Although deciding which implant material you want for your breast augmentation is a big step, there are other important decisions to me made- like implant shape, incision type, and implant location.
To start with, there are different shapes of implants. Most people only think of the round ones but in fact there are more options available to you. Teardrop shaped implants are becoming quite popular, they have a sloping portion that is at the top which many feel makes the implant look more natural once inserted. These implants require a textured surface because if they rotate, the breast will look deformed (a problem that won’t occur with a round shaped implant since it is perfectly symmetrical).
Another aspect of implant shape is the profile you want. Most of the time, doctors assume that you want a medium profile- those are what the majority of people get. However, depending on the look you are trying to achieve a higher or lower profile might be appropriate. Basically this aspect is when you set and implant down on the table, how tall is it.
This is an example of a patient who has gotten high profile implants. Keep in mind, these look relatively new and therefore they have not fully settled yet, but they ARE high profile and are probably not going to drop down very much—they will continue to have that very full appearance at the top of the breast. On a related note, you should always remember that what you look like immediately post surgery is not what you will look like permanently. Breast implants often take a couple months to fully “settle”. The body is recovering from a trauma (the surgery) and is adjusting to a foreign body (the implants) so there will be swelling and adjustments that the body makes before everything reaches its final positioning.
Below, is a patient who got low profile implants. You can clearly see the difference between these two types. If you are on the smaller side to begin with and are aiming for a very natural look with a modest size increase, low profile implants might be right for you!
The next important thing to consider is the incision type. As I mentioned before, silicone implants are at a disadvantage to saline implants in that they require larger incision types. The implant comes pre-filled and so you require a large incision to provide the surgeon access to place the implant. I know that reducing scarring is one of the TOP priorities for you and your doctor, so it is important to weigh incision types before you decide implant material.
Periareolar incisions are right around the nipple. This incision can be used for silicone implants, but they would need to be small since that would be very difficult—however it is not unheard of, just uncommon. These scars will be less noticeable than other methods and often blend in with the areola. One major advantage of this type of incision is that it permits the doctor great accuracy in placing the implants. The image below gives you an idea of where this incision is located; the scarring will be quite light, and really only noticeable upon close inspection… if somebody’s that close to your boobs, I’m pretty sure they aren’t going to complain about a faint line.
Inframammary incisions are located in an area called the inframammary fold. This is pretty much the crease where the bottom of your breast meets your rib cage. This type of incision can leave pretty noticeable scars, but is the ideal type for silicone implants. Again, if you think you wan silicone implants, you need to decide if they are worth the additional scarring.
A transaxillary incision will be located in the armpit and placed through a tunnel that is made to the breast. This is a nice option for those who do not want any visible scars on their breasts, but will leave scarring in the armpit (it’s quite small though) and can NOT be done with a silicone implant. One disadvantage however, is that this incision type more often has issues with symmetry of implants.
Now I’m sure that most of you have come hear about “no scarring” breast augmentation. That is achieved using a transumbilical (often called TUBA) incision. Saying that this has NO scarring is a bit misleading, really it is simply placing the incision inside of an existing scar—your belly button. The doctor makes a small incision in the belly button, makes two tunnels up to the breasts and places the implants. There are no visible scars on the breasts, and usually the scar inside the belly button is completely invisible. This incision is ONLY for saline implants and you must find a specific doctor who has been trained in this, since it is a relatively new procedure and not all surgeons perform this type.
Finally, implant location is one more choice you can make. An implant may be complete submuscular, partial submuscular, or subglandular.
Complete submuscular is where the implant is located completely below the pectoralis. This is often the best option for those undergoing reconstructive surgery after a mastectomy since the muscle will add tissue between the implant and the skin and allow for a more natural appearance.
Partial submuscular is when the implant is placed mostly under the pectoralis with the bottom portion only covered by breast tissue, not muscle.
Subglandular is when the implant is located on top of the muscle and underneath of the breast tissues. Many feel that this is the ideal location for realistic results, however this placement type is thought to lead to a higher rate of capsular contracture than the other locations.
On the left is subglandular and on the right is complete submuscular.
This should cover most of the basics about breast augmentation. I’m going to start discussing other types of cosmetic surgeries and will come back later to address the potential complications that may arise from breast augmentation. In the meantime, let me know if there’s a particular surgery you would like to read about!
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