Roslyn Heights, New York

(516) 484-8886

I have a very different perception for breast augmentation.

Manufacturers and the media have led the public to believe that implants have a limited life and need to be replaced every ten plus years. Why would an implant that cannot be destroyed in an oven or by any acid or alkali be destroyed in the human body. If an implant can be placed without an ever tightening ring of scar – it should last forever. I have well over 1000 patients of more than 25 years with a failure rate of less than .05%. I have done approximately 3000 plus procedures with a redo rate of approximately 2%.
Where to put, the implant- The majority of plastic surgeons now place the implant below the pectoral muscle – on the chest wall. This is more than appropriate on the extremely thin breasted women. However,

  1. the muscle is irrevocably damaged. It can never be reattached to the breast bone. Moreover, in operating on the patients, in many instances the muscle has been so injured that it has been replaced by scar.
  2. As the implant is wedged between the muscle and bone – it cannot freely flow. It is effectively a bump over which the breast moves.
  3. Sub muscle implants rise with time. Breast fall with time. This produces the snoopy or double-bubble breast.
  4. The implants move laterally with time. Therefore, there is little to no cleavage leaning forward.
  5. There is substantial pain and disability because of muscle injury, lasting up to months.
  6. Implants may suddenly shoot up and sit below the arms.

I have abandoned sub muscle implants in favour of implants under the breast.

  1. They move with and are integrated into the breast mound.
  2. They can produce more projection as there is no overlying muscle pushing backwards.
  3. Using silicone implants – they cannot be detected from breast tissue.
    Saline implants allow individual precise adjustments of each implant type.
    Symmetrise the breasts. Pre filled implants exaggerate pre-existing asymmetries.
  4. There is virtually No pain. Patients can be in a gym in a week. There can be No late rupture of silicone into the rib cage.
  5. Patients can have fullness, roundness, projection, volume without the constraint of a tight constricted muscle.


I prefer (having tried all others) an incision around the lower margin of the areola. This is the most central area and allows perfect visualization with a fiberoptic system The breast ducts are not divided, but rather pushed a part. The incision is invisible lying down, or with the arms lifted. As the areola is an area which a newborn traumatizes, it inherently heals quickly and cleanly. There are no external stitches to remove. Areola sensation remains normal, as the principle nerve supply comes from the lateral arm area.

Firmness and Capsule Formation

The down side of breast augmentation, particularly above the muscle is the formation of a tight firm capsule which constrict and restricts the breast. Implants below the muscle are effectively all encapsulated as they cannot freely move. It has taken the better part of my career to preclude this encapsulation. Moreover, I have developed operations to address patients who have had multiple failures with other plastic surgeons to produce a soft, mobile, pain-free breast.

I would be happy to discuss the niceties and details of these operations in the privacy of my office.


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