Breast augmentation in Paris
Increasing volume, correcting asymmetry, or restoring the breasts — with a focus on tissue preservation and natural-looking results
IN SHORT
- Five techniques address different situations: MIA and Preserved (minimally invasive), classic prostheses, lipofilling, composite augmentation.
- Three approaches: axillary, periareolar, submammary — the location of the scar depends on this.
- Three compartment positions: premuscular, dual plane, retromuscular, chosen according to the thickness of the covering tissues.
- Local anesthesia is possible in certain indications for preservation; general anesthesia in others.
- Implants subject to CE marking and ANSM materiovigilance.
- Personalized quote provided for consultation, legal reflection period of 15 days.
Table of contents
Breast augmentation addresses a wide range of situations: underdeveloped breasts since puberty, constitutional asymmetry, volume loss after pregnancy or significant weight loss, or the desire to harmonize one's silhouette. However, the approach has changed. Whereas breast surgery once required general anesthesia, extensive dissection, and several weeks of recovery, a growing number of procedures are now performed with tissue preservation in mind: less dissection, smaller incisions, and anesthesia tailored to the extent of the procedure.
This page presents all available techniques, focusing on the minimally invasive approach that now structures practice in the office, without neglecting traditional techniques that retain their indications. It also describes the procedure, risks, and medical context in which it is performed.
WHY TRUST DR. NATHANIEL STROUMZA-ESCOFFIER?
✔ Qualified plastic surgeon specializing in plastic, reconstructive and aesthetic surgery — registered with the Medical Council, RPPS 10100674943
✔ Former head of clinic at the Hospitals of Paris · Attending physician at Tenon Hospital (AP-HP)
✔ Specializing in breast surgery and minimally invasive breast enhancement techniques
✔ He is among the first French plastic surgeons trained in the MIA® (Costa Rica, 2023) and Preservé® (2024) techniques, by the teams that developed these approaches and brought them to France.
✔ Trainer of French and international surgeons in minimally invasive techniques; presentation of the MIA technique at the SOFCPRE national plastic surgery congress (November 2023); speaker at the AMWC (2025) and IMCAS (2026) international congresses
✔ Author of scientific publications in plastic and breast surgery (J Plast Reconstr Aesthet Surg, 2017)
✔ Over 15 years of surgical training and practice in Paris · Over 300 patients operated on to date with minimally invasive breast augmentation
SHORT ANSWER
According to Dr. Nathaniel Stroumza-Escoffier, a plastic surgeon in Paris, two decisions shape the project: the position of the pocket and the technique used to create it. The first depends on the thickness of the surrounding tissues, measured during the examination; the second on the anatomy and the desired volume. Preservative approaches are described as having less intensive recovery, but have more limited independent follow-up data than the traditional technique.
DEFINITION
Breast augmentation : placement of an implant in each breast to modify its volume or shape. Implant : a silicone elastomer shell filled with cohesive silicone gel or saline solution. Pocket : the space created by the surgeon to receive the implant, the position of which is determined in relation to the pectoralis major muscle. MIA and Preserved : tissue-preserving approaches developed by Establishment Labs, manufacturer of Motiva implants.
Who is Dr. Stroumza-Escoffier, a specialist in minimally invasive breast augmentation in Paris?
Dr. Nathaniel Stroumza-Escoffier is a Parisian plastic surgeon, former head of clinic at the Hospitals of Paris and practitioner attached to the Tenon Hospital (AP-HP), specializing in breast surgery, who is among the first French plastic surgeons to have integrated the minimally invasive techniques MIA® and Preservé® into his practice of breast augmentation.
His career combines comprehensive hospital and university training in plastic, reconstructive, and aesthetic surgery, scientific activity published in international peer-reviewed journals (including the Journal of Plastic, Reconstructive & Aesthetic Surgery), and an early focus on breast-preserving surgery. This expertise is based on specific training in Costa Rica with the teams that developed these approaches—first the MIA® technique in 2023, then the Preservé® technique in 2024—which he brought to France, on regular practice in minimally invasive breast surgery—more than 300 patients operated on to date—and on a commitment to teaching: Dr. Stroumza-Escoffier trains French and international surgeons in these techniques, presented the MIA technique at the SOFCPRE national plastic surgery congress in November 2023, and speaks at leading international congresses—AMWC (2025) and IMCAS (2026).
