Breast augmentation is one of the most popular and satisfying procedures in cosmetic surgery. It has undergone an evolution since its introduction thirty years ago.
The modern approach to breast augmentation, which is the technique we employ, is multidimensional and incorporates many different variables in attempting to create the ideal result. The main priority is the patient’s desires. This is determined only after a very thorough and detailed conversation about wishes for size, shape and contours. The examination requires detailed analysis of the chest size, the amount of breast tissue present, the elasticity of the skin, and the three dimensional appearance of the breast. By incorporating the patient’s wishes with the three dimensional analysis, a range of sizes of implants can be chosen that will create the desired result. The final decision is made in the operating room by examining the size, shape and slope of the breast implant from every angle. It is only after this meticulous process that the final result is achieved.
Breast augmentation can be performed through the nipple, the armpit, underneath the breast, or through the belly button. The implant can be placed under the muscle, above the muscle or in a “dual,” or double, plane. Implants can contain saline or silicone. Our preferred technique is insertion through the nipple or under the breast, with placement in a dual plane, using a silicone implant. The technique used will vary based on the individual and can only be determined after a full consultation.
Saline implants will provide a very aesthetically pleasing result.
In selected patients, silicone implants may be a superior choice. If you are considering getting silicone implants, you should be aware that the current guidelines require that you must be at least 22 years old. Also, current guidelines recommend screening MRI examinations every two years, which may not be covered by insurance.
Cosmetic surgeons undergo special training to use silicone implants. Make sure you consult with a surgeon who is up to date with the current guidelines.
This patient had 325 cc, high profile, silicone implants inserted under the muscle through an inframmary approach.
This is a woman who wanted breast augmentation. She brought many pictures of breast augmentation results she liked. We spend a considerable amount of time with each patient so that we may understand exactly what each person would like. We take numerous measurements and pictures and together with the patient decide on the appropriate size and style of implant to give the result desired. We inserted saline implants through the nipple and placed the implant under the muscle in a “dual” plane. The implants were filled to 370 cc. She has a result that matched exactly the pictures she liked.
The patient below wanted some fullness over the upper portion of her breasts, but not an excessive amount. She wanted an augmentation result that would be versatile in all kinds of clothing styles. We inserted the implant through the nipple and placed them underneath the muscle. As you can see in the “After” pictures, she has a good size augmentation with some fullness in the upper portion of her breasts. She also has smooth and round contours. Notice how well the scar around the nipple has healed. It is almost imperceptible. The pictures were taken approximately 3 months after surgery.
The patient below also request a natural looking result. We used 325 cc saline implants and inserted them through the nipple and under the muscle in a dual plane. The “After” pictures show a good size augmentation which compliments her frame and is natural looking.
The patient below requested breast augmentation. She wanted maximum fullness for her size. She also desired fullness over the upper portion of her breasts. After we obtained all of her measurements, it was clear that the regular implant that would fit on her chest was not going to give her the result she wished for. In order to provide her with more fullness, we selected what is called a “High Profile” implant. This is an implant which provides more fullness than the “Moderate” size but in a smaller diameter size. In other words, one is able to obtain greater volume and projection of the breast in a smaller or same size diameter implant. As you can see in the “After” pictures, she has maximum fullness of her breasts. There is also fullness over the upper portion of her breasts, as she desired. The shape is round and smooth. Again, our goal in breast augmentation is to carefully listen to each patient’s wishes and then safely and predictably give them the result they desire.
The patient in the pictures below requested an improvement in the appearance of her breasts. She wanted greater volume of her breasts and also wondered if anything could be done to improve the position and shape of the breasts. We performed a careful examination and determined that a breast lift was not necessary. We felt that an implant would be able to accomplish her goals. We reviewed her measurements and available implants and together we selected a range of sizes that would fit her well. A 350 cc silicone implant was inserted through the nipple and under the muscle in a dual plane. Her augmentation is proportional to her frame. The size compliments her very well. Notice also the improvement in the shape and position of the breasts. She has the effect of a “breast lift” with implants only. Her breasts have very smooth and round contours. Her incision is almost impercepible.
This patient (see below) requested a large augmentation. She desired maximal fullness over the middle and upper portions of her breast. The implant was chosen based on the three dimensional analysis of her breasts. The implant used was the maximum size recommended based on the measurements taken of her chest. It is important for a surgeon to select an implant that is within the recommended guidelines. If the implant exceeds this, it can lead to long term problems. A saline implant was inserted through the nipple and placed in a dual (under the muscle) plane. The postoperative pictures were taken approximately 1 month after surgery. Notice how well the scar around the nipple heals. With time, it becomes even less noticeable.
The following patient below requested breast augmentation. She had very thin tissues and specifically wanted silicone implants. For these reasons, the decision was made to use silicone implants for her augmentation. Based on her measurements and her wishes, we decided to use 375 cc size implants. The implants were inserted through the nipple, and underneath both the muscle and the breast gland. This is referred to as a “dual plane.” As you can see in the “After” pictures, she has a good size augmentation which complements her frame. She has very smooth and natural looking contours of the breast. The scar around the nipples is barely visible. The pictures were taken approximately 2 months after surgery.
The patient below wanted an augmentation. We also discussed the possibility of doing a breast lift at the same time. However, after a thorough discussion, she decided she only wanted the augmentation. The “After” pictures show her results after augmentation with 340 cc saline implants. The implants were inserted through the nipple and under the muscle.
The patient below requested a conservative augmentation. She did not want to be too large and also wanted to look natural. As you can see in the “After” pictures, her breasts are more full throughout. They have very smooth and round contours. The result is very natural looking. The pictures were taken approximately 6 weeks after surgery.
The patient below had a type of breast shape described as “Tuberous.” There is insufficient volume of the breast. There is also tightness of the skin in the lower half of the breast. Lastly, the breast and nipple appear too low in position. This is a very challenging case to improve. The breasts need to be augmented in volume, they need widening of the skin below the breast and they require lifting.
We decided to correct the breasts in one stage. We made an incision completely around the areola in order to try to reduce its size. Once this was done, we carefully manipulated the breast skin and tissue in the lower half of the breast to create a more rounded shape. Once these maneuvers were carefully completed, we then inserted a saline implant under the muscle. We meticulously positioned the implant to create the best shape and contour possible.
The “After” pictures were taken approximately one month after surgery. Notice the dramatic improvement in the appearance. Note also the smooth and round shape to the breasts.
The following patient (see below) desired a conservative augmentation. Her main concern was to have as much of a natural appearance as possible. A saline implant was inserted through the nipple and placed in a dual (under the muscle) plane. Notice the gentle and smooth contour of the breasts giving a very natural appearance to the result.
This patient (below) wanted a breast augmentation that was proportional to her frame and that looked natural. A saline implant was inserted through the nipple and placed in a dual (under the muscle) plane. Note the gentle contour and round shape of the breast.
The following patient below desired a breast augmentation which was proportional to her frame. She did not want a lot of fullness over the upper part of her breast. Instead, she wanted a more sloped contour of the breast. A saline implant was inserted through the nipple and in a dual (under the muscle) plane. As you can see, she has an augmentation which compliments her frame. The breasts are round, have a gentle and smooth contour and are natural appearing.