Breast Augmentation FAQs

Breast Augmentation FAQs

How do you pick the right implant?

It starts with an open discussion between you and Dr. Fiala.  Most women have a pretty good idea of the shape and size they’re hoping for.  Most commonly, we hear “a full C cup or small D – something that is proportional for me”.  For some patients, it’s more conservative. And some patients want a very full, round, and voluptuous look.

Let us know what you have in mind.  Bring in a few pictures of breast shapes you like – it’s helpful for discussion purposes.

The best way to get a “proportional look” is by matching the width of the implant to the width of the patient’s breast.  For example, a petite lady with a narrower breast width needs a smaller diameter implant, compared to a broad-shouldered lady who has a wider breast width.  Using this measurement-based approach also helps us get nice cleavage without excessive space between the breasts. It also  avoids unwanted excess fullness at the side of the breast (aka “side boob”) which can make the patient look heavier.

Once the width of the implant has been determined, then we can talk about the exact implant shape, or “profile”.  Higher profile implants give more fullness in the upper part of the breast, while lower profile implants give less fullness and a very “natural” look.  Women who want the roundest shape possible may wish to look at the ultra-high profile implants.  Between the various FDA-approved implant companies, there are many choices for every body type.

Often, the selection is a matter of the patient’s personal preference and taste.  There may be several implants that could potentially look good for a particular patient – they can pick the one they like the best.

We spend a lot of time with our patients, having them “try on” implant sizers.  We find this is a helpful method to figure out the optimal implant for each person and explains the effects that different sizes and implant profiles will have.  Additionally, the Volume Sizing System-shaped sizers by Mentor & Allergan also help to predict what the post-op shape of the breasts will look like.  We’ve found this is more reliable than some of the computer-based imaging systems which try to guess your post-op appearance.

What is an average implant size? 

While it depends on the patient, average implant sizes commonly run in the 325-425 cc range, which gives a proportional look for the average-frame patient.    The smallest implants we typically see are in the 180-250 cc range, while the largest have been in excess of 1 liter.

Should I bring photos of what I like to the consultation?

Many patients do – and these are a good starting place to discuss what your preferences are for breast shape and size.  Think about the results you like, but also the ones you don’t care for.  It’s often convenient to have these loaded on your smartphone.  Dr. Fiala will discuss with you the best strategies to achieve your desired size and shape, based on your preferences.

How is the breast augmentation procedure performed?

Dr. Fiala performs breast augmentation is performed in our on-site AAAASF-certified, hospital-grade operating room, under general anesthesia. The anesthesia is provided by one of our board-certified MD anesthesiologists, for optimal safety. Most commonly, the selected breast implant is carefully inserted behind the breast and pectoral muscles, in a precisely-tailored tissue pocket, using the Keller funnel and “no-touch” technique.  Dr. Fiala usually prefers the “dual plane” method, which has proven benefits of safety, effectiveness, and a very natural-looking result. The incision is typically placed in the crease area beneath the breast, also known as the “inframammary incision”.

Breast implant surgery typically takes between 60 and 90 minutes, with another hour or so for recovery from anesthesia.  A responsible adult then takes the patient home.  With the modern techniques used, most patients are pleasantly surprised that the recovery from breast augmentation is much easier than they expected.  With our enhanced recovery protocol, most patients use very few prescription pain meds at all!
If you also have loose breast skin, breast droop or sagging, you may require a breast lift operation to get an attractive result.

Does a breast augmentation lift my breast?  Will it replace a breast lift?

No – if the breast is droopy and the nipple position is low, or the breast skin is loose and stretchy,  a breast lift is typically needed to get an attractive result.  Sometimes a breast lift and a breast augmentation can be combined in the same surgery.  The augmentation portion, by itself, just gives you a “bigger version of what you already have”, and the nipple position would continue to sit low.  If you find yourself lifting up or pushing up your breast in order to demonstrate the appearance you would ideally like – then you’ll probably need a breast lift.  Click here for more information about breast lift surgery.

I already have breast implants and am looking for a size change.  Can you help me with that?

Yes, we can do that – the size change can either be an increase in volume, or a decrease, depending on your goals.  Different shapes of implants can also be considered, in order to ensure that the implant width nicely fits the patient’s chest width in a proportional way.  For example, if your breast seems too wide, following breast implant placement, switching to a narrower diameter implant may help to restore a slimmer shape.  Dr. Fiala is very familiar with helping patients with this.  Click here for more information on implant exchange and other secondary breast implant surgery.

Does Fiala Aesthetics perform a lot of breast augmentation surgeries?

