Breast Augmentation

The size, shape & look - you decide

Many patients who come to me for breast enhancement surgery are surprised that they can actually take an active role in deciding not only the size they want their breasts to be, but also the shape of the breasts and how much cleavage they want to have. The patient can also have input into how their breasts might feel and move through choosing the type of implants with their surgeon. In fact, patient input on nipple position can even be very important.

No two women are alike and so there is no one implant or operation that will suit all women.

Implant types

Implants come in not only many sizes but also many shapes, from round to tear drop, to asymmetrical and anatomic. The shape a woman wishes to achieve is measured against her existing breasts and her chest wall to determine the appropriate shape and size of the implant.

Both the surgeon's knowledge and his/her ability to communicate clearly with the patient is critical in these processes. The surgeon must have adequate experience to be able to understand the patient's desires and physical realities: current shape and size of breast, elasticity of the skin of the breast, position of the nipple and shape and bony contour of the patient's chest wall.

Implants are commonly filled with saline or silicone. Both implant types have advantages and disadvantages. It is my experience that most women who can will choose the saline implant. The saline implant has a natural feel and moves more naturally than silicone. The saline implant can also be inserted through a smaller incision that its silicone counterpart. Silicone implants are appropriate in cases where the woman has a bony chest well or very thin skin. Silicone may also be called for in women having implant replacement or reconstruction after mastectomy.

Most importantly, however, is that the patient needs to have the advantages and disadvantages of both silicone and saline implants discussed with them.