and in the armpit (transaxillary). In my practice, after having done many breast augmentations using all 3 different approaches, I have found that for the majority of women, the inframammary incision provides the best results. There are no scars through the breast itself and the small scar typically flattens, fades, and is often concealed nicely by the fullness of the breast.

Meet Dr. Eric Mariotti

Dr. Mariotti offers much more than beautiful results - he'll ensure that you feel relaxed and cared for. Discover why people from around Walnut Creek trust him for their plastic surgery.

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Dr. Mariotti

What does implant massage do to help the healing process?

During breast augmentation, a space for the implant is made beneath the breast tissue and chest muscle. This space, often called the "pocket," is made large enough to allow the implant a bit of room to move and give. That "give" and softness is what helps the implant to feel more like a breast. Implant massage is the process of gently moving the implant to prevent the pocket from tightening around it during the healing process. Unlike most plastic surgeons, I have my patients start implant massage, albeit gentle, just hours after the surgery while the ribs, muscle, and skin are still numb from the local anesthetic. After doing many hundreds of augmentations this way, I have found that patients can often forgo the pain and intense tightness that is common during breast augmentation recovery. Most patients will come in for their first post-op visit on day 3 or 4 and already have very soft breasts. The typical alternative, which is to wait a week or so after surgery, allows the sub-muscular space to heal and begin to shrink around the implant. In my opinion, if space for the implant can be established early, it is much easier to achieve that desirable softness.

Dear Dr. Mariotti,
I can never thank you enough for giving me back my figure. I feel so good about myself now.

JJ

What else do you do to control post-operative pain?

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The number 1 thing to control pain after surgery is something the surgeon can do: be extremely careful when creating the pocket. The least amount of trauma during surgery leads to the least amount of pain afterward. Then, just before closing the incision, I place 25 cc of Marcaine™, a long-acting local anesthetic, around the implant that makes everything numb — the ribs, skin, and muscle. I tell my patients, "I put a puddle of numbing medication around the implant just before I close up the skin. Everything will be numb. Don't worry; the numbness will wear off by the next morning. However, that is a great time to start your gentle massage, as well as shoulder pinching maneuvers and raising your arm up to the level of your shoulders. If you do these things while you are numb, it makes the next morning so much easier." I also do not use drains, nor do I wrap my patients at all after surgery. The only dressing is a small piece of surgical tape over the incision, thus making it easier to start the massage right away. I feel that if it looks like a small surgery, it will feel more like a small surgery.

How long will it take for my implants to settle?

Because I must create space for the breast implant under the skin and breast tissue and behind the chest muscle, it takes time for all 3 areas to stretch and relax. In addition, there is initial swelling that needs to resolve, which takes about 2 weeks. Initially the breasts will look and feel tight. This is normal and temporary. Although they may look good sooner, it takes approximately 6 to 8 weeks for the breast implants to fully settle into their soft, rounded, natural breast shape.

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