Breast augmentation is not simply about choosing an implant size. It is about selecting an implant that fits your frame and creating the right space for it within the breast.
Dr. Shain Cuber has performed breast augmentation for more than 25 years. During that time, he has developed a specific approach to creating the implant pocket.
Dr. Cuber places breast implants behind the pectoralis muscle, but unlike surgeons who use a traditional dual-plane technique, he preserves the muscle’s lower attachment along the ribs. His approach reflects a larger surgical philosophy: evaluate each patient’s anatomy carefully, preserve useful natural structures and select an implant that is proportionate to the patient’s frame.
Patients considering breast surgery often have questions about implants, recovery and what to expect from the process.
Every woman’s anatomy is different. Height, weight, chest width, natural breast tissue, skin elasticity and previous pregnancies all affect which implants will fit and how the breasts will look after surgery.
Dr. Cuber begins by listening to what you want to achieve. He then evaluates the characteristics of your breasts and determines which implant options your body can reasonably accommodate.
During your evaluation, Dr. Cuber considers:
Breast implants are available in many sizes and profiles, but not every implant will fit every body. Selecting an implant that is too large for the available tissue can place unnecessary stress on the breast and produce a result that looks out of proportion.
Dr. Cuber identifies a range of implants that fit your anatomy and then helps you choose the option that comes closest to the shape and volume you want.
Many women considering breast augmentation want to restore volume or create proportions they have never naturally had. They want to feel more comfortable in tops, dresses and swimsuits without looking as though an implant was simply added to their body.
Breast augmentation may help:
The goal is not simply to create larger breasts. It is to create a breast size and shape that feels natural for your frame and figure.
Breast implants add or restore volume, but they do not always correct significant sagging. Some women need an implant alone. Others need a breast lift. Women who have lost both volume and breast position may benefit from breast augmentation with a lift.
Dr. Cuber evaluates:
If the natural breast sits too low, adding an implant without repositioning the breast may not produce a balanced shape. In these cases, combining an implant with a lift may provide a better relationship between the implant and the natural breast tissue.
Breast implants are available in saline and silicone gel, as well as different widths, volumes and profiles. Dr. Cuber generally prefers modern, highly cohesive silicone gel implants. The gel within these implants is designed to maintain its form while still providing a soft feel.
The right implant is not selected according to volume alone. Width determines how the implant fits across the chest, while profile influences how far the breast projects forward. Dr. Cuber considers these dimensions together with your existing tissue and desired appearance.
Before and After
These before-and-after photos reflect the focus of the surgeons at Balikian Plastic Surgery on enhancing breast volume and shape while maintaining proportions that look natural for each patient.
Before surgery, Dr. Cuber makes detailed markings while you are standing. These markings identify important anatomical landmarks and guide the operation.
During surgery, Dr. Cuber:
Although the operation follows an established sequence, the details are adapted to each patient. Chest shape, muscle anatomy, breast width and natural asymmetry can all influence how the implant pockets are created.
For most breast augmentations, Dr. Cuber places the incision within the inframammary fold, the natural crease beneath the breast. He prefers this approach because it provides direct access to the area behind the pectoralis muscle and allows him to create the implant pocket under clear visualization. It also avoids passing through the breast tissue to reach the muscle.
Research has associated inframammary access with a lower rate of capsular contracture than periareolar access, although capsular contracture remains possible with any incision or surgical approach.
The incision initially appears pink and may be noticeable. It gradually softens and fades over several months. Its position within the breast crease helps conceal the resulting scar once it has matured.
Dr. Cuber places breast implants behind the pectoralis muscle. This provides an additional layer of natural tissue over the upper portion of the implant, which can be particularly valuable for women with limited breast tissue. However, Dr. Cuber does not use the traditional dual-plane technique.