Details of his background, training, and publications are presented on the "Expertise & Teaching" page of the website. Suggested internal link: anchor "expertise in minimally invasive breast surgery" → /docteur-stroumza-escoffier/expertise-chirurgie-mammaire-mini-invasive/. URL to be created/verified.
The journey through minimally invasive breast surgery — the key steps
Period | Stage |
|---|---|
2009 - 2014 | Surgical internship in Paris — training in plastic, reconstructive and aesthetic surgery. |
2014 - 2017 | Assistant Clinical Head at Tenon University Hospital (AP-HP), Paris. Publication of scientific works in the Journal of Plastic, Reconstructive & Aesthetic Surgery (Stroumza N. et al., 2017;70(8):1066-1072). |
2017 | Setting up a private practice in Paris and focusing the practice on minimally invasive techniques. |
2023 | Training in Costa Rica in the MIA® technique, with the teams that developed this approach — among the first plastic surgeons to bring it to France. Presentation of the MIA technique at the SOFCPRE National Congress of Plastic Surgery (November 2023). |
2024 | Training in the Preservé® technique and integration into the Parisian practice, within a framework of breast preservation surgery. |
2025 | Speaking at the AMWC (Aesthetic & Anti-aging Medicine World Congress) international congress on minimally invasive techniques. |
2026 | Speaker at the IMCAS (International Master Course on Aging Science) international congress, Paris. |
Today | Over 300 patients have undergone minimally invasive breast augmentation. Education: training of French and international surgeons in the MIA® and Preservé® techniques. |
Why did Dr. Stroumza-Escoffier choose to focus on breast-preserving surgery?
After several years devoted to classic breast surgery — aesthetic and reconstructive —, Dr. Stroumza-Escoffier turned to tissue preservation techniques in order to reduce surgical trauma, limit scarring and promote faster recovery, when the indications allow.
This choice is not driven by a passing trend, but by clinical observation: for comparable morphological results, less dissection, a shorter incision, and anesthesia tailored to the scale of the procedure significantly alter the surgical experience and postoperative course. It is part of an international movement—Preservation Breast Surgery—whose developments he has followed since their initial presentations, before training directly with the teams that developed them, and then contributing to their dissemination in France by training other surgeons. This prior experience and teaching activity explain the central role that MIA and Preservé techniques now play in the practice, without excluding them: traditional techniques are still offered whenever they represent the best indication.
What is the minimally invasive turning point in breast augmentation?
For decades, breast augmentation with implants has followed a stable procedure: an incision several centimeters long, open dissection, detachment of the pectoral muscle in a significant proportion of cases, general anesthesia, an overnight hospital stay, and several weeks of recovery. This procedure remains valid and safe for many indications.
However, an international development known as Preservation Breast Surgery has led to the emergence of techniques that separate tissues rather than cut them, reduce the size of incisions, and make the procedure feasible under local anesthesia. Dr. Nathaniel Stroumza-Escoffier is among the first French plastic surgeons to have integrated the MIA® and Preservé® techniques into his daily practice. This expertise is based on specific training in Costa Rica with the teams that developed these approaches—MIA® in 2023, Preservé® in 2024—on regular practice in minimally invasive breast surgery, with more than 300 patients operated on to date, and on a commitment to teaching at conferences and training courses for surgeons.
The MIA technique — minimally invasive augmentation via the axillary route
The MIA (Minimally Invasive Augmentation) technique involves injecting a cohesive silicone implant through a 2-3 cm axillary incision, leaving no visible scar on the breast. A patented injector deploys the implant into a balloon-created space, without the need for electrocautery. The biconvex, completely smooth implant is positioned above the muscle.
Its characteristics include local anesthesia, a short procedure, a measured volume increase (up to approximately 210 cc, representing a gain of half a cup size to two cup sizes), and a quick return to normal activities. It is suitable for patients seeking a moderate increase in volume and a natural result, without general anesthesia. A prospective study of 100 patients followed for 3 years documents the safety and efficacy data of this technique (Aesthetic Surgery Journal, 2025; sjaf196).
The Preserved technique — tissue preservation for larger volumes
The Preservé technique, developed by Motiva, extends the same preservation principles to larger volumes. It relies on a classic inframammary incision but uses proprietary instruments—a canal separator, an expander balloon, and a non-contact insertion device—that separate breast tissue and ligaments rather than cutting them. The implant is nestled within the natural anatomical support of the breast, above the muscle.
