What determines the cost of breast implants?
Four things determine what a breast augmentation costs: the surgeon, the anesthesia, the facility, and the implants themselves. Every quote is assembled from those four parts. Practices label them differently and bundle them differently, but a quote that cannot be broken back down into those four is a quote that has not been explained to you.
Each part moves for its own reasons, and one variable moves almost all of them at once: how complicated the operation is. Dr. Smith's own comparison is an augmentation in a young, healthy patient who has never smoked and has never had breast surgery, against one in an older patient with a smoking history and previous implants or breast surgery. The second requires more technical maneuvering, more anesthesia time, and more operating room time, and all of that shows up in the quote.
A breast augmentation therefore has no price the way a manufactured object does. It has a quote built around a specific plan for a specific patient, and most of the decisions behind that plan, set out on the breast augmentation page, carry a cost consequence.
The four parts of a breast augmentation quote.
A surgical quote is made of a surgeon's fee, an anesthesia fee, a facility fee, and the cost of the implants. Those line items appear under other names in some practices, and a few things move between them, which is why the useful question is not what the total is but what each part covers.
The surgeon's fee
The surgeon's fee reflects the difficulty of your particular case and the qualifications of the person operating. On the case, the questions are anatomical: the starting anatomy, what has been done to the breast before, and what the surgeon has to do to reach an excellent result. Previous implants, previous breast surgery, a smoking history, and age all add complexity.
On the surgeon, the questions are training, volume, and standing: where they trained, whether they completed a fellowship in aesthetic or breast surgery after residency, and above all whether they are board certified by the American Board of Plastic Surgery. Volume matters independently of training, since a surgeon performing several breast augmentations a week is in a different position from one performing a handful a year. Reputation is the last component, and the one least connected to what happens in the operating room.
The anesthesia fee
The anesthesia fee is driven by who delivers the anesthesia and how long the operation takes. Anesthesia is professional time, so a longer case costs more than a shorter one. Who provides the care is worth establishing directly rather than assuming. Dr. Smith works only with board-certified anesthesiologists.
Breast augmentation is performed under general anesthesia in most cases. IV sedation is an option in selected cases, and the decision is made at consultation. Anesthesia is administered by a board-certified anesthesiologist in the practice's QUAD A accredited operating room.
The facility fee
The facility fee is what it costs to be in the operating room. It covers the space, the staff supporting the operation, and the materials used. Many surgical supplies are disposable and bought new for every case, and reusable instruments have to be cleaned, sterilized, and processed between cases. Both scale with the length of the operation.
Practices differ in what they fold into this line, which is why the practice itemizes. A quote from Dr. Smith's office lists the facility fee separately from the surgeon's fee and the anesthesia fee, so it is visible rather than absorbed into a single number. An overnight stay is unusual after a breast augmentation, which is ordinarily a same-day operation.
The implants
The implants are a device cost, and it varies by what the implant is filled with. Saline implants tend to cost somewhat less than silicone gel implants; within silicone, cost varies with the gel, covered below. The implant is usually the smallest of the four line items.
How implant decisions affect what you pay.
The implant decision with the clearest cost consequence is fill type, and the second is how cohesive the gel is. Saline implants are a thin silicone shell filled with saltwater and sit at the lower end. Silicone gel implants are a silicone shell filled with a soft, cohesive gel, and they cost more.
Within silicone gel, cost tracks cohesivity. Cohesivity describes how firm or viscous the gel inside the shell is. More cohesive gels generally hold their shape better and tend to look and feel more natural than softer ones, and they are priced accordingly. This is the single implant variable most likely to move a quote once silicone has been chosen.
Dr. Smith places a limit on that relationship that is worth knowing before you pay for it. In his experience, the most extremely cohesive gels can begin to feel less natural rather than more. The most cohesive implant available is therefore not automatically the right one, and paying for maximum cohesivity is not the same as buying a better result. The right choice depends on the patient's tissue, frame, and goals, and belongs in the consultation rather than on a price list.
Size does not change the device cost in any meaningful way. Size changes the result, not the quote.
Why where the operation happens matters.
Where a breast augmentation is performed affects both the facility fee and the anesthesia fee, and Dr. Smith's position is that it also affects the operation. Almost all of his breast augmentations are performed in the private accredited surgical center inside his Manhattan office at The Ritz Tower, which is accredited by QUAD A.
His reasoning is about control and consistency rather than cost. In his own surgical center he knows exactly who his team is for every case, he is using his own instruments, and his protocols are followed exactly as written. The same nurses and the same anesthesiologists work with him case after case, which is what makes a routine genuinely routine.
Two conditions make a private facility the right setting rather than simply a cheaper one. The facility has to be accredited, and the anesthesia has to be delivered by a physician; Dr. Smith works only with board-certified anesthesiologists for every aesthetic surgery case. A patient comparing quotes across settings should confirm both in each one, since they are what separates a facility fee that reflects a leaner operation from one that reflects a thinner one.
What the practice's quote includes.
A quote from Dr. Smith's office is itemized into a surgeon's fee, a facility fee and an anesthesia fee, so each part is visible rather than folded into a single total. All post-operative visits are included in it. Other items are not, and anything falling outside those fees is identified when the quote is given. A quote is valid for 30 days, and a 10 percent deposit is taken at booking.
