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With regard to breast augmentation, it is a very very common operation, very common in our practice. We see wide variety of women with wide variety of concerns and you want to respond individual and uniquely to each of those concerns. Generically, I find it is far better operation to put the implant under the pectoralis muscle. It has less chance of injuring nipple sensation and less chance of hardening, it looks and feels more natural, and probably most importantly of all you have much better breast cancer surveillance with mammography and much better visualization of the breast. With breast augmentation in addition to implant placement, there is also a variety of locations where you can place the incision and that is an individualized decision. You meet with the patient and look at their anatomy, discuss their concerns, you weigh the pros and cons, and you decide on the right approach for each patient. Now we really have spent a lot of time with the patients reviewing saline versus silicon implants and they each have their pros and cons. I do not think it is a black or white decision, it is not an upgrade issue, it is not that one is always better than the other. They have certain pros and cons. Silicon implants certainly feels softer that is very relevant in the patient with thin skin and not a lot of breast tissue that is less relevant in the patient with thicker skin and a more substantial amount of breast tissue and that has to be weighed against the slightly larger incision that is required and the slightly more intensive followup. So each patient has to get that information so they can make good decisions.