Breast Augmentation Without Implants, Here Are Your Options

Rian A. Maercks, M.D., P.A., American Board-Certified Plastic Surgeon, is an artist and a leading aesthetic, craniofacial, and reconstructive plastic surgeon, based in Miami, Florida. His private practice, The Maercks Institute, is located in beautiful Design District and is fully equipped with a tastefully designed office and an AAAHC qualified operating room. Dr. Maercks has spoken on many panels and given numerous lectures, domestically and internationally, regarding his unique breast augmentation procedure, which has brought in a large number of patients from all over the world.

Haute Beauty chats with Dr. Maercks about the 3 options he offers when it comes to addressing a breast augmentation.


Breast Augmentation Miami
Cold-Subfascial Breast Augmentation

Photo Credit: The Maercks Institute

HB: What types of surgical options do you offer when it comes to different types of breast augmentation?

In addition to conventional offerings for breast augmentation surgery, Dr. Maercks offers specialized techniques to create the most natural and aesthetically customized results for his patients. Breast augmentation is completed in one of three ways at The Maercks Institute. Implant-based augmentation is offered in both conventional under the muscle techniques and the highly specialized Cold-Subfascial Breast Augmentation. Two types of breast augmentation are offered that do not require implants including autologous fat transfer and auto-augmentation lifts.

HB: How do each of the procedures work?

Dr. Maercks' signature Cold-Subfascial Breast Augmentation (CSBA) differs from the more commonly used "under the muscle" or "dual-plane" breast augmentation in that he is able to avoid the separated look, creating natural-appearing, close together cleavage. The CSBA also avoids extreme muscle animation, "muscle jumping." The fascia is a strong layer above the muscle that Dr. Maercks uses like a bra inside the breast for long-term control of natural shaping. This procedure is the best choice for patients seeking a natural appearance and is very popular among fitness professionals, athletic women and models.

Fat transfer to the breast uses the patient’s own fat to enlarge and shape the breast. This can be done alone to avoid the need for an implant or in addition to an implant, which is referred to as "composite breast augmentation." Alone it allows the patient to enjoy a completely natural result without any implant-related concerns. As a composite procedure, it allows a more customized shaping than implants alone.

Auto-augmentation lifting refers to several techniques that allow tissue that is usually thrown away in breast lifts to be structurally rearranged to create a full appearance that most patients think requires an implant. FEMMA-S (footprint elevation mastopexy mammary augmentation with sling support) techniques minimize scars by using only a vertical scar for most patients and only a horizontal scar for patients with more severe drooping. Dr. Maercks uses a sling comprised of a small portion of the pectoralis muscle to support the living tissue that was once on the bottom of the breast into the top of the breast creating youthful superior pole fullness that is missing in most lift techniques. Dr. Maercks is able to create a result that looks like a beautiful implant-based augmentation without an implant.

Breast implants Miami
Auto-Augmentation Lift

Photo Credit: The Maercks Institute

HB: Who is the best candidate for each of these types of breast augmentations

Each patient is evaluated individually for a customized intervention. Generally, patients with little breast tissue and thin stature seeking midline cleavage and a very natural appearing result are great candidates for Cold-Subfascial Breast Augmentation. Patients that seek a more augmented look and who are willing to tolerate the separation of the implants, changes in shape with arm movements and a low result with time are good candidates for under the muscle breast augmentation. Patients with more breast tissue are great candidates for auto-augmentation lifts particularly when the nipples are low. Fat transfer is great for patients seeking breast improvements and correction of fat collections somewhere on the body or those with stubborn fat around the waistline.

HB: What is recovery like?

Recovery is very minimal and many patients do not require pain medication thanks to Dr. Maercks use of a drug called Exparel in a tumescent technique. This means that the areas treated are numbed before the surgery and remain numb for the first three days. Patients need to avoid lifting and engaging in exercise for five days.

HB: What is the average cost of each?

Breast augmentation using specialized techniques is usually $15,000 and up, but can be as low as $12,000 depending on the exact needs of the patient.

For more information, visit Dr. Rian A. Maercks's social media: