Breast Implant Decisions: Material, Incisions, Placement, Size

Decisions, decisions, decisions. Choosing to enhance your shape with breast implants is only the first decision you’ll make as you prepare for breast surgery. Dr. Sajjadian customizes each breast procedure, working with his patients to create natural looking results that complement anatomy and meet aesthetic goals. This customized approach to breast augmentation surgery requires careful coordination between plastic surgeon and patient, and a lot of decision making. We’ll guide you through the process, offering tips and advice, so your new breasts are your dream breasts.

As one of Southern California’s most respected and sought-after plastic surgeons, Dr. Sajjadian has helped countless women through the breast augmentation process. He holds triple-board certification and has dedicated his career to perfecting the art of breast and facial surgery. Dr. Sajjadian has the experience and surgical expertise to help patients make these crucial breast augmentation decisions.

Material- Saline or Silicone?

Modern-day breast implants typically fall into one of two categories: saline or silicone. Dr. Sajjadian uses both of these breast implant types to craft stunning breast augmentation results for his patients. Breast implants are used to increase breast size, to enhance breast shape and fullness, to correct asymmetry, and to restore the breasts after pregnancy and breastfeeding. Both implant types can be used successfully for any of these purposes.

Saline Breast Implants

Saline breast implants feature a plastic outer shell that is filled with a medical-grade, sterilized salt water solution. Saline breast implants are FDA-approved for use on women that are 18+.

Saline implants offer several benefits including:

  • Lower Price Point- Saline implants are typically 25% less than similarly sized silicone implants.
  • Smaller Incision Size- Saline breast implants are placed into the breast unfilled. A deflated implant is much smaller than a filled one and incision size is considerably smaller with this implant type. This implant type also offers increased flexibility in incision types since it is placed into position unfilled.
  • Easy Rupture Detection- Saline implants deflate when they are ruptured. The saline solution is safely absorbed and expelled by the body. Saline is non-toxic.

Saline implants have a few downsides too. Some women find they feel a little too firm, not like natural breast tissue. This entirely depends on anatomy and preference. Saline implants are also more prone to wrinkling after extended use.

Silicone Breast Implants

There are two different types of silicone implants: silicone gel implants and form-stable implants, also known as gummy bear implants. Each type offers distinct benefits, so we’ll discuss them separately.

Silicone Gel Breast Implants

Silicone gel implants are our most popular option for breast augmentation. They are FDA-approved for use on women aged 22+. Our favorite benefits of these implants are:

  • A Soft and Natural Feel- Give your breast a quick squeeze. Now you know what a silicone implant feels like. These implants feel soft and natural, even outside of the breast.
  • Less Likely to Ripple- Silicone filled breast implants are less likely to ripple than their saline counterparts.

We recommend that patients with silicone implants receive regular checks to look for leaks for ruptures as the implant will not deflate if it is compromised. Another downside of silicone implants is the need for a larger incision and the increased risk of scarring.

Cohesive Silicone Implants

Gummy bear breast implants, also known as cohesive silicone implants or form stable implants, have a texture that is very similar to a gummy bear. Their advantages include:

  • Excellent Shape Holding- These breast implants hold their shape very well. They do not ripple.
  • Less Likely to Break- Form stable breast implants are filled with a thick, cohesive filling. They hold their shape, even if they rupture and are not likely to leak.
  • Natural Shape- The unique texture of these implants allows for a very natural implant shape. These implants are tapered, projected on the bottom and slimmed at the top. Many women love the beautiful breast shape that these implants create.

They are a firmer feeling implant, unnoticeable if they are well covered with natural breast tissue. Cohesive implants also require a larger incision with an increased risk of scarring.

Rest assured that whatever implant material you choose, all breast implants we offer are carefully selected for their safety. Saline, silicone, and cohesive silicone implants are all FDA-approved. Dr. Sajjadian uses all three types regularly, achieving some of the best breast augmentation results in Newport Beach, CA.



There are four primary options for breast implant incisions: trans-axillary, peri-areolar, inframammary, and TUBA. The best incision type for you will depend on your anatomy, the size and type of breast implants that you intend to receive, and your goals for the procedure. Dr. Sajjadian understands that this is a complex choice and will carefully explain your options, along with offering his recommendations for your incision placement.

