Breast augmentation, also known as augmentation mammaplasty, is one of the most commonly performed plastic surgery procedures and one with a high satisfaction rate. It has evolved over time with advances in implant materials and techniques that make this a very safe procedure. The expertise in this procedure lies in the nuances of implant choice and technical placement that compliments your body shape and provides longevity as a woman’s body changes through its life stages.
Women seek this procedure for various reasons: whether it is because of a natural small bust size, inability to fill bras and fit clothing, loss of volume after pregnancy and breast feeding, or a congenital cause whereby there is a deformity in the breast or a size discrepancy between the breasts.
My philosophy in breast augmentation is to achieve a balanced shape and size for your breasts that are in line with your overall body proportions. Often shape is compromised for volume but I feel both are equally important. Commonly my patients are happy with the cup size that their chest shape determines, yet cannot fill the volume in them; or have to constantly wear padded or tight push up bras that are uncomfortable. My aim is to fill the bra that you desire comfortably without the need for padding or pushing up whilst improving the shape such that when you are not wearing a bra, the breasts look and feel natural.
There are various options available in breast augmentation and these will be discussed at your initial consultation so as to best match your desires and life stage with what is technically possible. The technical choices available are: incision location, implant versus your own tissue, placement position, and implant specifications.
Incision location: options are inframammary (under the breasts), transaxillary (in the armpit) and peri-areolar (around the nipple). The former two are the most common in my practice and their choice depends on your lifestyle wishes and where the incision is least visible. There are also implications on which scar is best for what type of implant suits you.
Using your own tissue: using your own fat is ideal for small augmentations particularly if for breast reconstruction procedures. For larger augmentations, using fat requires multiple procedures and is less predictable as the body incorporates some and rejects the rest. For larger augmentations, I recommend using implants as size and shape outcomes are more reliable and can be performed in a single procedure with less downtime.
Implant placement position: there are essentially three locations implants are placed: under the breast tissue (subglandular), under the pectoralis muscle of the chest (submuscular), and subfascial – which is in between the first two positions. What suits best is determined by your own breast tissue and activity requirements.
Implant specifications: vary widely not just in size. Shape whether they be round or teardrop (also known as anatomic) is possible. They may be filled with saline or silicone gel and the gel properties available offer different feels to the implant. The surface of the implant may also be textured or smooth. There are many variations and personal preferences that may be confusing for the patient (especially when reading conflicting recommendations in websites, advertorials and magazine articles). My approach to this difficult topic is simple: to tailor what options are best and safest available on the market with what suits you. This comes about with the initial consultation where your wishes are explored and a detailed clinical examination is performed to best match the options for you.
I do not dissuade patients telling me what type of implants they want or bringing in photos as it is often a starting point to understand your wishes however one must be mindful of advertising that pushes a single or cheap option or photos that may show ideal breasts that do not match your body shape. For more information regarding the planning of your breast augmentation procedure, please refer to our post.
NOTE FOR MY PATIENTS: MY PRACTICE HAS NEVER USED PIP IMPLANTS: Please click here for more information.
The consultation for breast augmentation also involves exploring topics that are important depending on one’s health and age. These important considerations may include: future pregnancy and breast-feeding, mammograms or cancer surveillance, the longevity of the procedure, and The Breast Implant Registry.
In summary, breast augmentation should not affect pregnancy, breast feeding, cancer risk or detection and surgery results have good longevity.
The Breast Implant Registry: is a government endorsed initiative that is focused on patient safety. It is a secure environment to record and store data from any breast implant procedure for the purposes of public health and research. It costs $25 to register each implant (ie. $50 if two implants) and I encourage all my patients to opt-in. In the interest of your safety, my practice pays for your registration. If you prefer not to be on the register, please let me know so your wishes are respected. Please click here for more information.