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Posted March 11, 2011 in Breast Augmentation

Lady covering bare breastsOver the muscle, under the muscle, saline, silicone, under the arm, under the breast, under the nipple, through the belly button, round or teardrop, 300, 400, 500cc? The choices that women are faced with when dealing with breast augmentation are endless.

My opinions expressed in this article are intended to educate and inform you of what I believe are the best solutions to many of the breast augmentation dilemmas that you will face, mostly from false media perceptions.

1.It’s all about you and nobody else.
As a sign of femininity, fertility and beauty, a woman’s breasts are important to her. Unfortunately, media, celebrities and the Internet skew many of our perceptions of the ideal pair of breasts. Many Hollywood stars and glamour models have had multiple operations to help them achieve a look they will never have and it is impossible to have your breasts look exactly like your favourite celebrity through surgery. You are a unique and wonderful human being and your surgery is unique to you. Breast augmentation will enhance the size and shape of your breasts and in the majority of cases will improve your self-esteem and confidence. Remember that one simple rule. It’s all about you and nobody else.

2. Size does matter.
In so many respects, size matters. “Big” is not better! “Big” has more complications. “Big” will cause more revision surgery in the long term. The single most important factor that I will look at is the size of your chest. The size of the breast implant must match your chest size and dimensions. If your chest can’t “handle” a certain size, don’t go for it. Many of the complications we see are a result of the incorrect size of implant being placed at the initial surgery. The most common complication of a breast augmentation is capsular contracture, a condition that causes the breasts to harden and deform, and a condition that sometimes warrants removal of the implant permanently. Larger implants have the potential to cause more capsular contractures than smaller implants, so remember, size does matter!

3. Silicone is fabulous.
In 2007, silicone was brought back into the United States after years of prohibition. The reason for silicone’s ban was for unfounded claims of autoimmune diseases, cancer and many other strange diagnoses. Hundreds of studies lifted the ban, proving without doubt, that silicone did not cause any disease known to man, and did not cause cancer of any kind. Fortunately, in South Africa, these restrictions did not take place and South African plastic surgeons continued to use silicone implants during the “silicone war era”, providing exceptional experience with the use of silicone implants. It is interesting to note that many American plastic surgeons are now converting their practices into using silicone implants as apposed to saline implants. The only reason being that silicone implants look more natural, have less rippling and visibility and last longer than saline implants.

4. Cut under the breast or under the nipple and nothing else.
The second most dreaded and feared complication of breast augmentation is implant asymmetry. Whilst your breasts are never perfectly symmetrical, implants can displace and move around if the surgeon does not accurately make the “pocket” they are placed in. The best access for a plastic surgeon to make this pocket is by making an incision just under the nipple or just under the breast. Famous television shows will show “boob jobs” being done through the belly button. These have to be saline and the pocket is never accurately made and therefore there is a much greater risk of implant asymmetry. Very few surgeons worldwide will perform a breast augmentation through the belly button or through the armpit, in fear of breast asymmetry. The vast majority of the 4cm scars under the nipples or under the breast heal inconspicuously. Is it worth the risk?

5. Under the muscle or on top of the muscle? – Let your surgeon decide.
Plastic surgeons know the rules. I will listen to your expectations and desires, then examine you and then determine the right place to put the implant. With modern implants, we are able to achieve more and with less complications. The choice of implant location really does depend on your preferences and what’s best for you.

6. Round is always round and works!
A fairly recent advancement in Breast augmentation is the use of anatomical implants or teardrop shaped implants. These were originally designed to alleviate the challenges we deal with in breast reconstruction, a completely different field. Some plastic surgeons do use the “new” anatomical implants in breast augmentation but they certainly have their problems, for example if they move around, the breast will look considerably deformed, and is a very difficult problem to correct. I reserve the use of anatomical implants for breast reconstruction and in certain cases of congenital abnormalities. Round has worked for many years with great success so avoid the additional risk if it’s not necessary.

Breast augmentation can be life changing for many women. Whilst perfectly reasonable to desire a certain cup size, the ultimate implant size and style rests on factors that will provide you with a result that is low risk, safe and reliable in the long term.


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