Breast Augmentation

Part Two

There are three choices for breast augmentation incisions: nipple, breast crease and armpit. Each approach has its advantages and disadvantages. When you look at the entire scope of breast augmentation, such as size, shape, and symmetry, where the incision is placed is less important.

Because of the inherent ripples that can occur with saline implants, most plastic surgeons place saline implants under the chest muscle in order to hide the ripples and also hide any unnatural roundness to the implant.

So-called teardrop implants sounds good in theory but that theory doesn't translate into reality. Be leery of advertisements claiming to use anatomic, teardrop or biodimensional implants; their use is very limited in augmentation surgery.

Textured implants were originally invented in an attempt to reduce scar contracture around silicone gel implants. However, saline implants enjoy a much lower contracture rate and also, going underneath the muscle reduces contracture rate, too. Therefore, there is often no derived benefit in adding textured saline implants into the mix. In fact, textured implants likely have a higher ripple rate and rupture rate than smooth implants, and because of their texture, don't move as naturally as a smooth implant. Textured implants might be used for women who have recurrent contractures.

Final breast size is ultimately up to the woman although an experienced surgeon can help guide that decision. Most women often augment near the C-cup range, from a full B to a full C or small D.

The operation is called augmentation precisely because it augments the woman's given anatomy. Implants don't create the anatomy as much as they augment it. Most women have suitable anatomy such that simply making the breasts fuller; paying attention to anatomic landmarks, and filling out lost volume will achieve a great result. Some women need adjustment to the anatomy, such as a breast lift, in order to improve shape. A plastic surgeon conversant with breast augmentations can help a woman decide what her options are.

Breast augmentations should be performed only by plastic surgeons certified by The American Board of Plastic Surgery (call 1-888-4-PLASTIC). Be leery of office-based surgeries. Despite what the public thinks, any doctor can perform a breast augmentation in their office, whether or not they're a plastic surgeon. There is no government regulation. Hospitals and outpatient surgery centers at least credential their medical staff adding a level of security for the public.