Virtual Breast Augmentation Consultation Guide

Why This Virtual Breast Augmentation Consultation Guide Exists

Thirty percent of Dr. Mirrafati’s breast augmentation patients come from out of state. Many consult virtually from the comfort of their homes before traveling to California for surgery. This comprehensive guide provides everything you need to know about breast augmentation consultations—whether you’re considering Mira Aesthetics specifically or simply want to know what to look for when evaluating any plastic surgeon.

Even if you never schedule with us, this information helps you become an informed consumer capable of asking the right questions and recognizing quality surgical care.

Before the Consultation

Don’t Be Shy—There Are No Dumb Questions

The worst consultation mistake is leaving with unanswered questions because you felt embarrassed to ask. Write down every question before your consultation, no matter how basic or silly it seems:

• “Will this hurt?”
• “When can I go back to work?”
• “What if I hate the results?”
• “How much does this actually cost with all fees included?”
• “What happens if something goes wrong?”

Every question is valid. If a surgeon makes you feel stupid for asking, that’s a red flag about the patient-doctor relationship you’d have throughout the surgical process.

What to Research Before Consulting

1. Video Testimonials Trump Everything

Before scheduling consultations, watch extensive video testimonials showing:

• Patients in the recovery room immediately post-surgery
• Next-day post-operative experiences
• One-week follow-ups
• Six-week final results

Why video beats written reviews: Google reviews can be curated or manipulated. Video testimonials showing real patients at various recovery stages provide authentic insight into what you’ll actually experience.

2. Before/After Photo Galleries

Study the surgeon’s before/after gallery extensively. You’re evaluating:

• Aesthetic style – Does this surgeon’s work match your taste?
• Consistency – Are results uniformly good or sporadic?
• Variety – Can they achieve good results on different body types?
• Naturalness – Do results look obviously augmented or proportionate?

Critical point: A surgeon might be highly skilled but have an aesthetic style that doesn’t match your preferences. That doesn’t make them “bad”—it makes them wrong for you. Breast augmentation is artwork. You need to like the artist’s style.

3. Organized Galleries by Size

Quality surgeons organize galleries by implant volume ranges:

• 300-400cc results
• 400-500cc results
• 500cc+ results

This helps you visualize what different volumes look like on real bodies, not abstract concepts.

Evaluating Credentials

Board Certification—Necessary But Not Sufficient

What board certification means:

• Completed required training (minimum 1,000 procedures for plastic surgery)
• Supervised by established surgeons who verified competency
• Passed written and oral examinations
• Maintains continuing education requirements

What board certification does NOT mean:

• The surgeon is “good” or produces beautiful results
• They have extensive breast augmentation experience specifically
• Their aesthetic judgment matches your preferences
• They have excellent bedside manner or communication skills

Bottom line: Board certification is the baseline credential—required but not sufficient. It proves they have training. Their portfolio, testimonials, and consultation communication prove whether they’re right for you.

Surgical Approach Options

Four Incision Locations

1. Inframammary (Under the Breast)

• Location: Crease where breast meets chest wall
• Dr. Mirrafati’s opinion: Acceptable but scars the breast tissue itself
• Best for: Larger implants, revision surgeries

2. Periareolar (Around Nipple)

• Location: Border between areola and breast skin
• Dr. Mirrafati’s opinion: Okay but unnecessarily invasive for routine augmentation
• Analogy: “People don’t take appendix out by opening you up anymore—they use advanced scope techniques”

3. Transaxillary (Armpit) ⭐

• Location: Small incision in armpit
• Dr. Mirrafati’s opinion: Preferred advanced technique
• Advantages: Zero breast scarring, hidden incision location
• Recovery: Faster return to normal activities (often 3 days)

4. Transumbilical (Belly Button)

• Location: Through belly button
• Dr. Mirrafati’s opinion: Another advanced alternative
• Advantages: Completely remote from breast, unique approach

The advancement principle: Modern medicine moves toward less invasive techniques. Transaxillary and transumbilical approaches represent advancement beyond cutting directly on the breast.

Implant Placement—Over vs. Under Muscle

The Evolution of Thinking

Old dogma: “Everything goes under the muscle—it’s always best.”

Modern reality: After 30 years and 8,000 breast augmentations, Dr. Mirrafati learned that under-muscle placement isn’t universally superior. It depends on individual anatomy.

Factors Determining Optimal Placement

Breast tissue characteristics:

• Glandular (dense) vs. fatty (soft) tissue composition
• Amount of existing breast tissue providing coverage
• Skin thickness and quality

Muscle characteristics:

• Muscle strength and tone
• Muscle length (short vs. long pectoralis)
• Patient activity level and upper body use

Implant characteristics:

• Implant size relative to muscle dimensions
• Profile selection (projection needs)

The Short Muscle Problem

If you have a short pectoralis muscle and want 500cc implants, placing them “under the muscle” is anatomically impossible. The muscle doesn’t extend far enough to cover the implant. Attempting submuscular placement just tears the muscle, and the implant ends up positioned over muscle anyway—but now you’ve experienced unnecessary muscle trauma.

