2026

If you are considering breast augmentation, many of the most important decisions happen before surgery ever begins. Choices based on cup size, photos, or incomplete information can lead to results that do not feel balanced or appropriate for your body.

In this video, Dr. Dimitri Koumanis explains the most common breast augmentation mistakes he sees and what patients should understand before moving forward. He covers implant selection, anatomy, expectations, and recovery planning. The full video transcription is included below.

Video Transcription

If you’re thinking about breast augmentation, I want you to pause for a second because the biggest mistakes I see don’t happen in the operating room. They happen before surgery when women are choosing size, shape, and expectations based on the wrong information. In the next few minutes, I’m going to tell you what I wish every woman knew before breast augmentation so you feel confident, prepared, and excited about your decision.

I’m Dr. Dimitri Koumanis at Saratoga Springs Plastic Surgery. I’ve cared for many women considering implants for the first time, revisions or augmentations with lifts.

First, forget cup size. Cup size isn’t a medical instrument. One brand’s C is another brand’s D. What actually matters is your proportions, your chest width, shoulder balance, rib cage shape, and the amount of natural tissue you already have. When you choose implants based on a number or a photo alone, you risk ending up too large, too wide, or not fitting your frame.

Second, your skin and tissue quality determine what’s possible. Some women are happier with an augmentation plus lift because the lift reshapes the breast envelope and the implant provides volume. So, the key takeaway line is that an implant adds volume. It doesn’t always fix the droop.

Natural is a design choice. Shape, profile, and placement matter. Natural results come from smart design. That design includes implant dimensions, profile, and sometimes placement over or under the muscle based on the goals in anatomy. Some women want a subtle athletic enhancement. Others want a fuller upper pole. Neither is right or wrong. What matters is making sure your surgical plan matches your aesthetic goals and your lifestyle.

If you’re very athletic, if you lift weights, if you’re lean, or if you have a smaller natural breast, these details can influence the plan. Recovery is usually easier than fear makes it. But plan it right. Most women are surprised by recovery in a good way. The first few days are the most uncomfortable, and then it tends to improve quickly.

So, you need to choose a surgeon for safety, planning, and honesty, not hype. The best surgeon isn’t the one promising perfection. It’s the one explaining trade-offs clearly. You want someone who prioritizes safety, listens to your goals, shows consistent results, and makes you feel supported through the entire process.

So, if you’re considering breast augmentation, my biggest advice is this. Don’t rush the decision. A great result comes from a personalized plan that fits your body and your goals.

For more information about breast augmentation procedures, or to schedule a consultation with Dr. Koumanis, please contact Saratoga Springs Plastic Surgery today. We’ll talk you through sizing, options, recovery, and what would look best on you so you can move forward with total confidence.

If you are unhappy with breast sagging or shape, you may be wondering whether a breast lift alone is enough or if implants are also needed. This is one of the most common and important questions patients face when exploring surgical options.

In this video, Dr. Dimitri Koumanis explains how to tell if you are a good candidate for a breast lift alone or if combining a breast lift with implants may produce a better result. He discusses the role of natural breast volume, anatomy, and expectations. A complete transcription of the video is included below for those who prefer to read along.

Video Transcription

If you’re unhappy with the position or shape of your breasts and you’ve been told you might need a breast lift or mastopexy, you may be wondering, am I actually a good candidate for this
procedure? Today, I want to walk you through how to tell if a Mastopexy alone is right for you.
And one very important factor that often gets overlooked is having enough natural breast volume to achieve a beautiful result.

I’m Dr. Dimitri Koumanis at Saratoga Springs Plastic Surgery, and Mastopexy is one of the most rewarding procedures we perform, but only when it’s done on the right patient. Understanding
who benefits most helps prevent disappointment and ensures long-term satisfaction.

What does a Mastopexy actually do? A Mastopexy, or breast lift, reshapes the breast by removing excess skin and repositioning the nipple higher on the chest. It improves shape and position, making the breasts look firmer, perkier, and more youthful. What it does not do is add volume.