During a traditional dual-plane augmentation, a portion of the pectoralis muscle is released from its attachment along the lower breast fold. Dr. Cuber instead preserves this attachment while creating the implant pocket behind the muscle. This is an important distinction in how he performs breast augmentation. Dr. Cuber prefers to maintain the patient’s existing anatomy while creating a carefully controlled space for the implant.
He also does not routinely add surgical mesh during an uncomplicated primary breast augmentation. Additional support materials may still be considered in selected revision cases or when the condition of the tissues requires reinforcement.
Because Dr. Cuber preserves the lower muscle attachment, the implants commonly appear high during the first several weeks. The breasts may also feel firm or tight across the chest. This is an expected part of the early recovery. As the tissues gradually relax, the implants begin to settle and the breasts become softer.
Recovery varies according to the patient and the size of the implants used. Larger implants create more tissue stretching and may cause greater initial pressure or discomfort.
During the early recovery period, you may experience:
You will receive detailed instructions for medication, positioning, incision care and follow-up before surgery.
Dr. Cuber asks his breast augmentation patients to avoid jogging, swimming and weight training for approximately six weeks. This is his postoperative protocol for allowing the implant pockets and surrounding tissues to heal. Your return to exercise will be based on your individual progress and Dr. Cuber’s examination.
Light walking is encouraged during recovery, but strenuous exercise should not be resumed until you receive clearance.
Medical-grade light therapy may be incorporated into your postoperative visits as an additional recovery treatment.
Sessions are brief and comfortable. Light therapy supplements your postoperative care but does not replace rest, activity restrictions or follow-up with Dr. Cuber.
Breast implants are not lifetime devices. They may remain intact for many years, but you should understand that another operation could eventually be needed to remove or replace them or to address a complication.
Potential implant-related concerns include capsular contracture, rupture, displacement, asymmetry, rippling and changes in breast or nipple sensation. Patients with silicone gel implants may also need periodic ultrasound or MRI examinations to screen for a rupture that is not producing noticeable symptoms.
Dr. Cuber will discuss these considerations during your consultation so you understand both the benefits of breast augmentation and the long-term responsibilities associated with implants.
Breast augmentation is a personal decision based on your anatomy, goals and expectations.
You may be a good candidate if you:
During your consultation, Dr. Cuber will listen to what you want to achieve, examine your anatomy and explain which options are appropriate for your body.
Dr. Cuber approaches breast augmentation as more than placing an implant. He considers how the implant fits the patient’s frame, how the pocket should be created and how much volume the surrounding tissues can support.
His muscle-preserving approach reflects his preference for maintaining useful anatomy and adapting the operation to the individual patient.
Schedule a private consultation with Dr. Cuber to learn which implant options fit your body and whether breast augmentation is right for you.
How does Dr. Cuber choose the right implant size?
Dr. Cuber considers your chest width, breast dimensions, existing tissue, skin elasticity and desired amount of projection. He then identifies the range of implants your tissues can reasonably accommodate.
This is known as tissue-based planning. Research supports matching implant dimensions to the patient’s anatomy rather than selecting an implant according to volume or desired cup size alone.
What is the difference between silicone and saline breast implants?
Saline implants contain sterile saltwater and visibly deflate if the shell develops an opening. Silicone implants contain cohesive silicone gel, and a rupture may not produce an obvious change in breast size or shape.
Dr. Cuber generally prefers modern, highly cohesive silicone gel implants, but the appropriate implant depends on your anatomy, tissue coverage and preferences.
Where does Dr. Cuber place the incision?
Dr. Cuber generally places the incision within the inframammary fold, the natural crease beneath the breast. This gives him direct access to the area behind the pectoralis muscle without passing through the breast tissue.
Research has associated inframammary access with a lower rate of capsular contracture than periareolar access, although capsular contracture remains possible with any incision.
Does Dr. Cuber place breast implants above or below the muscle?
Dr. Cuber places breast implants behind the pectoralis muscle. The muscle provides an additional layer of tissue over the upper portion of the implant, which can be particularly beneficial for women with limited natural breast tissue.