The honest assessment: Your surgeon must examine YOUR anatomy and explain why over or under muscle is better for YOUR specific situation. One-size-fits-all approaches indicate cookbook surgery rather than individualized assessment.

The Sizing Process

Why Virtual Imaging Failed

Many practices use computer imaging showing simulated post-augmentation appearance. Dr. Mirrafati discontinued this approach after finding it “really dishonest”—it shows results looking too good and doesn’t accurately represent what you’ll actually look like. Also read our blog about What Do DD Breasts Look Like?

Failed methods also tried:

• Rice in stockings approximating implant weight
• Water displacement calculations
• Mathematical formulas based on chest measurements

The Method That Actually Works

Dr. Mirrafati’s proven approach at Mira Aesthetics:

Step 1: Measurement Measure chest width from mid-sternum to mid-axillary line determining maximum implant diameter your anatomy can accommodate (typically 11-14cm).

Step 2: Bring Actual Implants Provide real implants in relevant size range based on measurements—perhaps 325cc, 350cc, 375cc, 400cc for a medium-framed patient.

Step 3: Physical Sizing

• Place implants inside special sizing bras
• Patient wears their own shirt over the sizing bra
• Evaluate profile in mirror from all angles
• Try different sizes on each side for direct comparison

Step 4: Side-by-Side Comparison “Put 350cc on the left side, 375cc on the right side. Which profile do you prefer?” Then switch: “Now try 375cc left, 400cc right. Which side looks better?”

This direct visual comparison on YOUR body wearing YOUR clothing provides accurate prediction of post-operative appearance. If you’d like to see more, see our Breast Augmentation for Dropped Breasts — Step by Step Drawing Guide. Listen to the YoungerLook Podcast on spotify.

The Between-Sizes Decision Rule

Common scenario: “I can’t decide between 350cc and 375cc.”

Dr. Mirrafati’s rule: When torn between two sizes, always choose the larger.

Why? The external sizing shows slightly more volume than you’ll see post-operatively because the implant sits outside your body during sizing. Inside your body, the 375cc will look approximately like the 350cc appeared during external sizing.

Translation: If you like how 375cc looks during sizing, that’s what you’ll get. If you choose 350cc thinking it looks good during sizing, you’ll be disappointed post-operatively when it looks smaller than expected.

Understanding Cup Size Translations

General Volume-to-Cup Guidelines

C Cup Range: 300-400cc

• 300cc = Small C
• 350cc = Full C
• 400cc = Very full C

D Cup Range: 400-500cc

• 400cc = Small D
• 450cc = Medium D
• 500cc = Full D or small DD

DD+ Range: 500cc+

• 500-550cc = Small DD
• 600cc+ = Full DD to DDD

Critical caveats:

• These are approximations, not guarantees
• Starting breast tissue affects cup size achieved
• Band size matters (C on 32 band ≠ C on 38 band)
• Focus on appearance, not cup letter targets

Don’t Knock DD Until You Try It

Many patients declare: “I definitely don’t want to go DD—that’s too big!”

Dr. Mirrafati’s response: Don’t make this decision abstractly. During physical sizing, actually try 500-550cc implants and see what they look like on YOUR body with YOUR proportions.

You might be surprised to discover that “DD” on your 5’9″ frame with broad shoulders and curvy hips looks perfectly proportionate and natural—not the excessive mental image you had based on the letters “DD.”

The sizing consultation exists precisely to replace abstract fears with visual reality.

Communication Standards

The Layman’s Language Test

Your surgeon should explain everything in language you completely understand without medical jargon.

Dr. Mirrafati’s principle: “If I know what I’m doing, I should be able to explain it in regular language that you understand. If I use a lot of medical languages and ‘hufftuff mufftuff’ words you don’t understand, that means I don’t understand.”

What this means practically:

❌ Bad explanation: “We’ll create a submuscular pocket with dual-plane dissection ensuring adequate inferior pole expansion while maintaining superior pole coverage through partial pectoralis preservation.”

✅ Good explanation: “We’ll place the implant partially under your chest muscle and partially under your breast tissue. The upper part gets muscle coverage for natural appearance. The lower part sits under breast tissue so the implant can settle properly and create nice lower fullness.”

If you leave a consultation confused about what the surgeon said, that’s a problem with their communication—not your intelligence.

