5 Breast Augmentation Questions to Ask Your Plastic Surgeon


You’re starting a very important and personal journey! Have an open conversation with your plastic surgeon and make sure you have a clear understanding of your options and your surgeon’s abilities. Be sure to choose a board-certified plastic surgeon like Dr. Ravi Somayazula so that your care is in the safest hands. There are many options when it comes to breast augmentations in Houston, Texas. Do your due diligence when choosing your surgeon and ask the following questions during your initial consultation.

1. Will my implants be placed above or below the muscle?

Breast implants can be placed either above (subglandular) or below the muscle (submuscular). Each scenario has its own distinct advantages. With the submuscular placement of breast implants, there is a slightly lower risk of capsular contracture over time compared to subglandular placement. Submuscular implants have a lower chance of implant rippling, visibility, and palpability compared to implants placed above the muscle. In patients with a strong family history of breast cancer, submuscular implants allows for better visualization of the remaining breast tissue during surveillance mammography. The disadvantages of submuscular placement is that the implants themselves tend to ride higher for a bit longer and may not drop as fast as subglandular implants. In certain athletic individuals, submuscular placement can lead to an animation deformity in which the implant moves as the patient flexes their pectoral muscles. In most women, this is not bothersome. There is slightly more discomfort after surgery with submuscular placement than with subglandular implant placement. Location of the implants can also change your activity restrictions after surgery. Patients are not allowed to perform any strenuous gym activities for 6 weeks with submuscular placement versus only 3 weeks with subglandular placement.

2. How will you determine the appropriate sized implants?

During the initial consultation, Dr. Ravi and our patient care coordinator have an in-depth conversation about our patient’s goals. Afterwards, precise breast measurements are then taken to help determine the appropriate size implant for each individual’s body. These measurements include:

  • Sternal Notch to Nipple
  • Nipple to IMF (inframammary fold) both while relaxed and on stretch
  • Anterior stretch of the Nipple
  • Upper pole thickness
  • Base width

Any visible breast volume asymmetry is also addressed. To try to make the breasts more symmetrical, different sized implants can be used. Keep in mind that breasts are sisters and not twins; slight asymmetry can still be seen after placement of differently sized implants. Based on these measurements Dr. Ravi recommends the implant sizes he feels would be best for you. Temporary sizers are then tried on in the office, so the patient can get an idea of the result. This is the most scientific and precise way to determine implant sizes that produce the highest patient satisfaction and optimal results.

3. Do you use FDA approved implants?

In the United Sates, there are three companies that manufacture FDA-approved breast implants. These include Allergan, Mentor and Sientra. Every surgeon has their own preference when it comes to which implants they utilize in their practice. At Body by Ravi Plastic Surgery and Associates, Dr. Ravi prefers to use Allergan implants. Natrelle INSPIRA are his choice in breast implants for their look, feel and fullness.

4. How do you manage any pain or discomfort after surgery?

One of the things that makes Dr. Ravi stand out from the other surgeons is his insistence on making this a comfortable and enjoyable journey. During breast augmentation surgery he goes the extra mile to use an injectable medication known as Exparel. Not many plastic surgeons utilize this medication due it’s high cost, but Dr. Ravi includes it in all his surgeries as he finds it really makes a difference in comfort. Exparel is lysosomal bound bupivicaine that works long-term by alleviating pain for up to 3 days post-surgery. Patients are also given a prescription for an oral pain medication that they can take at home. Most patients can also begin taking regular Tylenol by post-op day 3 to 5.

5. What kind of bras are used?

Our patients are instructed to only wear the specific bras that we provide for them after surgery as they are both soft and supportive. The duration depends on the individual and will be determined by Dr. Ravi. It can last anywhere from one to six weeks. There have been certain situations, particularly if the implants were placed under the muscle, where patients are recommend to stop wearing the bra after the first week of surgery to allow the implants to settle. After 6 weeks, patients can wear any type of bra they wish including underwire bras.

If you are interested in a breast augmentation and would like to meet with board-certified plastic surgeon, Dr. Ravi Somayazula, please call 281-242-1061. Our office is located conveniently in Houston and is close to Memorial, Katy, the Heights, and the Galleria. We are here to help guide you in your journey!

Body By Ravi Plastic Surgery and Aesthetics

Dr. Ravi Somayazula and Dr. Swapna Gopathi, both Board-Certified Physicians, use a patient-centered approach and spend as much time as needed to make each patient feel special and respected—not just another person walking through the door. As a team, a one-of-a-kind treatment plan is created to address concerns from head to toe with the latest surgical and non-surgical techniques, including: Breast Augmentation (Implants), Tummy Tucks, Liposuction, Mommy Makeovers, miraDry®, Botox®, Dermal Fillers, and Sculptra®. Working side-by-side, Dr. Ravi and Dr. Gopathi strive to create a long-lasting relationship with each patient, meeting any new aesthetic needs as they arise. Together, the staff at Body by Ravi Plastic Surgery and Aesthetics take each patient step-by-step through their cosmetic journey to achieve the desired aesthetic results.

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Body by Ravi Plastic Surgery & Aesthetics sends well wishes to all of those impacted by COVID-19. Dr. Ravi and our staff understand that this has impacted our community in multiple ways, but we are ready to support you in any way we can. Patients have multiple concerns and anxieties, and we want to assure you that as a medical practice, we are here for you.

Our office is currently open and ready to serve you. We are performing elective surgeries per Texas state guidelines at our Ambulatory Surgery Center, Houston Plastic Surgery Center.  All surgical patients are required to test for Covid-19, this will be reviewed in detail with you by your Patient Care Coordinator.  We are also still performing Injectables, such as Botox and fillers, and other in-office Med Spa procedures, such as miraDry and Morpheus8 radiofrequency microneedling.  In order to do our part to decrease the spread of Covid-19, our office does have a strict screening protocol and all staff and patients are required to wear masks at all times.  Our staff continues to follow strict guidelines to increase the frequency of cleaning of all contact surfaces, such as door handles and countertops, with appropriate cleaning solutions. Your safety has always been, and will continue to be, of utmost importance.

Dr. Ravi Somayazula and Dr. Swapna Gopathi, both board certified physicians, continue to offer in person consultations as well as virtual consultations via a secure HIPAA compliant platform. We are happy to provide these two options to guarantee your comfort.

As responsible leaders in our community, we will always take the appropriate steps to ensure that every decision we make is focused on the health and safety of our patients and staff. We continue to monitor the CDC’s guidelines on infection control and are implementing their recommendations on an ongoing basis.

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