It allows for larger augmentations (up to approximately 380 cc, or one to two cup sizes) while maintaining the goal of breast preservation. Data published by the manufacturer reports good stability of the implant position in the medium term. Like MIA, it can be performed under local anesthesia or light sedation, depending on the case.
The choice between MIA and Preserved techniques depends primarily on the desired volume and the individual's body shape : MIA for a discreet augmentation without scarring on the breast, Preserved when a larger volume is desired. Details of these two minimally invasive techniques are presented on a dedicated page.
"A successful breast augmentation is not one that attracts attention: it's one that seems to have always been part of the silhouette."
— Dr. Nathaniel Stroumza-EscoffierWhy is local anesthesia possible in a minimally invasive approach?
The possibility of performing breast augmentation under local anesthesia is the most tangible difference between the minimally invasive approach and traditional surgery. This is not a matter of comfort but a clinical choice, for three reasons.
- Reduce the overall risk profile. General anesthesia is now a very safe procedure, but it is never without risk: nausea, difficulty waking up, and cardiac or pulmonary contraindications. Avoiding it when possible reduces this risk, particularly in patients with comorbidities.
- Allow strict outpatient care. Without general anesthesia, the return home takes place the same day, without an overnight hospital stay — which transforms the patient's journey.
- To enable intraoperative dialogue. The conscious patient can validate symmetry in a sitting position, which no general anesthesia allows.
This choice is not absolute: traditional large-volume implants and composite augmentation are still most often performed under general anesthesia. The nature of the procedure, the patient's morphology, and their clinical condition determine the type of anesthesia, which is decided in consultation with the surgeon and anesthesiologist.
What are the other techniques: traditional prostheses, lipofilling, composite?
The minimally invasive approach does not cover all situations. Three other techniques have specific indications and are among the tools offered by the practice.
Traditional breast implants
This is the historical gold standard technique. A silicone implant is placed behind the gland, behind the pectoral muscle, or in an intermediate position known as dual plane. It allows for a clear and controlled increase in volume, with a wide range of sizes and shapes, and remains suitable for significant augmentations that fall outside the scope of minimally invasive techniques. It is performed under general anesthesia, with a standard overnight hospital stay.
Breast lipofilling
Lipofilling involves reinjecting the patient's own fat, harvested via liposuction from another area. Without implants or foreign bodies, it provides a very natural-looking result within the breast, with a more moderate increase in volume. A portion of the injected fat is reabsorbed in the following months: studies report varying retention rates from one group to another, without a single, reliable figure being established. It is particularly suitable for subtle augmentations, correcting asymmetry, or enhancing the décolletage.
The composite increase
The composite approach combines a prosthesis and fat grafting during the same procedure: the prosthesis provides volume, while the fat refines the shape and masks the edges of the implant for a more blended result. This is an attractive option for slender patients with thin skin.
Technical | Assets | To know |
|---|---|---|
MIA (minimally invasive) | Local anesthesia, no scar on the breast (axillary approach), rapid recovery | Moderate volume (≤ 210 cc); implant to be monitored over time |
Preserved (minimal invasive) | Tissue preservation, larger volumes, local anesthesia possible | Inframammary scar (≤ 380 cc); implant to be monitored over time |
Traditional prostheses | Net and controlled profit, wide range of sizes and shapes | General anesthesia; implant to be monitored over time |
Lipofilling | Without implants or foreign bodies, the result is very well integrated within the body. | Moderate gain; variable degree of resorption; several sessions possible |
Composite | Prosthesis volume and natural shape provided by fat | More comprehensive intervention; implant to be monitored over time |
MIA or conventional augmentation: what concrete changes does the minimally invasive approach make?
Criterion | MIA (minimally invasive) | Traditional augmentation with implants |
|---|---|---|
Anesthesia | Local | Generate |
Scar | Axillary fossa — no scar on the breast | Submammary or periareolar sulcus |
Hospitalisation | Strictly outpatient, same-day return | One night usually |
accessible volume | Moderate (≤ ~210 cc) | Wide range, including large volumes |
Implant position | Above the muscle | In front of or behind the muscle, or dual plane |
Resumption of daily life | Often as early as the next day | Several days to a few weeks |
Indicative table: the precise modalities depend on each clinical situation and are defined in consultation.