The Pre-Operative Appointment

At Mira Aesthetics, once you’ve decided to proceed with surgery, you schedule a pre-operative appointment covering:

Medical Review

• Complete consent forms with detailed risk discussion
• Review all post-operative instructions
• Discuss pain management and recovery timeline
• Schedule follow-up appointments

Final Sizing Confirmation

• Repeat the physical sizing process
• Confirm final implant selection
• Verify both parties agree on size and expectations
• Last opportunity to adjust if second thoughts arise

Why this matters: Patients sometimes feel different about sizing after they’ve committed to surgery and had weeks to think about it. The pre-op visit provides one final opportunity to confirm or adjust choices before the operating room.

What Virtual Consultation Can’t Replace

While 30% of Dr. Mirrafati’s patients consult virtually before traveling for surgery, certain elements require in-person assessment:

Must be done in-person:

• Physical breast examination assessing tissue quality
• Chest measurements for implant diameter selection
• Physical sizing with actual implants in bras
• Muscle assessment for over/under placement decision

Can be done virtually:

• Initial consultation discussion
• Before/after photo review
• Procedure explanation and approach discussion
• Preliminary size range discussion
• Cost and logistics planning

The hybrid model: Virtual consultation for initial assessment and decision-making, then in-person pre-operative visit before surgery for physical examination and final sizing confirmation.

Red Flags to Watch For

Warning Signs of Poor Surgical Candidates

❌ Consultation red flags:

• Surgeon rushes through consultation without answering questions
• Dismissive of your concerns or makes you feel stupid
• Uses only medical jargon without plain explanations
• Offers one-size-fits-all approach (everyone gets same technique)
• Cannot clearly explain why they recommend specific approach for you
• Pressures you to book immediately with limited-time pricing
• Before/after gallery is sparse or shows inconsistent results
• No video testimonials available from actual patients

❌ Practice red flags:

• Not performed in accredited surgical facility
• Anesthesia provided by non-board-certified providers
• Unclear all-inclusive pricing with hidden fees
• No clear complication management protocol
• Difficulty reaching office with questions
• High-pressure sales tactics from staff

Your Consultation Checklist

✓ Before consultation:

• Watch extensive video testimonials (recovery room, next day, one week, six weeks)
• Study before/after galleries organized by size
• Write down all questions no matter how basic

✓ During consultation:

• Verify board certification and credentials
• Ask about incision approach and why surgeon recommends specific technique
• Ask about over/under muscle placement and rationale for your anatomy
• Request explanation in plain language you understand
• Review sizing methodology—ideally physical sizing with actual implants

✓ Evaluating the surgeon:

• Do their results match your aesthetic preferences?
• Do they communicate clearly without jargon?
• Do they customize approach to your anatomy or use one-size-fits-all?
• Do you feel comfortable asking questions?
• Are they honest about limitations and realistic outcomes?

✓ Red flags to avoid:

• Cannot explain rationale for recommendations
• One-size-fits-all approach for all patients
• Dismissive of your questions or concerns
• Sparse portfolio or inconsistent results
• Pressure tactics or limited-time offers

Available at Mira Aesthetics

Dr. Mirrafati performs breast augmentation at three California locations:

Costa Mesa – Serving Orange County
Downey – Serving Los Angeles County
Montclair/Rancho Cucamonga – Serving Inland Empire

Experience: 30+ years, 8,000+ breast augmentations
Approach: Transaxillary (armpit) preferred for scarless results
Sizing: Physical sizing with actual implants during pre-op
Results: Extensive video testimonials and organized before/after galleries

Virtual consultations available for out-of-state patients. In-person pre-operative visit required before surgery for physical examination and final sizing.

At Mira Aesthetics, the consultation process is designed to educate, not pressure. Whether you begin with a virtual breast augmentation consultation or meet in person, the goal is to help you understand your options clearly and confidently.

During your consultation, Dr. Mirrafati reviews your goals, evaluates your anatomy, and explains incision approaches, implant placement options, and sizing methodology in plain language. You will learn why certain techniques may be recommended for your body type rather than receiving a one-size-fits-all plan. The focus is on individualized surgical planning, honest discussion, and realistic expectations.

Virtual consultations are ideal for initial education, especially for out-of-state patients. However, final sizing, chest measurements, and physical examination are completed in person before surgery to ensure precision and safety. This hybrid model allows patients to make informed decisions before traveling for their pre-operative visit.

With over 30 years of experience and more than 8,000 breast augmentations performed, Dr. Mirrafati emphasizes transparency, organized before-and-after galleries, video testimonials, and physical implant sizing rather than computer simulations.

If you are considering breast augmentation and want a clear, thorough consultation process, contact Mira Aesthetics at (714) 544-8678 to schedule your virtual or in-person appointment at our Costa Mesa/Newport Beach, Downey, and Rancho Cucamonga/Montclair.

FAQ: Virtual Breast Augmentation Consultation Guide