All post-operative visits, not a set number of them
Patients are seen the morning after surgery, then at one week, two weeks, one month, three months, six months and one year. That schedule is the minimum rather than the allowance, and patients can come in as often as they want without a visit charge appearing afterward.
Dr. Smith leads all post-operative care. He and the practice's physician assistant see post-operative patients together, and he is present for every major visit; some minor visits may be with the physician assistant alone. That is continuity from the surgeon who performed the operation, with a dedicated physician assistant so that follow-up can be as frequent as a patient needs rather than rationed.
If a revision is needed
For one year after surgery there is no surgeon's fee on a revision. The patient remains responsible for the anesthesia and facility fees, since those are paid out to the anesthesiologist and for running the operating room. Breast implants are devices, and some patients will need a further operation at some point, whether for a complication such as capsular contracture, for an exchange, or to refine the result. That is a property of implant surgery rather than a reflection on the surgeon, and the policy is stated before booking rather than negotiated afterward.
What the practice requires before surgery
Three requirements affect whether and when an operation can be booked. No nicotine in any form for four weeks before surgery and four weeks after, covering cigarettes, vaping, pouches, patches and gum, and the practice tests for it. Any supplement or medication that can act as a blood thinner stops ten days before surgery. Weight has to be stable for three months before operating.
Medical clearance and laboratory work are required for every case done under anesthesia, laboratory work for cases done under local, and an EKG for patients over 40 having anesthesia. Those are arranged in advance, and they are worth budgeting time for when planning a surgical date.
Consultation, financing, and insurance.
A consultation with Dr. Smith is $500, it is applied toward any procedure booked, and it is never waived. The consultation is where a quote becomes specific: the implant decisions, the surgical plan, and the operative time are settled there, and the quote follows from them rather than the other way around. You can schedule a consultation with the practice directly.
Financing is available through CareCredit and Alphaeon Credit. The practice does not work with other lenders or offer in-house payment plans, and any terms come from the lender rather than from the practice.
Dr. Smith is out of network with all insurance plans. The practice helps patients use out-of-network benefits toward care where those benefits apply. Cosmetic breast augmentation is not a covered service under any plan.
Your questions about breast implant costs.
What determines the cost of breast implants?
The surgeon, the anesthesia, the facility, and the implants. Those four parts make up every quote. Case complexity moves nearly all of them at once, since a more complex operation takes more surgical work, more anesthesia time, and more operating room time.
What is included in the facility fee?
The operating room, the staff supporting the case, and the materials used, including disposable supplies and the sterilization of reusable instruments. A surgical bra and any overnight stay may be bundled into the facility fee or listed separately, which is why it is the line item to ask about in detail.
Are silicone implants more expensive than saline?
Yes. Saline implants tend to cost somewhat less than silicone gel implants. Saline is a thin silicone shell filled with saltwater; a silicone implant is a shell filled with a soft, cohesive gel. Silicone gel is the more popular choice in Dr. Smith's practice because of how it looks and feels.
Does gel cohesivity change what an implant costs?
Yes. Within silicone gel implants, cost tracks how cohesive the gel is. More cohesive gels generally hold their shape better and tend to look and feel more natural, and they are priced higher. Dr. Smith's caution is that the most extremely cohesive gels can begin to feel less natural, so the most expensive gel is not automatically the right one.
Does a bigger implant cost more?
Not in any meaningful way. Implant cost is driven by fill type and gel cohesivity rather than by volume. Size changes the result, not the quote.
Are post-operative visits included in the price?
Yes, all of them. Patients are seen the morning after surgery, then at one week, two weeks, one month, three months, six months and one year, and they can come in more often than that without a visit charge. Dr. Smith leads all post-operative care and is present for every major visit, seeing patients together with the practice's physician assistant.
Who delivers the anesthesia, and does it affect the cost?
Dr. Smith works only with board-certified anesthesiologists, for every aesthetic surgery case. Who provides anesthesia is one of the three things that drive the anesthesia fee, along with the setting and the length of the operation. It is worth confirming directly on any quote rather than assuming.
How long is a quote valid, and is a deposit required?
A quote is valid for 30 days, and a 10 percent deposit is taken at booking. The quote is itemized into a surgeon's fee, a facility fee and an anesthesia fee, so what each part covers is visible rather than folded into one number.
What happens if a second operation is needed?
For one year after surgery there is no surgeon's fee on a revision. The patient is responsible for the anesthesia fee and the facility fee, which are paid out to the anesthesiologist and for running the operating room. Implants are devices and some patients need further surgery eventually, so the policy is stated before the first operation rather than after the second one becomes necessary.
Does the practice offer financing?
Yes, through CareCredit and Alphaeon Credit. The practice does not work with other lenders and does not offer in-house payment plans. Terms come from the lender.
Does insurance cover breast augmentation?
No. Cosmetic breast augmentation is not a covered service. Dr. Smith is out of network with all insurance plans, and the practice helps patients use out-of-network benefits toward care where those benefits apply.
How much is a consultation?
A consultation is $500, applied toward any procedure booked, and never waived. It is where the quote is built, because the implant choice, the surgical plan, and the expected operative time are all settled there.