What does the minimally invasive approach not allow?
Defending the minimally invasive approach requires stating its limitations. Offering a minimally invasive technique to a patient who is not a suitable candidate is a sure source of disappointment.
- Very significant volume gains. Beyond two cup sizes, in a patient with limited skin coverage, classic prostheses or composite augmentation still have their indications.
- Some corrections to the form. Marked ptosis requiring tightening (mastopexy), significant asymmetry or constitutional deformity may exceed the scope of minimally invasive surgery alone.
- Complex revisions. A resumption after severe capsular contracture or a reconstruction after cancer falls under the category of surgery in the full sense of the term.
It is this lucidity that protects the credibility of the minimally invasive approach: a technique offered for the right indications becomes established permanently; a technique promoted as universal ends up disappointing.
What are the surgical approaches for breast augmentation?
Figure 1 — The three approaches to breast augmentation, in cross-section (educational diagram for explanatory purposes, not derived from medical imaging).
First way | Scar location | What it allows | To know |
|---|---|---|---|
Axillary | Armpit crease, away from the breast | No scars on the breast | Moderate volume; more indirect approach to the lodge |
Peri-areolar | Perimeter of the areola | Scar concealed by the color blend | Passes through the gland; reserved for certain anatomies |
Submammary | Groove located under the breast | Direct and wide access to the box, all volumes | Scar in the crease, visible when topless |
No single approach is inherently superior: the choice depends on the anatomy, the desired volume, the type of implant, and the patient's medical history. The decision is made in consultation with the surgeon.
Prostheses: what shape, what surface area, what positioning?
There are three compartment positions: pre-muscular, dual plane, and retro-muscular. The choice depends on the thickness of the covering tissues, the desired volume, and the presence of ptosis.
Round or anatomical prostheses
Round implants offer a fuller cleavage and are more forgiving of minor post-operative rotations. Anatomical (or teardrop) implants replicate the shape of the breast—flatter at the top, fuller at the bottom—and are suitable for achieving a very blended result, particularly in reconstruction. The choice depends on the desired outcome, the morphology of the chest, and the desired skin coverage.
Smooth or microtextured surface
Historically, several types of surfaces have coexisted. Since 2019, following the work of the ANSM (French National Agency for Medicines and Health Products Safety) on anaplastic large cell lymphoma (see below), macrotextured and polyurethane-coated implants have been withdrawn from the French market. Today, only smooth and microtextured surfaces are used.
The investment plan
Three positions exist: retroglandular (in front of the muscle), retromuscular (entirely behind the muscle), and dual plane (intermediate position). The minimally invasive MIA and Preservé techniques place the implant above the muscle, thus preserving muscle dynamics and avoiding the stress-induced deformation sometimes observed with submuscular implants.
Why consult a surgeon specifically trained in minimally invasive techniques?
MIA and Preserved techniques rely on proprietary instruments and gestures that differ from classical dissection: mastering them requires dedicated training, provided by the manufacturer and the teams that developed them, followed by regular practice.
Three reasons make this criterion crucial. The first relates to the learning curve: separating tissues without cutting them, deploying an implant with an injector through a 2-3 cm axillary incision, or using a balloon expander are specific procedures, different from those of traditional augmentation. The second relates to the selection of indications: the success of a minimally invasive technique hinges on the surgeon's ability to identify suitable patients before the procedure—and to refer others to a traditional technique—before the operation. The third relates to managing unforeseen situations: only a plastic surgeon who has mastered all breast augmentation techniques can convert or adapt the procedure if the anatomy requires it.
This is why minimally invasive breast augmentation—in Paris as elsewhere—must be performed by a qualified plastic surgeon, specifically trained in these techniques and also practicing traditional breast surgery. Dr. Stroumza-Escoffier meets these three requirements and personally trains other surgeons in these approaches.
WHAT CHARACTERIZES THE FIRM'S APPROACH
✔ An indication determined on a case-by-case basis — never a single technique offered to all patients
✔ Maximum tissue preservation, whenever the anatomy allows
✔ Local anesthesia when possible, general anesthesia when preferable
✔ Scars designed to be as discreet as possible, without promising invisibility
✔ A complete pre-operative assessment, including breast imaging according to recommendations
✔ Honest information about the limitations, risks, and follow-up required for implants
✔ Extended and organized post-operative follow-up, with implant card and traceability
How is breast augmentation performed?
