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Introduction to breast augmentation

Breast augmentation is a surgical procedure that increases the volume of the breasts to improve symmetry and shape, or to restore breast volume after a pregnancy or weight loss. Breast augmentation may also be the treatment of choice after breast tissue has been removed due to a mastectomy or a traumatic injury. Breast augmentation can greatly improve the self-image, confidence, and sense of femininity for a woman. 

Breast augmentation procedure

There are many different types of breast augmentation procedures and breast implants, but the basic steps remain the same: a small incision is made within the natural fold of the breast; the implant is placed within the breast in order to increase volume and create a more ideal shape, and then the incision is closed. Breast implants are typically placed during a short surgery and do not require any stay at a medical center or hospital. Most patients are put under general or local anesthesia during surgery.

Why choose breast augmentation?

A woman’s breasts tend to be an important part of her self-confidence, but many women are unhappy with this area of their body. Whether you’ve never liked the appearance of your breasts, pregnancy and breastfeeding have changed the way they look, or cancer has taken your breast tissue from you, breast augmentation is very often used to restore self-esteem and enhance appearance. Those who have undergone the procedure often report increased self-confidence and an overall improved quality of life.

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How much does a Miami breast augmentation cost?

Throughout the country, the cost for breast implants ranges from $3,500 to $18,000. At The Maercks Institute in Miami, the elite transaxillary Cold Subfascial Breast Augmentation with advanced gummy bear implants is competitively priced at $15,000, which includes all fees, anesthesia, and operating room. If the breast implants must be replaced over time, this is considered a second surgery and is not factored into the cost of the original implant. However, if there is a need for a correction in the first twelve months, there is usually no surgeon’s fee applied — only the operating room and anesthesia charge of $2,500. Please note that pricing is subject to change, and insurance will not cover the cost of breast implants if the surgery is done for purely cosmetic reasons. If the surgery is done as a corrective procedure, your insurance may cover some of the costs. The best way to determine if your insurance will pay for surgery is to contact them beforehand to get a definitive answer.

Who is a good candidate for a breast augmentation in Miami?

If you’re considering breast augmentation in Miami and you’re wondering if you’re a good candidate, it may be the perfect procedure for your needs.

Ideal candidates for breast augmentation are those who:

  • Are over the age of 18 (for saline implants) or over the age of 22 (for silicone implants) 
  • Are unhappy with the size, shape, or asymmetry of their breasts 
  • Are not pregnant or breastfeeding
  • Are non-smokers in overall good health
  • Have realistic expectations of what a breast augmentation can accomplish


Dr. Maercks’s technique is often used in combination with a new anesthetic called Exparel®, which helps to make recovery nearly painless. Patients who use Exparel often have no need to take post-op pain medication. The recovery time depends much on the patient and the size and type of implant that is placed. If you live alone, be sure to have someone checking on you over the course of a week to make sure you’re safe and recovering. The following guidelines should also be carefully followed:

  • Have creams and medications easily within reach
  • Wear loose, comfortable clothing
  • Eat healthy foods
  • Wear a support bra after the surgical bra is removed
  • Apply cream over scars every day

Do not lift heavy objects or raise your hands above your head for three days after the surgery. You may notice fatigue during this time and should be restrictive with movement until your healing has been completed. If your job does not require any type of heavy lifting or bending, you may resume work after three days post-surgery. the incisions will return to their natural color after several months, although the breasts may remain swollen for up to two months.

Making Your Breast Augmentation Undetectable - Dr. Maerck’s Unique Approach

Dr. Maercks combines a number of methods to create his unique approach to breast augmentation that looks natural and full, giving you the perky, bouncy, and beautiful breasts you want. 

His incision placement ensures there is no scarring, while the pocket design and implant selection he exclusively uses allows for fullness and cleavage, without the wide valley between the breasts. Finally, the placement of the implants under the fascia gives the breasts a secure height and ensures there isn’t any moving around.

Options for implant placement

Breast implants can be placed in one of four places, three of which are:

  • Between the breast tissue and the pectoral muscles (subglandular placement)
  • Between the pectoralis muscle and a strong tissue layer called pectoral fascia (subfascial placement)
  • In the subpectoral plane, i.e., beneath the pectoral muscle (submuscular placement)

Although submuscular placement (under the pectoral muscle) is the most commonly selected placement in the United States, it tends to create a widely separated, unnatural-looking “augmented” look to the breasts. Implants placed here tend to bottom out quickly, and patients tend to end up having multiple revisions over the course of their life. The subglandular plane (placement between the breast tissue and the pectoral muscles) tends to have less than satisfactory longevity as well.

