Breast Augmentation – How to decide what shape and size is best for you

by | Breast Augmentation, Plastic Surgery

What one person considers a natural looking breast augmentation, may not be same for the next. I personally believe that the most beautiful breast augmentation is one that looks so good, people wonder if you had surgery, but so natural looking that they are left guessing. Once it is easy to recognize an implant, some of the wonder and beauty is lost.

Choosing the right plastic surgeon is the most important choice you will make in this whole process. You are putting your health, your beauty, and your life in their hands. Make sure they are the right hands. I would suggest to start by asking your friends who have had surgery, or your GP, what plastic surgeon they would suggest. I would look into their training and their reviews.

When you have it narrowed down to 2-3 surgeons, go and meet them. See if you think they are listening to your concerns and your goals. Do you have an easy rapport with them? Do you trust them? Do you think they are being honest about what can realistically be achieved or are they promising the world? Are they pushing you into signing-up or giving you time to think about things? Have they asked you to go away and give it a sober second thought and offered you a chance to meet them again… or even several more times if that is what you need? Will they do everything possible to give you the results you want? Will they be accessible to you for questions ahead of time and to support you after the fact? If you can answer these questions, then take a leap, but always listen to your gut.

Before and After

25-34 year old woman treated with Breast Augmentation. Subfascial placement of tear drop shaped silicone implant.)

Breast lift or breast augmentation?

To lift or to augment, that is the question… Some people need volume, some need to tighten their skin, and some need both. When considering whether a breast lift alone is right for you – basically, if you like how your breasts look in a bra, then go with the breast lift. That is what they should look like without a bra after a mastopexy (breast lift.) If you prefer the look you have with a padded bra, then more volume may be a better choice. The pros and cons of a breast lift versus implant, or a combination are best sorted out in a consultation with a plastic surgeon.

Choosing your breast size:

The perfect breast augmentation is the one customized for you. A consultation to go over your goals; what you feel is appropriate sizing; review different photos to determine what you are looking for and use different sizing techniques to select the right implant and ideal size; and a discussion about the pros and cons of different choices will help you make the right choices to get the best breast augmentation result.I want my patients to have a beautiful, natural looking breast. I try to use my experience to help them select the best option for their body and goals.

It is a process you will need to go through, and it usually takes a few visits, so that you and your surgeon know exactly what you are looking for, and they can customize the surgical plan for you. Do not think of breast augmentation as an off-the-rack surgery. This should be tailor-made for you. If you don’t think you are getting that attention… go elsewhere! The single most common reason I see patients from other clinics and do revision surgery is that the implant was poorly chosen. Patients describe feeling rushed to decide, encouraged to go too big, and pressured to sign-up. That is not the way you would choose a tailored suit, and is not appropriate for selecting your future breasts. Take the time with your surgeon and strive for a perfect result!

At the end of the day, you have to have faith that your surgeon has really listened to you and has a clear picture of what you are looking for, so they can give you that result on the day of surgery. I always bring different implant sizers that are close to the goal size and trial different models during surgery to make sure I give my patients the most perfect shape and size…not just size. Sometimes, an implant that is a tiny bit narrower/wider or taller/shorter, or flatter/perkier may make all the difference. It adds a bit of time to your surgery, but the perfect result is worth it.

Over or under the muscle:

I generally like to go above the muscle if at all possible during breast augmentation surgery. The surgery is less invasive and has a quicker recovery.It is a more natural looking breast and ages nicer over time, in my opinion. Placement under the muscle is generally reserved in my practise for patients who have thin tissue thickness in the upper breast that would not conceal their implant well. When you see a surgeon, take them lots of photos so they can best understand your goal and help in your decision-making about breast implant placement.

I think that the subfascial plane is excellent for thin, active patients that do not want a sub muscular implant. The fascia is a layer that wraps around the pectorals muscle and is adherent to the underside of the breast tissue. It is not thick, but what it does is help to smooth out the top of the implant, creating a softer, more natural contour. It takes additional surgical time, but in my opinion, can really make a nice difference.

From an aging perspective, being above the muscle will likely give you a nicer result for longer, as the implant and your breast will come down together over the years. Keep in mind that the heavier the implant, and the less you wear a bra, the faster that this will happen.

Breast fat transfer:

Breast fat transfer can be amazing! For some women, fat grafting may be a better choice than choosing an implant. Generally, it is best in a patient that has a nice shape to their breast, but is interested in adding a modest amount of volume. Breast fat transfer entails liposuction to remove fat from a stubborn area on the body. This fat is then prepared and injected into the breast. It is a very meticulous procedure and can be time consuming. However, the results can be exquisite. Your breasts will feel perfectly natural because it is your own fat being used. Other benefits include liposuction to that area of fat, which otherwise never seems to disappear, and there is virtually no scar.

The amount of fat that can be transferred for a breast augmentation is dependent on the space it can be placed. If you have really small breasts to start, not as much fat can be placed, compared to if you were larger. Trying to put too much fat, or careless placement of fat, will diminish results.

The volume of fat to be transferred is limited by the size of the breasts to begin with and the amount of fat to be harvested. As a rough idea, you could approximately double your breast volume as a maximum in one procedure. Not all fat survives, so you will lose some volume over time. That “some” will vary from person to person. However, with meticulous harvesting and placement of fat, this number can approach 60-80% at the high end. The reason not all fat survives is multifactorial, but a significant component is the technique used by different surgeons. Anyone not willing to take the time to place each fat droplet individually, simply will not get the best results possible. Make sure your surgeon focusses on this technique and does a lot of fat grafting.

Remember, fat grafting is a very meticulous surgery. Only go to someone that does it regularly… otherwise they may not get the fat to survive as well, and your money will be wasted. Anyone can transfer fat, however, it takes skill, finesse and patience to do it well. Even the greatest surgeon needs lots of patience to get the best fat survival.

What is the recovery time?

In general, the recovery time following a breast augmentation procedure is approximately 2-6 weeks. Sure, you will feel a bit bruised, but in most cases that discomfort can be easily addressed with medications. In general, after a couple days you will feel quite well and usually it is your surgeon telling you to just take it easy. That being said, you should be back to a desk job in a few days and full workouts including yoga by 6 weeks or so.

As with any surgery, there are potential risks that you must be aware of. During your private consultation, your surgeon will take a thorough medical history from you, discuss your surgical options, explain the complete procedure and potential risks, discuss what to expect pre and post breast augmentation surgery, and your estimated recovery time.

Click here to see more before and after photos.

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