The process begins with one or more preliminary medical consultations: clinical examination, measurements, in-depth discussion of expectations, choice of technique, and, if necessary, a fitting of different sizes. Depending on the chosen technique, the procedure is performed under local anesthesia (MIA, certain indications for Preserved and Lipofilling) or under general anesthesia (conventional implants, composite implants).
The incisions are chosen to be as discreet as possible:
- axillary — using the MIA technique, without scarring on the breast;
- submammary fold — route of Preserved and classic prostheses;
- periareolar — scar around the areola, depending on the case;
- millimeter-sized puncture points for lipofilling.
Minimally invasive techniques are performed on an outpatient basis, with patients returning home the same day. An overnight hospital stay is usually required for traditional implants and composite augmentation. A compression bra is then worn for several weeks, as instructed by the surgeon.
Breast augmentation: aftercare and recovery, how long does it take?
Light activities can be resumed within a few days. Wearing a compression bra and avoiding sports and strenuous activities are recommended for several weeks, as instructed by the surgeon.
The first few days involve swelling, bruising, and discomfort, which are well controlled with appropriate pain medication. The minimally invasive technique generally allows for a faster recovery: daily activities often resume the very next day with MIA, whereas a traditional augmentation requires more rest. Resuming intense sports and upper body weight training is delayed, according to a schedule determined by the surgeon on a case-by-case basis. Direct sun exposure on the scars should be avoided for several months.
The final result can be appreciated after a few weeks to a few months, once the implant has settled, the swelling has disappeared, and the skin has adapted.
Breast augmentation: what are the contraindications and what are the special cases?
Certain situations are systematically investigated during consultations and may lead to postponing, adapting, or rejecting the intervention:
- pregnancy and breastfeeding in progress or recently — a delay is recommended after the end of breastfeeding;
- progressive breast pathology — unexplored nodule, personal history of breast cancer without prior oncological consultation;
- active smoking not stabilized — see below;
- progressive autoimmune diseases or a history of marked inflammatory reactions to an implant;
- unstable coagulation disorders or inappropriate anticoagulant treatment;
- unrealistic expectations regarding the outcome, or a fragile psychological context.
Smoking is a major contraindication for breast surgery. Joint recommendations from the French Society of Clinical Palliative Care (SoFCPRE) and the French Society of Anesthesia and Intensive Care (SFAR) advise quitting smoking at least 6 to 8 weeks before the procedure and continuing for several weeks afterward. The use of electronic cigarettes and nicotine replacement therapies must also be discontinued. This cessation significantly reduces the risk of delayed wound healing, infection, and skin necrosis.
What are the risks of breast augmentation and what monitoring is required?
Breast augmentation is a well-defined and regulated procedure, but it remains a surgical act with its potential complications, even in its minimally invasive form. Complete information is provided during the consultation and informed consent is obtained.
Early complications
These can include: hematoma (sometimes requiring further surgery), seroma, surgical site infection, delayed wound healing, and temporary changes in breast or nipple sensation. Most are benign and treatable without lasting effects when detected early.
Capsular contracture — the most frequent long-term complication
Capsular contracture is the formation of an excessively tight fibrous capsule around the implant, which can harden, deform the breast, and cause discomfort. A recent meta-analysis (Haas E. et al., Aesthetic Surgery Journal Open Forum, 2025;7:ojaf003) confirms that it is the most frequently reported long-term complication and the leading cause of revision surgery after breast augmentation with implants.
Its incidence varies depending on the population, implant type, placement plan, and follow-up duration. The literature reports rates ranging from 10% to 37%, depending on the series. A long-term follow-up study of 5,122 implants in 2,565 patients undergoing primary augmentation (Calobrace et al., Plastic and Reconstructive Surgery, 2018;141(4S):20S-28S) reported a cumulative rate of 10,8% per device at 10 years. This complication warrants regular follow-up.
Other complications to be aware of
- Malposition or displacement of the implant — may require repositioning;
- Implant rupture — rare event with modern prostheses, often asymptomatic, detected by follow-up imaging;
- Rippling — perception of folds under the skin, more frequent when the skin cover is thin;
- Permanent change in breast sensitivity — possible, to be discussed in consultation.