Cold Subfascial Breast Augmentation

Dr. Maercks has developed a new type of breast augmentation in Miami, a procedure called Cold Subfascial Breast Augmentation©. This technique creates the most natural-looking results, with optimal longevity. Combining art, aesthetic sensibilities, and anatomical knowledge, Dr. Maercks developed this technique to provide supported, long-term control of breast shape and cosmetic appearance. 

In Cold Subfascial Breast Augmentation, the fascia (a thin layer of strong tissue within the breast) is elevated off the pectoralis major muscle, and the implant is placed inside this strong layer, which acts almost like a bra inside the breast.

Not only does placing the implant within the fascia provide extra support; it also allows Dr. Maercks to customize the shape of the breasts to fit the patient’s unique chest wall. Instead of an “implant shape” to the breasts, it appears much more natural and harmonious with the patient’s body. In addition, the unparalleled support holds the implant in place and stops it from putting pressure on the breast tissue and skin. Cold Subfascial Breast Augmentation truly allows exceptional control compared to other techniques.

How Cold Subfascial Breast Augmentation is performed 

An incision is made to place the implant and, while Dr. Maercks can give you an in-depth look at the different types of incisions, the final choice is ultimately in the hands of the patient. Dr. Maercks prefers to leave the breasts with a scarless appearance using a special transaxillary technique (i.e., through the armpit). Incision sites can include:


This is the preferred incision placement of most plastic surgeons when placing silicone gel implants. An incision is made directly below the inframammary fold, giving the surgeon easy access to the pectoral muscles. However, the scar is very obvious when nude, and can often be seen riding below some bikini tops.


This incision is made around the border of the areola. Patients often choose this option because there’s less scarring and the breasts can be lifted at the same time implants are placed. Dr. Maercks tends to avoid this approach unless a lift is necessary.


An incision is made in the armpit to access the breast, and the implant is then placed in the breast area through the armpit. There is virtually no scarring with this type of incision, although it requires more technical skill from your surgeon. Dr. Maercks generally performs all primary breast augmentations in Miami through this approach because it leaves a scarless appearance of the breasts, and the axillary scar generally fades to resemble a natural crease.


A small incision is made in the belly button, and the implant is worked up the navel toward the breast, producing a virtually scarless implant. This option is less safe and very unpredictable. This is because it’s not possible to precisely control the plane of the implant. In addition, silicone implants cannot be placed in this manner. Dr. Maercks generally advises avoiding this technique.

Out of town patients

Patients visiting Miami to take advantage of the benefits of Dr. Maercks’s Cold Subfascial Breast Augmentation are asked to stay in town for five days — however, a minimum of a three-day post-operative stay is required. 

Before & After Breast Augmentation in Miami

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Advantages to gummy bear breast implants

  • Thicker than traditional silicone implants, making rupture or breaking less likely
  • Semi-solid consistency makes them less likely to wrinkle or fold
  • No concern of leaking after surgery
  • Less scarring
  • They’re pre-filled, making them feel more natural and softer under the skin
  • Maintain their shape even years after placement

Candidates for gummy bear breast implants

  • Must maintain a healthy lifestyle
  • Have no history of problems with anesthesia
  • Do not smoke
  • Are not prone to infection
  • Are not pregnant or breastfeeding
  • Have realistic expectations for the surgery

More about gummy bear implants 

Research and advancements in the field of cosmetic surgery have led to the development of breast implants that are more natural-looking than ever, and this includes gummy bear implants. 

Made of a cohesive high-strength silicone gel that is both soft and solid, the nature of the gummy bear implant allows it to constantly keep its shape, which gives the breast a more natural look after surgery. Additionally, gummy bear implants offer more customization, which helps achieve more attractive and natural-looking breasts. 

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Why choose The Maercks Institute for breast implants in Miami?

A well-planned breast augmentation in Miami can ensure you get the breasts you want. The Maercks Institute is a high-profile, Miami-based surgical center that offers advanced techniques in surgical procedures that challenge “status quo” plastic surgery by delivering bespoke results that appear as if they are made by nature. President and medical director Dr. Rian Maercks is a board-certified plastic surgeon who elevates the standard of patient care and safety. His approach to both surgical and non-surgical procedures of the face and body have earned international recognition by both surgeons and patients alike, and his undergraduate training in fine arts and philosophy created the framework through which he explores the world of medicine and plastic surgery. As the expert who will formulate the right treatment plan for your goals, Dr. Maercks uses his attention to detail, artistic vision, and experienced judgement to design a procedure that leverages your unique beauty in a manner that is anything but cookie-cutter. If you’re interested in breast implants, reach out to us today and discover why Dr. Maercks has changed the lives of thousands of patients over the years at his boutique practice in Miami.

