The Plastic Surgeon’s Guide to Breast Implants

Breast augmentation surgery with breast implants continues to be the best alternative for women to choose the right size breasts for their body and aesthetic goals. Breast implants offer women control over how their bodies look and feel. Whether you desire breast implants to create more fullness or to correct the signs of aging, breast augmentation surgery provides a solution to meet your needs. 

What is Breast Augmentation?

A breast augmentation is an operation that makes the breasts larger by inserting a breast implant or, rarely, the injection of the patient’s own fat from another part of the body. Breast augmentation is a surgical procedure requiring general anesthesia. However, most breast augmentations are outpatient procedures.

Breast augmentation with implants has been around for over 50 years. The techniques and products have improved during this history. Breast augmentation with fat is unconventional and limited by the fat available from the patient for transfer. I have performed fat transfer breast augmentation operations several times, but it remains an unconventional method of augmentation.

Today, women have more options for breast augmentation, like determining the incision placement and type of implant. I work with each patient to create a customized surgical plan to meet the patient’s specific needs and goals.

Breast Implant Types

Implants come in two main types of breast implants: silicone gel or saline-filled. Within those two types, patients have additional options. For example, breast implants come with either a texturized or smooth surface, different projections, and a few other options. We seldom offer texturized implants as they have now been associated with a rare cancer and the FDA has removed one of the varieties from the market. Other forms of implants have not had these issues.

During the surgical consultation, we discuss the implant types, including the pros and cons of each. In the end, the surgeon works together with the patient to select the best implant to meet the patient’s needs. Silicone gel implants cost more than saline-filled. However, many patients opt for silicone gel to achieve their aesthetic goals.

Regardless of the type of implant selected, the surgery will produce high-quality results. When deciding which size breast implant to select, patients often make a conservative choice only to wish they’d selected a larger size.

Incision Options for Breast Augmentation

I offer three types of incisions: inframammary, periareolar, and axillary. The most popular option is the inframammary where the incision falls in the lower crease of the breast. In fact, I now place nearly all implants with an inframammary incision.

The second most popular incision is the periareolar where the incision goes through the lower areola. Finally, the axillary incision is in the armpit and requested least frequently.

We discuss the benefits of each type of incision so the patient can make an informed decision. For most patients, the inframammary incision offers a cleaner route of entry and may decrease the incidence of capsular contracture compared to the other incision types. 

Usually, I use the inframammary incision unless a patient requests an incision through the areola or the axilla. We will accommodate this request if the patient feels it is best for them.

Breast Implant Placement Options

Each patient must choose whether to place the implant below or above the muscle. Both placement options have pros and cons. When the breast implant goes over the muscle, the patient usually experiences a quicker recovery with less post-surgery pain.

However, many patients experience a more natural feeling with placement under the muscle. Most patients have greater pain when the implant goes under the muscle, like the pain experienced with a pulled muscle. 

With certain shaped breasts, placing the implant over the muscle tissue produces better aesthetics. I walk each patient through the advantages and disadvantages of breast implant placement options based on their unique body.

Recovery and Life After Breast Implants

Recovery from breast augmentation surgery is usually straightforward. This is an outpatient procedure, but the patient will need someone to drive them home and provide care during the first day due to the anesthesia. However, most patients are up and about the day after the operation.

The patient can drive once they feel they can do so safely. Patients on narcotics for pain relief should not drive. However, most patients do not require prescription pain medication. Also, most patients return to work after one week. Patients with strenuous jobs may require a limited activity for up to four weeks.

After one week, the patient may resume athletic activity and exercise. However, the breasts should remain at complete rest. For example, allowable exercise includes an exercise bike but not running. Most patients resume full activity in four weeks.

During the recovery from breast augmentation surgery, the patient should wear a post-surgical compression bra. This allows the breasts to heal properly. For the best results and quickest recovery, wear the compression bra, even during sleeping, for at least four weeks. 

Is Breast Augmentation Surgery Right for You?

If you want to rejuvenate your body to its youthful appearance or change the size or shape of your breasts, breast augmentation surgery with implants provides a proven solution with lasting results. 

Part of the decision-making process with any plastic surgery requires the consideration of all factors, including physical, overall health, financial, and quality of life. I consult with each patient to discuss all aspects of surgery so that patients can make an informed decision.