IMPORTANT INFORMATION: LAGC-AIM (BIA-ALCL)
Breast implants have been linked to a rare form of lymphoma, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). According to the French National Agency for Medicines and Health Products Safety (ANSM), 121 cases had been diagnosed in France as of December 31, 2024. The vast majority occurred with macrotextured or polyurethane-coated implants—types withdrawn from the French market in 2019. Smooth implants used in the MIA and Preservé techniques present a risk considered exceptional. This condition generally occurs several years after placement, most often manifests as late-onset effusion, and has a good prognosis when detected early. It should not preclude breast augmentation, but it does warrant prior education and regular monitoring.
Do the implants need to be changed, and how often?
Modern prostheses are designed to last, but they are not lifetime devices. There is no fixed expiration date mandating systematic replacement: clinical monitoring and imaging guide the decision. A replacement may be prompted by capsular contracture, a confirmed rupture, malposition, a desire to change the volume, or simply the replacement of old prostheses.
Post-operative follow-up involves several elements:
- regular check-ups, according to a schedule defined by the surgeon;
- breast self-palpation, with vigilance regarding any swelling some time after the procedure;
- follow-up imaging (ultrasound, MRI) according to current recommendations;
- retention of the implant card — mandatory, with the precise references of the device.
Breast augmentation: cosmetic or medical treatment?
Breast augmentation for purely cosmetic reasons is not covered by French national health insurance. Certain medical or reconstructive situations may qualify for coverage, subject to conditions and prior approval: tuberous breasts (CCAM procedures QEMA003, QEMA004), breast agenesis, Poland syndrome, significant breast asymmetry, and reconstruction after breast cancer. The surgeon will determine during the consultation whether the situation qualifies.
The medical and legal framework
Breast augmentation is a strictly regulated surgical procedure in France, including its minimally invasive version:
- complete information on benefits, techniques, limitations and risks;
- detailed quote provided at the end of the consultation;
- mandatory 15-day reflection period between the delivery of the quote and the intervention (article L.6322-2 of the Public Health Code);
- implant card given to the patient with the device's references;
- Mandatory traceability of the implant in the medical file and the national register.
Breast implants are medical devices subject to European Regulation (EU) 2017/745, monitored by the ANSM (French National Agency for Medicines and Health Products Safety). Since the PIP scandal and the investigations into BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma), medical device vigilance in breast surgery has become particularly rigorous in France.
What is the price of breast augmentation in Paris?
The price of breast augmentation depends on the technique, the type of implant, and the clinic fees. It is detailed in a personalized quote provided during the consultation, along with the legally mandated 15-day reflection period.
The price depends on the chosen technique (MIA, Preserved, traditional implants, lipofilling, composite), the type of implant, the anesthesia method, the facility, and the anesthesiologist's fees. Minimally invasive techniques, by avoiding general anesthesia and an overnight hospital stay, alter the cost structure. For procedures performed for purely cosmetic purposes, no coverage by health insurance is available. A detailed estimate is always provided after the consultation; the practice's fee schedule provides a general idea of the cost per technique.
How to choose your surgeon for breast augmentation?
The choice of surgeon is the most significant factor influencing the safety and quality of the outcome. Four objective criteria guide this decision:
- The qualification. Registration with the National Council of the Order of Physicians, qualification in plastic, reconstructive and aesthetic surgery, RPPS number.
- Specific experience in breast surgery, and in particular, mastery of the techniques under consideration—a point to be addressed directly during the consultation, especially for minimally invasive techniques which require dedicated training. The surgeon's involvement in teaching these techniques is an objective indicator of this mastery.
- The clarity of the consultation. A surgeon who listens, explains the alternatives, sets limits in the face of an inappropriate request and respects the reflection period.
- The organization of security and monitoring. Accredited clinic, traceability protocols, scheduled post-operative consultations, implant card systematically provided.
"The right implant is not the one that provides the most volume: it's the one that respects the patient's anatomy."
— Dr. Nathaniel Stroumza-Escoffier
Where can I consult Dr. Stroumza-Escoffier for breast augmentation?
Consultations take place at the office located at 11 rue du Faubourg Saint-Honoré, in the 8th arrondissement of Paris, very close to the Place de la Concorde and the Champs-Élysées. Procedures are performed in accredited Parisian clinics (Turin and Eiffel clinics).
