 |
Information for Performed, Costs, Doctors, Photo
|
|
|
The choice of implant shape varies from round to teardrop. The round implant comes in both low- and high-profile varieties. The majority of patients in my practice elect to have round-shaped implants. Since I prefer placing the implant in a submuscular pocket in most patients, implant edge visibility in the upper pole of the breast can be avoided. The round implant tends to be ideal for those patients with good-shaped natural breasts who desire a straightforward enlargement.
Use of the teardrop (anatomical) shape depends on the patient's desire, as well as her body shape. The shape variation is in the width and projection of the implant for any given size. The spectrum of breast implants available to the surgeon can therefore provide great versatility in achieving a more natural look.
In general, there are two groups of women who benefit
teardrop-shaped breast
implants. It can be the ideal choice for
women who have droopy or tuberous breasts.
Mild elevation of the nipple in relation to
the breast mound can be achieved without the
need for extra scars on the breast (unlike a
breast lift). In these cases, the implants
will be inserted in a subglandular (subfascial)
pocket (under the breast tissue).
Secondly, some patients specifically want
less fullness in the upper quadrant.
Teardrop breast implants certainly offer
less fullness in these particular
situations. It should be noted, however,
that this request tends to be very personal,
as most women are seeking breast
augmentations in order to obtain upper pole
fullness.
Teardrop implants do have a slight tendency
to rotate. Unfortunately, this problem can
only be corrected by secondary surgery.
Breast implant fill
I use both the cohesive silicone-gel and
saline-filled breast implants. The new
generation silicone-gel breast implant is
very safe and generally feels and looks more
like a natural breast. Most breast
augmentation operations in Australia are
performed with silicone-gel implants. In
December 2006, the Food and drug
Administration (FDA) approved the use of gel
implants in the US market. The decision was
based on a great amount of scientific
research into siliconegel implants.
Breast implant size
Breast implant size is one of the most
important decisions in a breast augmentation
procedure. Because of this, a good surgeon
will take several approaches to help the
patient make the best decision based on
their anatomy, personal preferences and the
appearance they wish to achieve. In a recent
survey, over 80 percent of patients
undergoing breast augmentation stated a
C-cup was their desired postoperative goal.
A D-cup was the second most popular request.
For this consideration, I always begin by
showing the patient numerous photos of
actual patients who have had breast
augmentation. By finding someone who has a
similar preoperative appearance and
evaluating their results with the size of
implant they chose, the patient can get an
idea of her own final result and increase or
decrease the implant size according to her
wishes.
The surgeon will also measure the patient's
breast and
chest shape, paying particular
attention to the base and projection of the
breasts. This gives the surgeon an idea of
what size breast implant will help achieve
the patient's desired size postoperatively.
As breast implant size increases, so does
the diameter of the breast implant. In most
cases, there is a breast implant that will
be an ideal match for the diameter of the
patient's natural breast, and I find this is
a good starting point for discussion.
Choosing a breast implant smaller than the
patient's natural breast shape will not
provide the proper cleavage and shape
following the procedure. Similarly, choosing
a breast implant too large for the patient's
natural chest shape is more likely to give
an unnatural appearance.
Unfortunately, breast implants do not come
in cup sizes. Rather, they are categorised
by the volume of gel that they are designed
to hold. There are several reasons for this.
First, the final cup size will be partially
determined by the preoperative breast size,
and every patient is different in this
regard. Second, a C-cup from one bra
manufacturer is not necessarily the same as
a C-cup from another manufacturer.
Although every woman is built differently
and bras are not manufactured to a set
standard, it can be expected that a C-cup
implant size is approximately 200g or 200cc
in a woman of average height and average
build. That number will ordinarily be
slightly higher if the woman is tall or has
broad shoulders. Similarly, if the patient
is shorter than average or has a narrower
chest, that number can be expected to be
slightly lower. Although a desire for a
certain cup size is helpful in guiding the
patient in the selection of the proper
breast implants, I find it is more helpful
to focus on the shape and appearance she
wishes to achieve.
Breast implant position
The next consideration is where to place the
breast implant - on top of or behind the
muscle. In general, I prefer to place breast
implants behind the muscle so they are
partially covered. I find the muscle allows
a smooth takeoff from the chest wall. If put
directly on top of the muscle the breasts
can look like rounded balls on the chest,
which is another definite giveaway.
In women with mild droopy (ptotic) breasts,
I use a dual-pocket technique of dissecting
both on top of and underneath the pectoral
muscle, but inserting the breast implant
behind the muscle. In cases of moderate
droopy breasts where the patient does not
wish to undergo a breast lift procedure, I
will consider full placement of implant on
top of the muscle.
Smooth vs textured Implants
This issue is controversial. This is
because, generally speaking, textured
implants are said to reduce the rate of
capsular hardening or contracture, but they
also are known to create more wrinkling
issues down the track, especially in thin
patients I see in my Sydney practice. This
wrinkling is normally felt in the lower edge
of the breast where the implant is closest
to the skin surface.
Smooth implants may give a smoother look and
feel in many cases, particularly in thinner
patients, but the downside is that the
patient needs to massage the implants for at
least one year to help prevent capsular
hardening.
There are many different combinations of the
above breast implant considerations. To
attain a natural-looking breast
augmentation, the surgeon must be skilled in
deciding the best options for each
individual patient as well as carrying out
the surgery.
|