  • Trans-axillary- Trans-axillary breast augmentation incisions are placed in the armpit. This ensures no scarring on the breast. This incision can only be used one time, so if revision surgery is needed, a new incision will need to be made. Some patients dislike the visible scar that remains in the armpit after surgery.
  • Peri-areolar- The peri-areolar incision is made around the areola, right along the color transition. This hides scars and makes them practically unnoticeable for most women. The peri-areolar incision does limit the size, type, and shape of implant that can be used and may not be advisable for women with small areola or large implants. This incision provides good access to the breast for your plastic surgeon.
  • Inframammary- The inframammary incision is placed under the breast, in the crease where the breast meets the chest wall. It is well hidden by the overhang of the breast and is unnoticeable for most women after it has healed. This incision provides Dr. Sajjadian with the best possible access to the breast tissues. This is the most popular breast augmentation incision by far.
  • TUBA- The TUBA breast augmentation technique, also known as trans-umbilical breast augmentation, places the incision inside of the belly button. Using an endoscope, the breast implant is then carefully moved from the abdomen up into the breast area. Only saline implants are used with this technique. They are inserted deflated and filled after they are in position. The TUBA approach creates no breast scarring but is very complex and time-consuming. Only a few plastic surgeons in Southern California offer this specialized and advanced breast augmentation technique.

Dr. Sajjadian is very familiar and experienced using all four of these techniques. Many surgeons offer only one or two options for breast incision placement, but Dr. Sajjadian’s exemplary surgical skills allow him to provide his patients with more options and more treatment flexibility.


Breast implants can be placed over or under the pectoral muscle. Typically, a sub-muscular placement is preferred as it offers a more natural looking result, easier coverage of the implant, lower risk of bottoming out and capsular contracture, and better post-augmentation mammography results. Recovery tends to be longer and more difficult after this type of breast augmentation.

Some patients will be better served by a sub-glandular patient. This placement option typically offers a shorter, easier recovery and allows for a larger implant, provided there is sufficient breast tissue to cover it. Sub-glandular placement may also be preferable in patients involved in heavy exercise or weightlifting as the implant won’t distort when the pectoral muscle is flexed, as is common with a sub-muscular placement.

For both sub-glandular and sub-muscular placements, Dr. Sajjadian creates a pocket for the breast implant. The implant is placed in the pocket during breast surgery. At first, the pocket will be tight. In time, the skin and tissues surrounding the implant will relax, and the implant will settle into position. This is a process known as “drop and fluff” and takes 3-6 months to occur after surgery. This process usually happens quicker in sub-glandular placement patients.


There is no perfect size for the female breasts. We’ve seen women with stunning breasts at every cup size. Our goal is to find a breast implant size that complements your aesthetic goals and works with your anatomy.

When choosing an implant size, we are somewhat limited by the patient’s natural anatomy. An implant must be fully covered by breast tissue for a natural look. If we use an implant that is too large, ridges or bumps may be visible at the edges of the implant. Larger implant sizes may also be difficult, or uncomfortable, for smaller patients.

Dr. Sajjadian realizes that size is only one variable in the appearance of your breasts after augmentation. By varying implant shape, projection, placement, and other factors, he can create your ideal breasts, even if there are limitations to the size of implant your body can accommodate.

How Do You Find Your Ideal Implant Size?

Before your breast augmentation consultation, spend a little time contemplating your ideal breasts. Forget about cup sizes; letters and numbers matter less than appearance. We love when patients bring celebrity photos of breasts they love as it gives us a better idea of your desired appearance. Grab those gossip magazines and start shopping for your ideal breasts!

Many patients also use an easy at home test to “try on” different breast sizes. It is called the rice test. Simply cut off and fill the boot section of a pair of pantyhose with rice. Place these rice sizers in a sports bra and try on all of your favorite clothing styles. Adjust the quantities of rice and take notes so you can share your research at your consultation with Dr. Sajjadian.

Making Breast Augmentation Decisions- The Importance of a Consultation

Are you feeling a little overwhelmed yet? There are many decisions to make as you prepare for cosmetic breast surgery, but these decisions aren’t meant to be made alone. When you choose Dr. Sajjadian for your breast augmentation, you get one of the best breast surgeons in Southern California and his carefully selected team of nurses, patient coordinators, etc. as your advisors. You may not know a lot about breast surgery, but we do, and we’re here to hold your hand and help you make these difficult decisions.

During your consultation, we’ll dive into the pros and cons of each option. We’ll talk about expense, downtime, longevity, and your anatomy and their effects on each decision. Dr. Sajjadian liberally shares his expert medical advice, honed over years of surgical practice.

There are decisions to be made, and we’ll work together to make them. It all starts at your consultation. Call our Newport Beach plastic surgery office to schedule your consultation for breast augmentation surgery.