Question: My breasts are just too small for the rest of my body. I would like breast augmentation and I’m planning surgery for a birthday present to myself. Can I choose where I want the incision or is that your decision? Is this performed with local anesthesia? Answer: Our preference is for general anesthesia for breast augmentation and the under the muscle position for the implants. In terms of the incision, we usually leave this up to the patient but many times this is determined by the shape and size of the breasts. For very small breast I prefer the areola incision and for more pendulous breast I prefer the inframammary incision, although this is something we discuss with the patient and we have them help us with this decision.