In every breast augmentation, Boston plastic surgeon Dr. Mark Markarian initially places a temporary silicone sizer by Natrelle before replacing it with a permanent silicone implant.

A temporary implant sizer allows Dr. Markarian and his patients to see what different-sized implants will look like on them and whether they suit their natural frame. Once patients decide the sizer’s appearance meets their goals, Dr. Markarian replaces a sizer with a permanent implant.

Below are the steps Dr. Markarian takes during implant sizer placement to ensure his patients know what to expect from their final breast augmentation results.

1) Make an inframammary fold incision

Initially, Dr. Markarian creates an inframammary fold incision right underneath the breast fold about 7-8 millimeters deep to ensure the fold is the correct place to become the new fold after placing the implant. The incision is placed precisely underneath the breast, hiding any scarring once the implant has settled.

He then enters the incision with a lighted retractor to go down to the muscle through the breast tissue. Patients are under anesthesia and will not feel any discomfort throughout this process.

2) Divide the pectoralis major origins from the ribs

Dr. Markarian then separates the pectoralis major origins from the ribs to isolate and completely divide them to the inside of the breast to ensure the creation of a cleavage. Physiopedia describes the pectoralis major muscle as “a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.”

3) Put the sizer in

When placing the sizer and to optimize the small incision length (2 ½-3 centimeters), Dr. Markarian uses a cone-shaped funnel.

4) Make any necessary adjustments

Once the sizer is in place, Dr. Markarian uses an Army Navy retractor to make any necessary adjustments.

5) Put stitches in and place the permanent implant afterward

Once the implants are in and adjustments made, Dr. Markarian puts stitches in, and then he and the patient decide if the size is right for them. Placement of the permanent breast implant placement is afterward.

Watch Dr. Markarian place an implant sizer below, and follow us on Instagram for more educational content.

Considering Breast Augmentation?

Dr. Mark Markarian is a Harvard-trained, board-certified aesthetic plastic surgeon with over 18 years of experience delivering thousands of successful breast augmentations. Dr. Markarian utilizes sizers before placing your permanent implants to help you find the perfect size for your frame and goals. If you’re considering adding volume to your breasts, schedule a consultation today to discuss your options and develop a customized surgical plan with Dr. Markarian.