Procedure Steps
What would occur during a Breast augmentation surgery?
Step 1 – Anesthesia
In order to assure patient comfort during the breast augmentation procedure, the proper medications will always be given. Our patients will have the option or intravenous sedation or general anesthesia. Dr. Spindel will always recommend the best choice for his patients.
Step 2 – The incision
An incision is a surgical cut made in certain areas to reduce noticeable scarring. Incisions are made in non-prominent areas to minimize noticeable scarring. You and Dr. Spindel will discuss incision options and which incision would be most appropriate for the desired outcome. Incision options include:
Inframammary incision

Transaxillary incision

Periareolar incision

Incisions differ in size due to the type of implant chosen, desired enhancement size, and patient body type.
Step 3 – Implant choice: Silicone breast implants or saline breast implants?
It is extremely important for our patients to be honest about the expectations. Desired cup size and breast shape are important. Implant type (saline or silicone) and bust size will be determined not only by the desired increase in size but by a patient’s breast anatomy, elasticity of skin and body type.
Options for Breast Implants
Saline Breast Implants
Saline breast implants contain a silicone outer shell filled with a sterile saltwater (saline) solution. Saline-filled implants come in different sizes and have either smooth or textured shells. The FDA approved saline-filled breast implants for breast augmentation in women age 18 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.
Silicone Breast Implants
Silicone breast implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells. Silicone gel-filled breast implants are approved for breast augmentation in women age 22 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery. The gel is made to feel like real breast tissue and feel very natural. Unlike saline implants, the body will not absorb the gel if the implants leak. The gel may stay inside the implant shell, or may release into the implant pocket.
*It is important to schedule regular appointments with Dr. Spindel to make sure the implants are functioning properly.
Saline breast implants are FDA-approved for augmentation in women 18 years of age and older.
Silicone breast implants are FDA-approved for augmentation in women 22 years of age and older.
Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes or legal guardian’s permission.
Step 4 – Insertion and placement of breast implant
After the incision is made, a breast implant is inserted into a pocket either:
- Under the pectoral muscle (a submuscular placement), or
- Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)
Implant type, size and body type are very important when determining the insertion and positioning of the breast implants.
Step 5 – Closing the incisions
Incisions will be closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.
Step 6 – See the results
Breast augmentation results will be immediately visible after the enhancement procedure. Swelling and incision lines will improve with time. Recovery time is different for everyone, so it is important not to become discouraged if recovery takes several weeks. Self-image and self-confidence should improve with recovery.

Dr. Michael R. Spindel, M.D.
St. Mary’s Outpatient Center • 2860 3rd Ave #220 • Huntington, WV 25702
Call Us: 304.697.5272
Monday - Thursday: 8:30 am - 4:30 pm