Yes, it’s our #1 most common procedure, with more than 200-300 breast augmentation surgeries performed each year for women from all over the United States, and from all walks of life.

Why should I choose Fiala Aesthetics for my breast augmentation surgery?

It starts with good communication: we spend a lot of time with each patient, understanding their goals, and helping them find an implant that can meet their needs.

Technically speaking,  we have a great deal of experience with breast implant surgery, and have been on the forefront of technological advances.  Fiala Aesthetics was one of the first surgery centers in Central Florida to adopt the rapid recovery technique for dual-plane breast augmentation and was one of the first locally to adopt the proportional sizing method, based on measurements of the patient.

We were also one of the first locally to adopt the use of the “no-touch” technique with the Keller funnel for all augmentations – both silicone and saline, which has been shown to reduce the chances of complications.

Also, we were also one of the first practices in Central Florida to adopt the innovative structured saline implant, which dramatically improves the feel of the saline implant, compared to the traditional model.   This has been ideal for women who prefer a saline implant but want an improved implant to feel over the traditional saline device.

These advances and innovations make the surgery experience better for the patient, with a quicker recovery and improved outcomes.

What is the 14 point plan for reducing complications in breast augmentation?

The 14 point plan was developed by Australian surgeons in 2013 and presented at US meetings shortly thereafter.  It is designed to minimize the number of bacteria that could potentially contaminate breast implants at the time of surgery.  The current thinking is that bacterial contamination – even at levels too low to cause actual infection – may be linked to capsular contracture development and subsequent need for revision surgery. The suggested 14 steps are:

  1. Use intravenous antibiotics prior to the incision.
  2. Avoid periareolar incisions (around the nipple).
  3. Use nipple shields during surgery.
  4. Perform careful dissection to minimize damage to the breast tissue.
  5. Carefully stop any bleeding during surgery, to minimize blood collecting around the breast implants.
  6. Avoid cutting into the breast tissue itself. Using a submuscular or dual plane pocket also decreases the risk of bacteria from the breast tissue coming into contact with the breast implant.
  7. Perform pocket irrigation with appropriate solutions, including half-strength betadine or proven antibiotics solutions.
  8. Use an introduction sleeve, so that the breast implant does not come into direct contact with the skin and its bacteria.
  9. Change surgical gloves before handling the implant.
  10. Minimize the time between opening the breast implant from its sterile packaging and placing it in the anatomical pocket.
  11. Minimize repositioning and replacement of the implant.
  12. Use a layered closure.
  13. Avoid using a drainage tube, which can be a potential site of entry for bacteria.
  14. Consider the use of antibiotic prophylaxis to cover subsequent procedures that breach skin or mucosa.

By using the 14-Point-Plan, the number of bacteria attaching to implants may be reduced, and the risk of breast implant complications may be minimized.  These are guidelines and are still awaiting confirmation by subsequent studies.  Dr. Fiala agrees with this concept and has used this plan since its introduction.

How much does breast augmentation cost?

It depends on the implant chosen, and additional procedures needed.

average prices
Typical monthly payments, 36 mo. financing with interest

– traditional saline (“Mentor”, “Allergan”)

– silicone gel (“Mentor MemoryGel”, “Allergan Natrelle SR series”)

– extra-cohesive silicone gel (“Allergan Natrelle SS series”)
Cases with asymmetry may have an additional charge for extra OR time


$ 5175

$ 6175

$ 6925





–  concentric (“donut”) with silicone gel (“Mentor MemoryGel”, “Allergan Natrelle SR”)-  vertical lift with silicone gel (as above)

–  full lift (“inverted T”) with silicone gel (as above)
Does not include liposuction of lateral chest.








IMPLANT EXCHANGE $5,175 – $9,000 $175+
Note:  Complex revisionary surgeries may be more costly than shown here, due to additional time and materials necessary, such as mesh, ADM or fat grafting.
Certain patients may not be good candidates for short-scar lifts or certain types
or sizes of breast implant.  We do not offer breast lifts to active smokers.
Implant exchange and explantation prices vary with need for additional capsulectomy and other related procedures.


How do I schedule a breast augmentation consultation?

To schedule your breast augmentation consultation with Dr. Fiala, please call 407-339-3222 today. Located in Altamonte Springs, we welcome women from Winter Park, Orlando, Maitland, Heathrow, Altamonte, Longwood, and all surrounding areas of Central Florida.  Also, if you’d like to get some preliminary information, please feel free to call our office, and speak with one of our cheerful nurses about the procedure.


220 East Central Parkway
Suite 2020
Altamonte Springs, FL 32701
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