PATIENT RESOURCES / DR’s Blog

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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Reviews

Dr. Shortt preformed a gynecomastia gland removal on me

Dr. Shortt preformed a gynecomastia gland removal on me, I am 20 years old and have been dealing with gynecomastia my whole life, it has caused me alot of pain and discomfort. I am very athletic and fitness is my passion, having these glands affected how I looked cosmetically as well. I was recommended by my doctor to have Dr. Shortt as my surgeon, and I am so happy I was recommended to him. Throughout the process getting ready for my surgery he was extremely knowledgeable and professional providing all the information I needed to know. His staff were very helpful as well and I sent several emails asking questions and always got a reply right away. The surgery itself went really well and I was surprised that there was very little pain following the surgery, I didn’t really need any painkillers. He removed both glands which happened to be quite large from my chest. I saw Dr Shortt for follow up appointments for the first 3 weeks after, we were both extremely happy with how I was healing and the results. In fact, I am blown away by how much better I look, there is no scar at all and no soreness and discomfort like I had before I got the surgery done. I’m impressed, and I haven’t even healed fully yet since I am only 3 weeks out, I am looking forward to the final results because it’s only going to get better from here. This was a life changing surgery for me, I am so pleased I was able to get the opportunity to have such a great surgeon perform it. If you are a male that is looking for a good surgeon to perform this type of surgery, I am confident that you will be beyond happy with what Dr. Shortt can do, I know I was. Thank you.

I highly recommend dr. Shortt, he is very honest.

I highly recommend dr. Shortt, he is very honest. I had a consultation for my son to do his nose he explained everything to us thoroughly and spend enough time with us and answered all our questions.

I had sought a breast reduction to ease the back and neck pain

I had sought a breast reduction to ease the back and neck pain I had endured for years. I had met a few other plastic surgeons over a year period. I had never been comfortable or confident enough to make the decision to have surgery…not until I met with Dr Shortt. I had been afraid of surgery and never felt convinced it was worth it. After my consultation with Dr Shortt , I was excited about how he could help. He made me feel very comfortable. During the initial examination we also spoke about the large deposits of skin and fat under my arms – a constant source of embarrassment and discomfort. I had not worn anything sleeveless in years as they spilled out. He spoke to me about “auxiliary breast tissue removal”. I was thrilled there was something that could be done and both surgeries could be performed together When explaining what the procedure would entail and the recovery time, he spoke with me not at me. He acknowledged my fears and concerns. All my questions had been answered and I knew that surgery was the right decision and he was the right surgeon for me! ( I was so excited about the prospect now that I shared with my daughter now amazing he was – she had also meet other plastic surgeons for implants for herself – she met him and was also so impressed – she had her surgery performed by him as well!) The surgery went well. At all the follow up appointments, he was always timely. You would think being exposed and examined would be uncomfortable, but is wasn’t. He is such a professional and put you at such ease with him that I never had the chance to feel uncomfortable He would exam the areas and scars and instruct how to best take care of them. He shared in my joy and excitement for the difference this had made! I feel better and look better I also want to mention what an amazing team he has as well. Everyone I came into contact with at his office were amazing! I can’t come up with one thing that I feel he could have improved on. Without any hesitation I would, and do, recommend him!

I selected Dr Shortt based on his credentials and experience

At 51 years of age and many, many years of pain, I sought out a Surgeon who would perform for me an OHIP covered Breast Reduction and after a great deal of research, I selected Dr Shortt based on his credentials and experience. Reviewing his past surgery accomplishments, I soon wanted the “Mommy Makeover”. At my first appointment, I was pleasantly surprised by the Dr Shortt’s demeanor. He was found to be very approachable and empathetic. He took the time to explain everything that I needed to know and also answered all of my questions without making it seem a burden. He went through step by step what I would go through during and after my surgery. As a very self-conscious person, he was able to make me feel very comfortable being fully exposed and was professional every step of the way. His Support Staff are all so very courteous and professional. As far as the surgery itself, I would have to say I think that not only is he an excellent Surgeon, he is a Sculptor. I am extremely pleased with the results. The few people that I have shown my stomach and newly formed belly button are astounded at the results. Currently I am 9 weeks post op and feel wonderful and able to go back to the gym. Dr Shortt being a Perfectionist wants another 6mth appt to ensure that I remain am as happy as I am today and that the scarring is as minimal as possible. He has changed my life and I am very grateful. I would and have recommended him to several people already.

I am currently 5 weeks post op and am extremely pleased with my results

I am currently 5 weeks post op and am extremely pleased with my results so far and Dr.Shortt told me if I’m happy with the results so far, wait until I’m finally healed. Dr Shortt is an amazing doctor, his bedside manner is impeccable and at every step of the way he made me feel comfortable and you could tell he genuinely really cared. He took his time to listen to me and my concerns and reassured me he would do his very best, and the results so far are amazing, I am extremely happy and feel amazing. With any big surgery it can be scarey and nervous but Dr.Shortt is very knowledgeable and most of the time had already answered all my questions I had for him and he put me at ease. His staff are amazing to work with too, especially Joanne. Thank you guys, from my very first consult to today you have made this whole experience absolutely amazing. I would highly recommend you definitely go see Dr.Shortt his professionalism and the fact that he actually treats you like a person first shows he really cares.

I am very pleased with the excellent work of Dr. Rodger Shortt

I am very pleased with the excellent work of Dr. Rodger Shortt. His expertise and great manners helped me a lot through the difficult times and multiple operations I went through. As a cancer breast patient, I had two mastectomies for my right and left breasts. Dr. Short joined the surgeon on my second mastectomy and started his wonderful work of inserting the breast tissue expanders. I visited Dr. Shortt’s clinic several times to inject the saline into the breast expanders. During these visits, I appreciated the staff pleasant attitudes and Dr. Shortt recommendations. At the last stage of the process, Dr. Shortt removed the breast expanders and inserted the breast implants and he reconstructed my nipples from my breast skin. I am very pleased with the wonderful job Dr. Shortt has completed. I highly recommend Dr. Shortt and wish him every success with all the patients.

I am so very grateful for all the hard work he did

About 8 years ago I had a lumpectomy leaving my breasts very unbalanced. It has made super uncomfortable about my appearance especially in a bathing suite. Dr. Shortt did an amazing job fixing this. I am so very grateful for all the hard work he did. My girls look like twins instead of cousins. Also, his staff is excellent and caring. I am so happy and recommend him to anyone who needs a good Plastic Surgeon who listens and get the best possible results for his patient.

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