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Preparing for surgery

  • A baseline mammography is needed for patients 35 or older, or for those with certain risk factors
  • Avoid blood thinners or aspirin before the procedure
  • Stop smoking or using tobacco a month before surgery
  • Arrange a ride from surgery, and a helper to stay with you for several days
  • Plan to miss a few days of work after the procedure

Day of surgery

  • You will be given a mild sedative before surgery
  • General anesthesia is applied after you fall asleep
  • Drainage tubes and bandages are applied after the procedure
  • You will be given a surgical bra to provide breast support
  • You will then be monitored in recovery and may be able to go home after just a few hours
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What Are the Three Most Obvious Indicators of Fake Breast Augmentation?

Breast augmentation in Miami enhances the breasts, bringing a youthful roundness and perky look to your silhouette. But all too often, the augmentation can have an unnatural, obviously altered, “plastic” look, showing that you’ve had plastic surgery and your breasts are fake.

Number One: 

Scars on the breasts. Breast augmentation scars are usually either under the breasts or at the bottom of the areola to the crease below the breast (and/or around the areola). These scars are a telltale sign that work has been done. 

With the Maercks Institute technique, there is no scarring on the breast. The skin around your full, round breasts will be smooth and untouched. Instead, there will be a small incision on the armpit fold.

Number Two: 

A wide separation between breast implants. This is a look that can sometimes be jokingly referred to as “Miami Valley.” The look is artificial and is a dead giveaway of a “boob job.” 

At the Maercks Institute, we have a specific pocket design and implant selection. This approach eliminates this issue and gives patients round but more natural breasts that are not easy to detect as augmented. The look we create provides cleavage, a very natural but perky and bouncy effect, and side-boob.

Number Three:

Movement of implants. The way most breast implants are done, you will commonly see the implants move around when you use your pectoral muscles during exercise or intimacy.

 You won’t have that problem when having your breast augmentation here at The Maercks Institute in Miami. Dr. Maercks inserts the implants in a different plane. He places each implant above the muscle but under the fascia (the sheets of connective tissue under the skin). The fascia acts as an internal bra that is able to hold the implants securely in place. With Dr. Maercks’ approach, you won’t have to worry about your implants moving around when you’re active.

Patients who have implants already placed can have Dr. Maercks reconstruct their pectoral muscles to give them the same excellent results.

Breast Augmentation FAQ

How long do implants last?

Once breast implants are placed, they can have a very long life — although there is no way to specifically determine exactly how long each implant will last. As with any surgery, there are risks and complications. These can include scar tissue or ruptures that make it necessary to remove the implant. If an implant is made of saline and a rupture occurs, the body simply absorbs the solution. If an implant is silicone and ruptures, an MRI is required to determine if the condition is, in fact, a rupture. If the implant has indeed ruptured, it will most likely be removed and simultaneously replaced with a new one.

Which type of implant is right for you?

Patients have several options when it’s time to choose the right type of breast implant. At The Maercks Institute, we’re proud to offer both saline and silicone gel implants (otherwise known as “gummy bear” implants). Dr. Maercks’s preference is to use anatomically-shaped gummy bear cohesive silicone implants.

What are the risks of breast augmentation?

As with any surgery, there are risks with breast augmentation. These should all be thoroughly explored during your consultation before you make the commitment to undergo the procedure. Risks of breast augmentation include infection, wrinkling/rippling of the implant, necrosis, implant rupture, capsular contracture, the need for additional surgery, changes in bust sensation, and results that are unsatisfactory.

What is dual plane breast augmentation?

Many breast augmentations performed use the dual plane method, in which the muscle is cut at the bottom, then reaches up to the top of the breast to cover the implant. This technique has some considerable disadvantages. This can include an unnatural-looking appearance, implants that move around too much, and implants that widely separate. Dr. Maercks’s innovative Cold Subfascial Breast Augmentation technique avoids all of this by inserting the implant within the fascia, a thin layer of strong tissue within the breast. His method utilizes the fascia to provide extra support and allows for optimal customization. Another advantage of Cold Subfascial Breast Augmentation is that it leaves the breasts without scars, as the entire procedure can be performed through a small incision in the armpit.

What is scarless breast augmentation?

Scarless breast augmentation can be achieved using a transaxillary incision, which is Dr. Maercks’s preferred method. A transaxillary incision is made in the armpit to access the breast, and from there the implant is inserted into the breast. This technique can be tricky, but in the hands of a skilled plastic surgeon such as Dr. Maercks, it is often the optimal choice. A scarless breast augmentation can also be done using a transumbilical incision, in which the incision is made in the belly button — however, Dr. Maercks generally advises avoiding this technique as it is unpredictable.

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