The practice welcomes patients from Paris and throughout the Île-de-France region—particularly from Hauts-de-Seine (Neuilly-sur-Seine, Levallois-Perret, Boulogne-Billancourt), Yvelines (Versailles, Saint-Germain-en-Laye), and Val-de-Marne—as well as international patients drawn to minimally invasive techniques, which are still relatively uncommon in France. Located in the heart of western Paris, the practice is easily accessible by metro (lines 1, 8, 9, 12, 13, and 14—Concorde and Madeleine stations) and from Parisian train stations and airports.
A word from Dr. Stroumza-Escoffier
My commitment to breast surgery stems from a conviction: the success of a project is not measured by the volume gained, but by the harmony between the new breast and the rest of the silhouette—the chest, the shoulders, the overall height. This is why I dedicate the necessary time to the initial consultation to understand the patient's goals and then to define the parameters for a harmonious result.
The rise of minimally invasive techniques—MIA, Preservé—has transformed my practice because, for suitable patients, they offer a natural result with minimal impact: no scar on the breast, local anesthesia, and a rapid recovery. I was among the first French plastic surgeons to incorporate these techniques, after training in Costa Rica with the teams that developed them, and I now train French and international surgeons in these approaches for breast-preserving surgery. To date, over 300 patients have undergone minimally invasive breast augmentation at my practice. However, I also offer all the traditional techniques because the diversity of tools is not a marketing ploy; it allows me to recommend the most appropriate technique for each consultation, rather than the one I am most proficient in.
I am finally being transparent about what wearing implants entails: long-term monitoring, vigilance for any late-stage symptoms, and the possibility of a change at a later date. This information is essential for truly informed consent.
If you are considering breast augmentation, I would be happy to see you for a consultation at my office at 11 rue du Faubourg Saint-Honoré to define together the most suitable plan.
— Dr. Nathaniel Stroumza-Escoffier
Plastic surgeon, qualified in plastic, reconstructive and aesthetic surgery — RPPS 10100674943. Practitioner attached to Tenon Hospital (AP-HP) · former head of clinic at the Hospitals of Paris · specializing in breast surgery and minimally invasive breast harmonization techniques · trainer of surgeons in MIA® and Preservé® techniques · consultations at 11 rue du Faubourg Saint-Honoré, Paris 8th (Turin and Eiffel clinics).
FAQ — Frequently Asked Questions
What is minimally invasive breast augmentation?
This approach preserves breast tissue: small incisions, gentle dissection, implant placed above the muscle, and the procedure can be performed under local anesthesia. The MIA (axillary approach, without scarring on the breast) and Preserved (tissue preservation, larger volumes) techniques are the two main applications of this approach in the office.
What is the best breast augmentation technique?
There is no single best technique: the right technique is the one that best suits each patient's anatomy, desired volume, and expectations. MIA (Medium Implant Incision) is suitable for moderate augmentations without scarring on the breast, Preserved for larger volumes using tissue preservation, traditional implants for significant gains, and lipofilling for subtle augmentations without implants. A clinical examination is the deciding factor, never a generic classification.
Which technique gives the most natural result?
The naturalness of a result depends less on the technique than on the suitability of the chosen volume to the individual's morphology. Lipofilling and preservation techniques (MIA, Preserved), which place the implant above the muscle and respect the surrounding tissues, are well-suited to achieving a discreet result; a well-proportioned conventional implant can be just as natural. Selecting the appropriate indication is more important than choosing the right tool.
Is it possible to have surgery without general anesthesia?
Yes, minimally invasive techniques, particularly MIA, are performed under local anesthesia. Preserved tissue and lipofilling alone can also, in some cases, be performed without general anesthesia. Large-volume traditional implants and composite augmentation are still most often performed under general anesthesia.
What is the difference between MIA and a classic breast augmentation?
Traditional breast augmentation usually involves an incision under the breast, under general anesthesia, with a recovery period of several weeks. The MIA technique is minimally invasive: axillary approach, local anesthesia, implant placed above the muscle, no scarring on the breast, and a quick return to normal activities.
How long does a MIA breast augmentation last?