Unlike a traditional dual-plane augmentation, Dr. Cuber preserves the muscle’s lower attachment along the ribs while creating the implant pocket.
How long is recovery after breast augmentation?
Recovery varies with your anatomy, implant size, occupation and individual healing. Most patients can perform light daily activities relatively soon, but tightness, swelling and pressure are expected during the early recovery period.
Dr. Cuber asks patients to avoid jogging, swimming and weight training for approximately six weeks. He will determine when you can resume each activity based on your healing.
General medical literature describes a return to light work or activity within approximately one week and full activity by about six weeks, although recovery instructions differ among surgeons and patients.
When can I exercise after breast augmentation?
Dr. Cuber asks patients to avoid jogging, swimming and weight training for approximately six weeks. This is his postoperative protocol for allowing the implant pockets and surrounding tissues to heal.
Research has not established one required exercise timeline for every breast augmentation patient. One randomized trial found that supervised early exercise did not increase complications or reoperations among the patients studied. Your return to activity should still follow Dr. Cuber’s instructions and your individual progress.
Can I breastfeed after breast augmentation?
Many women can breastfeed after breast augmentation, but surgery cannot guarantee that you will be able to breastfeed or produce a full milk supply.
Research suggests that women with implants may be less likely to breastfeed exclusively than women without implants. Another large study found that most women with implants who wished to breastfeed were able to do so.
Should I wait until after pregnancy to have breast augmentation?
You do not necessarily need to finish having children before breast augmentation. However, pregnancy can change breast volume, stretch the skin and alter the position of the natural breast tissue.
These changes can affect the appearance of an augmentation even when the implants remain intact. If you expect to become pregnant soon, postponing surgery may be practical. If pregnancy is not part of your immediate plans, Dr. Cuber can help you consider the potential benefits and tradeoffs.
Will breast augmentation change nipple sensation?
emporary numbness, tingling or increased sensitivity can occur after breast augmentation. Permanent changes are possible but appear to be less common.
A large long-term study found a low reported rate of nipple-sensation changes among patients whose implants were placed through inframammary incisions. Outcomes can still vary with implant size, tissue stretching and individual anatomy.
How long do breast implants last?
Breast implants are not lifetime devices, but they do not automatically expire after ten years. Some remain intact considerably longer, while others require earlier removal or replacement.
Additional surgery may become necessary because of rupture, capsular contracture, implant movement, changes in the natural breast or a change in the patient’s preferences. Research shows that reoperations can occur after primary breast augmentation, but the rate varies among implant types, studies and lengths of follow-up.
How is a silicone breast implant rupture detected?
A silicone implant can rupture without producing obvious symptoms, which is known as a silent rupture. Ultrasound and MRI can be used to evaluate implant integrity.
Research supports the accuracy of MRI for detecting silicone implant rupture. More recent evidence indicates that high-quality ultrasound can also be effective.
Dr. Cuber will explain the appropriate imaging schedule based on the implants used and current recommendations.
How satisfied are women after breast augmentation?
Patient-reported research has found significant improvements in satisfaction with breast appearance and psychosocial well-being after breast augmentation.
Satisfaction depends on appropriate implant selection, realistic expectations, surgical outcomes and a clear understanding of the possibility of future procedures. This is why Dr. Cuber takes time to determine what you want to achieve and whether that result is realistic for your anatomy.
Dr. Shain Cuber is a breast & body plastic surgeon specializing in aesthetic surgery of the breast and body.
With more than 20 years of surgical experience, he is known for creating natural-looking results through breast enhancement, tummy tuck, liposuction, Mommy Makeover and body-contouring procedures.
Dr. Cuber combines meticulous surgical technique with attentive, patient-focused care, helping each individual feel confident and comfortable throughout their surgical journey.
Patients trust Dr. Shain Cuber for his warm, personalized approach, advanced surgical techniques and results that look natural and refined.
