What is the best way? I just posted some ideas of mine having done breast augs for upwards of 37 years. There was a very interesting article that was a capsule summary of a questionnaire answered by 1067 plastic surgeons. So I thought you all might be interested in the results.

Almost 52% of surgeons DO NOT use anatomical implants. I do not due to cost in some cases and the potential for mal rotation. Post op massage is popular with the majority of surgeons and I for one believe in it. Most surgeons use smooth implants and 83.9% of the surgeons surveyed used the inframammary approach. Axillary was preferred by only 3.3% of the surgeons. Almost 80% believed partial sub muscular pockets versus 5.4% who prefer sub glandular. Depending on the amount of soft tissue I prefer sub glandular. I think it give a more natural look and for sure a much easier recovery. Most surgeons – me included use IV antibiotics prior to surgery. Most surgeons allow normal activities from 4-6 weeks. I usually allow patients to return to normal in around 4 weeks. The vast majority (+ 90%) of implants are silicone. Once a capsule forms, about 36% of surgeons may try pharmaceutical agents. I have tried them on occasion with limited success. Regarding the use of a patient’s own fat for augmentation less than 20% currently offer this to their patients. A lot in my opinion depends on the availability of donor sites. I use this quite often to enhance the aesthetics of my breast augs by placing fat ABOVE and MEDIAL to the implant. I call this a composite aug. Great procedure….great technique.

In the end I would say that each individual surgeon should do what he or she does best. There is no right way. It is a collection of each individual surgeons collected years of experience. For sure my experience has altered what I do today versus 20 years ago. Surgical art and skills are in a constant state of flux.