Breast augmentation is a form of cosmetic surgery performed by our plastic surgeons for women who wish to increase the size of their breasts. In many cases the woman wishing to undergo a breast augmentation procedure feels her current breast size is too small or disproportionate to her particular body size. Breast augmentation is considered an aesthetic surgical procedure that most often occurs with women who have not been satisfied with her final breast development size reached after puberty, and in some cases women's breasts have developed unevenly and she would like to achieve proper symmetry. Women who have lost a significant amount of weight or have had pregnancies may find their breast size has shrunken and they wish to restore their breast size through breast augmentation.

Now breast augmentation is one of the most popular plastic surgery procedures in the world. In spite of their overwhelming popularity (here comes the bad news), breast implants have limitations. Breast augmentation surgery will not improve nipple asymmetry, move your breasts closer together, lift droopy breasts, or remove stretch marks. If you have droopy breasts, you may need a breast lift (mastopexy). Also, breast implants are not free of problems. In order to determine whether breast augmentation surgery is for you, you must weigh the risks and the benefits. The following pages will explain all of the options, Tips for Getting the Best Results from your Breast Augmentation ,Complications of Breast Augmentation and recovery of the surgery.

After you have had a chance to learn about the options in breast augmentation (below) and , be sure to visit to help you minimize your risks, expedite your recovery, and get the best possible results.

Options in Breast Implants

Before you sign up for breast augmentation surgery, you and your plastic surgeon should have a long discussion about these important issues:

1. Position (under or over the muscle) 

By implant position, plastic surgeons are referring to whether the breast implant should be placed above or below the pectoralis muscle. Advantages for placing the breast implant above the muscle include less discomfort post-operatively, less swelling, and less chance that the breast will appear to move when you are exercising your upper body. This last issue has been one of great concern for many women, especially those who have full workout regimes. Simply put, if your breast implants are under the muscle, then when you flex your pectoralis muscles (as you often do during workouts), your breasts may appear to move. Sometimes (though not commonly) the breast motion will appear quite distorted. Now, to bring things into perspective, you should realize that many women who work out (and even some professional female athletes) have implants under the muscle and are very happy with their appearance. In other words, if you work out a lot, do not automatically believe that your breast implants need to go over the muscle. Advantages for placing the implants under the muscle include less interference with mammography and less rippling in the upper half of the breast. Generally, thin and small-breasted women should favor implant placement under the muscle. The advantages of less interference with mammography, less rippling of the upper half of the breast, and more cushion between the implant and the skin outweigh the drawbacks, many of which are temporary. Athletic women should consider placement of the implant above the muscle (as long as they have adequate breast tissue and body fat) to avoid breast distortion when the pectoral muscles are flexed. Thin, small-breasted, athletic women must weigh the options. In general, they are probably better off with implants under the muscle. A more significant cosmetic problem for these women is rippling, which is less likely to occur in the upper half of the breast if the implants are placed under the muscle. Of course, this is your call. Be sure to discuss it carefully with your plastic surgeon. An alternative for these women is to have silicone breast implants.

2. Breast Implant surface (textured or smooth) 

By implant surface, plastic surgeons are referring to whether the implant is smooth or textured. A smooth implant is just that - as smooth as the surface of a balloon. Textured implants are rough, somewhat like sandpaper. Once they are in placed under your breasts, it is impossible to tell whether you have smooth or textured implants. Textured implants were developed because plastic surgeons thought that they would be less likely to cause capsular contractures  Unfortunately, studies have not shown a consistent advantage of textured implants over smooth when it comes to capsular contractures.

3. Shape (round or anatomic (teardrop))

By this, plastic surgeons are referring to round or teardrop shape. Round implants are shaped like jelly donuts. Teardrop implants are shaped more like the breast. At first, you might be thinking that (of course) teardrop implants would be better. However, most plastic surgeons disagree: they think that teardrop implants tend to become round with the forces of healing and that the teardrop implants do not necessarily give a better result.

4. Volume

This is the all-important size issue. Breast implants come in all sizes with the most common sizes ranging from 200-600 cc. This is equivalent to 7-20 ounces. Within that range, 300-450cc is probably the most common. By the way, a cc (cubic centimeter) is the same as a ml (milliliter) - just in case you have visited other sites which refer to volumes in mls. This decision is highly personal and highly individualized. The best way to determine your size is by placing breast implant sizers (your plastic surgeon will hopefully have them) in your bra and then put a sweater, blouse, or t-shirt on (or, perhaps try all of them, as you will appear different in each). Do not allow your surgeon to dictate your size. You must have input in this decision.

5. Breast Implant projection (standard vs. high profile)

Breast implants are designed so that, as volume increases, so does diameter (the footprint of the implant) and projection (the amount it sticks out, away from your body). Standard implants are designed so that MOST women who choose a given volume will be able to accommodate the breast implant's diameter beneath her breasts. This is so because women with narrower breast diameters often have smaller bodies and tend to choose smaller breast implants; women with wider breast diameters often have larger body frames and tend to choose larger breast implants. In other words, women tend naturally to choose an implant volume that is in proportion with body size and breast diameter, and breast implants were designed in anticipation of that. BUT, what if a woman wants a breast implant that has a larger volume than would be considered proportionate (by breast implant manufacturer standards) for her breast diameter, chest wall size, and body frame? In that case, placing a standard implant would risk an unnatural result, because it would be too wide for her body frame and would likely also extend too high and too low on her chest wall. In these cases, a High Profile implant is recommended. With a high profile implant, the volume is the same, but the diameter (footprint) is narrower and the projection (the amount that it sticks out away from your body) is greater. Most women (over 95%) are best suited to standard implants. The way to tell if you should have standard implants or high-profile is as follows: First, your surgeon should measure your breast diameter. Next, you should choose the implant volume that you want. Finally, your surgeon should compare the diameter of the desired implant size (standard implant) to the measured diameter of your breast. If the diameter of the implant size you selected is about the same or smaller than your measured breast diameter, then a standard implant is appropriate. If the diameter of the desired breast implant is larger than you breast diameter, then you should consider high profile breast implants.

6. Saline Vs. Silicone Gel

On 11/17/06, the FDA approved silicone gel breast implants for use in primary breast augmentation for woman. This approval is expected to result in a large number of women seeking silicone breast augmentation.
Silicone breast implants provide a more natural look and feel, which is particularly important to women who have a modest amount of breast tissue. Although all women want a natural look and feel, women with larger breasts can often achieve this with saline implants. Women with smaller breasts typically cannot. The main disadvantage of silicone gel breast implants is that the incision is usually longer and the cost is higher than saline breast implants.

7. Site of Incision (This Pertains only to Saline Implants)

The options for site of incision are under your breast, around your nipple,or in your armpit. An incision under the breast is placed within or near the natural crease beneath your breast. This incision has the advantage of having the scar hidden in the shadow of the crease under the breast. It also heals well. It also is the incision you would likely get anyway if you require revision surgery later in life. Most plastic surgeons use this incision. Around the nipple can give a good result in some women, but is riskier because it is at the focal point of the breast, so any irregularities in the scar will make it far more obvious. It also imposes a higher risk of nipple numbness and inability to breastfeed. Under the arm is an option and has the advantage of being hidden in the armpit. Although many of these scars heal favorably, some armpit (axillary) incisions can be unsightly. Also, revision surgery, if needed, might not be possible through the existing armpit scar, so an additional scar would be necessary.

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