Choosing to undergo breast augmentation or reconstruction is a deeply personal decision—and one that comes with more variables than most patients realize. According to Pittsburgh plastic surgeon Jeffrey Antimarino, MD of Bellissimo Plastic Surgery & Medi Spa, it’s not just about picking a size or shape. From long-term health to newer implant options, here are five things he wants every patient to understand before having their breast surgery.
1. Implant placement isn’t just cosmetic
There’s growing buzz around placing implants above the muscle for a faster recovery or a more natural look. But Dr. Antimarino says the risks are rarely part of that conversation. “When implants are placed above the muscle, mammograms may miss up to 15 percent of breast tissue,” he explains. “That could delay detection if cancer is developing. Under-the-muscle placement allows for full breast visibility during imaging.”
For that reason alone, he places implants under the muscle in every augmentation case. “Until radiologists confirm that newer imaging eliminates this issue, I won’t change my approach,” he says.
2. Don’t get caught up in numbers
Dr. Antimarino doesn’t advertise implant sizes on social media, and there’s a reason for that. “No two women are built the same,” he says. “A 375cc implant might look great on one person and totally different on another. The focus should be on the overall look and proportion, not chasing a specific number.”
3. There’s a new implant option worth knowing about
Motiva implants are one of the newest entries to the U.S. market and are quickly becoming a popular choice. “The technology is impressive,” says Dr. Antimarino. “The gel is bonded to the shell, which reduces rippling and helps the implant maintain its shape longer.”
Motiva also forms thinner, softer capsules, which lowers the risk of capsular contracture. “It’s a great choice for patients who want a soft, natural appearance,” he says.
4. Bigger implant sizes are changing reconstruction outcomes
Historically, patients with higher BMIs or broader frames had limited options when it came to implant size. That’s finally changing. “Mentor recently released implants that go up to 1,340cc, which is a big deal for reconstruction patients,” Dr. Antimarino says. “Now we can restore proportion and shape more effectively for all body types.”
5. Trends shouldn’t dictate your treatment plan
Whether it’s the latest celebrity sharing their implant size or a viral TikTok about “half-under” placement, it’s easy to get influenced by what’s trending. But Dr. Antimarino warns against making decisions based on hype. “Your surgery should be tailored to your anatomy, your goals and your long-term health,” he says. “Not what worked for someone else online. What looks good on one person might not be safe or effective for you.”