The MIA procedure is short—significantly shorter than a traditional augmentation—and is performed on an outpatient basis, with patients returning home the same day. The exact duration depends on each individual case and is discussed during the consultation.
Is it possible to return to work two days after minimally invasive breast augmentation?
Often, a sedentary lifestyle is possible after a MIA procedure: daily activities frequently resume the very next day. Physically demanding jobs and heavy lifting require a longer recovery period, determined by the surgeon. After a traditional augmentation, the recovery period is usually several days to a few weeks.
MIA or Preserved: how to choose?
The choice depends primarily on the desired volume. MIA is suitable for moderate augmentation without scarring on the breast (axillary approach). Preserved augmentation allows for larger volumes through a discreet inframammary scar, while also preserving tissue. A consultation will help determine the best option based on your body shape and goals.
Who are candidates for the Preserved technique?
The Preserved technique is for patients desiring breast augmentation with implants up to approximately 380 cc, with a focus on tissue preservation and with compatible anatomy assessed during a consultation. It is not suitable for significant ptosis requiring a mastopexy or for certain complex revisions, which require traditional surgery.
Which surgeon should I consult in Paris for a MIA or Preserved technique?
These techniques require a qualified plastic surgeon specifically trained in their application. Dr. Nathaniel Stroumza-Escoffier, a plastic surgeon in the 8th arrondissement of Paris, is among the first French plastic surgeons trained in the MIA (2023) and Preservé (2024) techniques by the teams that developed them; he has performed minimally invasive breast augmentation on over 300 patients and trains other surgeons in these approaches. A list of trained practitioners can also be obtained from the manufacturer.
Is the scar truly invisible with the minimally invasive procedure?
With MIA, the scar is concealed in the armpit crease: there is no scar on the breast. With Preservé, the inframammary scar is discreet, hidden in the crease. No scar is truly invisible—it is concealed, which is different.
Implants or lipofilling: which to choose?
Implants provide a clear and controlled increase in volume; lipofilling, which is more integrated into the breast, offers a more moderate increase with a variable rate of resorption. Composite augmentation combines both. A detailed comparison is available on a dedicated page.
Do breast implants need to be replaced regularly?
Modern implants are designed to last, but they are not eternal. There is no fixed expiration date that mandates systematic replacement: clinical monitoring and imaging guide the decision.
What is capsular contracture?
This is the formation of a fibrous capsule that becomes too tight around the implant, which can harden and deform the breast. It is the most frequent long-term complication and the leading cause of revision surgery; reported rates range from 10% to 37% depending on the study. Regular follow-up allows for its detection.
What is LAGC-AIM (BIA-ALCL)?
This is a rare lymphoma associated with breast implants, primarily macrotextured implants—which have been withdrawn from the French market since 2019. The ANSM (French National Agency for Medicines and Health Products Safety) had identified 121 cases in France as of December 31, 2024. Smooth implants using the MIA and Preservé techniques present a risk considered exceptional. When detected early, the prognosis is good.
Can you breastfeed after breast augmentation?
In most cases, yes, especially when the surgical approach and implant placement preserve the mammary gland. Minimally invasive approaches—such as the axillary approach for MIA—preserve the gland and milk ducts. This is a point to discuss during a consultation if pregnancy is being considered.
When can we resume playing sports?
Recovery is gradual and depends on the technique. With MIA, daily activities often resume the very next day. Intense sports and upper body strength training require a longer waiting period, determined by the surgeon during follow-up appointments.
Is it possible to have a mammogram with implants?
Yes. Mammography is still possible: the radiologist uses specific views (Eklund technique). Ultrasound and MRI may be added depending on the indications. Always inform the doctor if you have implants at the time of the examination.
Is breast augmentation covered by insurance?
Not for aesthetic purposes. Certain medical situations may entitle patients to coverage after prior agreement: tuberous breasts, breast agenesis, Poland syndrome, major asymmetry, reconstruction after breast cancer.
What reflection period must be observed?
A minimum of 15 days must pass between the delivery of the quote and the procedure (Article L.6322-2 of the Public Health Code). This waiting period is mandatory for all cosmetic surgery procedures, including minimally invasive ones.
List of anatomical areas concerned
- Tits
- Areoles
- Nipple
- Pectoralis major
- Pectoralis minor
- Mammary gland
- Inframammary fold
This article is for informational purposes only and does not replace a medical consultation.