Breast Augmentation: The Basics

So you want larger, perkier breasts? Breast augmentation surgery may be the perfect procedure to achieve your goals. You’ve done some research. You’ve read about breast implant types and shapes, and different incisions. You may have even read about the different surgical approaches, such as placing the implants above the muscle and placing implants below the muscle. The amount of information online can be daunting. The good news is that it really isn’t as complicated as it sounds. Here are some of the nuts and bolts surrounding breast augmentation surgery that is intended to simplify the process.

You probably know that silicone breast implants feel and look more natural than saline breast implants. So why would anyone ever chose saline over silicone?

Saline implants are cheaper. The decision to chose saline over silicone may save a patient $1,000.

Saline breast augmentations can be performed with smaller incisions.

Saline implants can be overfilled to create more perkiness which may be beneficial when performing a concomitant lift with augmentation.

Saline implants may create a more unnatural look — for which some women desire.

A fear of breast implant rupture. While studies have demonstrated that ruptured silicone breast implants cause no systemic harmful effects to the body, some women still feel more comfortable using salt water rather than silicone to enlarge their breasts.

Why shouldn’t I get the high profiles? Doesn’t high profile mean more projections?

The profile of the breast implants looks at volume and diameter. For any given volume of silicone or saline, the width of the implant can be more narrow or more wide. In turn, the projection will also vary. High profile implants, if they were instead named “narrow implants” would garner much less interest among women. But that is precisely what they are. The disadvantage of narrow implants are that you sacrifice cleavage and side boob for projection. In women with narrow chests, high profiles may indeed be the better fit. But for those that want more cleavage and side boob (and often more natural looking breasts, moderate profile may be the better choice.

Why would I ever get breast implants over the muscle?

The advantages of sub muscular breast augmentation are mainly 1) the medial (inner) aspect of the breast implant becomes more padded and generates less potential implant rippling, and 2) the muscle action from the pectorals major reduces the risk of capsular contracture (hardening of the tissue around the implant). In women who compete with body building, it may be more desirable to place the implants above well developed muscles to reduce the potential for animation deformities when the muscle is flexed.

Why would I not want an incision in my armpit?

Transaxillary breast augmentations offer a big disadvantage: the dissection necessary to create the space for the implant isn’t “anatomically friendly”. Meaning, a lot of tissue needs to be traversed to get to the important areas where fibers must be carefully cut. In turn, visualization is poor and pocket dissection is more likely to be imprecise. Precise pocket dissection is critical for proper implant placement (and breast shape). In addition, the scars in the axial often heal thick and get nicked when shaving. In addition, large silicone breast implants cannot be placed through this route.