Breast Augmentation: How to Choose the Right Implant

By Doctor Waldemar Weiss

25 June 2026

Breast augmentation with implants is one of the most commonly performed cosmetic surgery procedures worldwide. Yet every patient faces the same fundamental question: how do I choose the right implant? Volume alone does not define a result. The implant shape, surface texture, surgical approach and placement all play a decisive role in the final outcome. Doctor Waldemar Weiss, a cosmetic surgeon in Paris, guides each patient through this crucial decision to ensure a natural, harmonious result in line with his philosophy of bespoke surgery. Dr Weiss regularly welcomes international patients and provides personalised consultations in English and Polish.

Round or anatomical implants: which shape to choose?

Implant shape is the first structural decision. Round implants provide even filling throughout the breast, with a more noticeable cleavage effect. They suit patients who wish for a visible but proportionate fullness in the upper pole.

Anatomical implants, also called teardrop implants, mimic the natural breast shape with more volume concentrated in the lower pole. They are particularly well suited to slim patients with limited breast tissue, as they create a very natural silhouette.

Dr Weiss emphasises that the choice is never based on abstract aesthetic preference. It depends on the patient's body proportions, tissue quality, chest wall shape and expectations. During the preoperative consultation, trial sizers in different volumes and shapes help the patient visualise the expected result.

Volume: finding the right balance

Volume is understandably the question that concerns patients most. Breast implants range from approximately 125 ml to over 600 ml. However, a given volume does not produce the same result depending on the patient's build, chest width and existing breast tissue.

Dr Weiss insists on a fundamental principle: "A little less is always better than too much." An implant that is too large relative to the patient's frame creates an artificial appearance and can also lead to long-term complications: skin stretching, premature sagging, and visible implant edges.

The ideal volume integrates seamlessly into the overall silhouette, respects body proportions and remains imperceptible to the eye. This precision work is not decided from a photograph but through a thorough exchange between patient and surgeon.

Smooth or textured surface: the selection criteria

The implant shell -- its outer surface -- influences how it behaves over time. Smooth-surface implants move naturally within the implant pocket, giving them a more natural feel. They are today preferred in many indications.

Textured or micro-textured implants were developed to prevent rotation of anatomical implants and to reduce the risk of capsular contracture (hardening around the implant). The choice between these options depends on the implant type selected, the surgical approach and the placement plane.

Dr Weiss exclusively uses CE-certified implants manufactured by established laboratories, meeting the strictest safety standards. Implant quality is a non-negotiable factor.

Above or below the muscle: implant placement

Implant placement is a technical decision that directly affects how natural the result looks. Two main options exist:

Sub-glandular placement (above the muscle): the implant sits between the breast gland and the pectoral muscle. This position is appropriate when the patient has sufficient tissue coverage. It provides a natural cleavage and a faster recovery.

Sub-muscular placement (below the muscle): the implant is placed partially or fully beneath the pectoralis major muscle. This position is preferable for slim patients with little breast tissue, as the muscle provides additional coverage that conceals implant contours. It is also associated with a lower risk of capsular contracture.

The "dual plane" technique, which combines both planes, is frequently used by Dr Weiss to achieve the best compromise between a natural look, patient comfort and long-term implant stability.

Surgical approach: where will the scar be?

The surgical approach refers to the incision site through which the implant is inserted. Four approaches are possible:

• Inframammary approach: the incision is made in the crease beneath the breast. This is the most common approach, offering direct access and a discreet scar hidden in the natural fold.
• Periareolar approach: the incision follows the lower edge of the areola. The scar blends into the colour transition between the areola and surrounding skin.
• Axillary approach: the incision is placed in the armpit. It avoids any scar on the breast itself, though it requires a more technically demanding procedure.
• Transareolar approach: the incision crosses the areola. It is less commonly used today.

The choice of approach depends on the implant type, placement plane and the patient's preferences. Dr Weiss systematically discusses these options during the consultation so that each patient is fully involved in the decision.

The consultation: an essential step

Choosing an implant should never be done online or based on photographs alone. It is built through an in-depth dialogue between patient and surgeon. The consultation allows the surgeon to examine the patient's anatomy, measure the chest, assess tissue quality and understand the patient's true expectations.

Dr Weiss takes the time to demonstrate different trial volumes, explain the advantages and limitations of each option, and propose a personalised surgical plan. He will always decline requests he considers disproportionate -- out of honesty towards his patients and his commitment to excellence.

Before-and-after photographs of consenting patients can be shown to illustrate expected outcomes based on the implant type and the patient's body shape.

Results and post-operative follow-up

Breast augmentation is performed as a day case or with one overnight stay, under general anaesthesia, in an HAS-accredited clinic. Normal daily activities can usually be resumed within 5 to 7 days. A support bra is worn for 4 to 6 weeks.

The result stabilises gradually over 3 to 6 months as the tissues soften and the implant settles into its final position. Post-operative follow-up includes regular consultations with Dr Weiss and scheduled ultrasound checks over time.

Modern implants have an extended lifespan, but they are not considered permanent. Long-term monitoring is necessary, with regular check-ups to verify implant integrity.

In summary

Choosing a breast implant is far more than choosing a volume. It is a series of decisions -- shape, surface, placement, surgical approach -- that must be tailored to each patient individually. This is precisely Dr Weiss's speciality: building a bespoke surgical plan guided by naturalness and safety, for a result that integrates harmoniously with each woman's body and personality.

To learn more or book a consultation, contact Dr Weiss's practice.