The ideal candidate is someone who has sagging breasts with adequate volume. You may be a
good candidate for a Mastopexy alone if your main concern is sagging, but you’re generally
happy with your breast size. These patients typically still have enough natural breast tissue to
create a nice full shape once the breast is lifted and tightened and shaped.

So the clear takeaway is a successful Mastopexy depends on having enough existing breast
volume to reshape. So why does the volume matter so much in a breast lift? This is one of the most important points. I wish every patient understood. If a woman has significant volume loss, especially in the upper breast, the lift alone can sometimes result in a breast that looks higher, smaller, or flatter than expected. In other words, the breast may be in a better position but still lack fullness. This isn’t a failure of surgery. It’s a matter of anatomy.

So, what are the signs you may not be an ideal candidate for mastopexy alone? You may
not be the best candidate for a lift if your breasts look deflated or empty on top, you’ve lost
significant volume after pregnancy or weight loss. You want more fullness or cleavage than you
currently have. In these cases, combining a mastopexy with implants often produces a much
more satisfying and balanced result.

So, combining a lift with implants is sometimes the better choice. When a patient has both
sagging and loss of volume, a lift alone corrects position but not fullness. Adding an implant
restores volume while the lift reshapes and supports the breast. If volume is lacking, combining
procedures may be the best path to a result you’ll truly love.

For more information about breast lift procedures, or to schedule a consultation with Dr. Koumanis, please contact Saratoga Springs Plastic Surgery today.

Many women considering breast surgery feel confused about whether they need a breast lift, implants, or a combination of both. While implants add volume, they do not always address sagging, and a lift improves position without increasing size.

In this video, Dr. Dimitri Koumanis clearly explains the difference between breast lifts and breast implants and how to determine which option fits your concerns and goals. Understanding what each procedure does can make the decision process much clearer. The full transcription of the video is included below.

Video Transcription

If you’re unhappy with the appearance of your breasts and you’re considering surgery, one of the most confusing questions is this. Do I need a breast lift, implants, or both? Many women assume implants will fix everything, but that’s not always the case. Today, I want to explain the difference clearly so you can understand which option is right for your body.

I’m Dr. Dimitri Koumanis at Saratoga Springs Plastic Surgery, and this is one of the most common conversations I have in consultation. Once patients understand what each procedure actually does, the decision becomes much easier.

Breast implants are designed to add volume. They increase fullness and can enhance cleavage. However, implants do not lift the breast tissue or reposition the nipple. If your breasts sit higher on the chest and you mainly want more size or fullness, implants alone may be all you need.

What a breast lift actually does is a breast lift is a mastopexy, which reshapes the breast by removing excess skin and repositioning the nipple higher on the chest. A lift improves shape and position not size. It can make the breasts look perkier and more youthful, but it does not add volume unless combined with an implant.

So, how do you tell which one you might need? A simple way to think about it is this. If your main concern is size, implants may be enough. If your main concern is sagging, drooping, or nipples pointing downward, a lift is likely needed. If you want both more volume and a higher perkier shape, then the lift with breast implants is often the best solution.

Why implants alone sometimes disappoint patients. One of the most common reasons patients are unhappy after surgery is when implants are used to mask sagging. While an implant can fill loose skin, it doesn’t correct the underlying droop, and over time, gravity can make the result worse. In these cases, combining a lift with an implant creates a more stable and longer-lasting result.

So, why do some women not need an implant at all? Not every patient wants to be larger. Some women are happy with their volume, but want their breasts to look firmer, higher, and more youthful. For those patients, a breast lift alone can be incredibly transformative.

There’s no one-size-fits-all answer. Your anatomy, skin quality, lifestyle, and goals all matter. A good consultation focuses on evaluating your breast position, tissue support, and expectations, not just implant size.

For more information about breast surgery procedures, or to schedule a consultation with Dr. Koumanis, please contact Saratoga Springs Plastic Surgery today.