Updated: Mar 6, 2022
All About Breast Augmentation
Cosmetic surgery has come a long way in recent years and coupled with advancements in aesthetics, and plastic surgery, people have so much more power over their choice of physical appearance, no longer being ‘stuck’ with what they were born with.
Reassuringly, with the arrival of the internet, surgeons are now even more accountable for their results. Word of mouth is the biggest advertiser for practices all over the world, and they are no longer willing to put their names to less than ideal results and a plastic surgeon can expect his before and after photos to be thoroughly scrutinised.
However, deciding whether or not to proceed with any kind of cosmetic surgery is a huge decision, and one that often takes people many years to completely decide on. Perhaps the motivator might be being finished having children, having lost a significant amount of weight, a recent divorce, or even just never being content with an aspect of your body. But specifically with breast augmentation, once you make the decision to proceed, how do you decide on a surgeon, what size implant should you get, do you go over the muscle, under the muscle or sub-facial? The options are huge, and perhaps I can help you with some of them?
Picking a surgeon.
Speak to friends who have had the same procedure done.
Reach out on social media. Bustmob on Facebook and Instagram is incredible and full of the most amazing and supportive women all over the world.
Internet search, look at before and after pictures and reviews
Don’t be afraid to book a consultation to discuss options and go with your gut. You need to leave that room feeling like you have been listened to, that they understand your goals, but also that the surgeon is realistic on what is achievable for you.
Choose some goal photos to help your surgeon understand your goals Bustmobs goal finder is brilliant for this
Research your surgeon, experience, length of time in practice, qualifications etc
Compare prices of known quality surgeons, they will all be roughly the same price in the same area. Be concerned if something sounds too good to be true - it might be!
Choosing a size
Don’t get obsessed with bra sizes here, they mean very little. Bra sizes vary massively between manufacturers and the vast majority of women wear the completely wrong sized bra anyway. Implants are sized in CC’s (cubic centimetres) with roughly each 150cc equaling a cup size. Take photos of similar sized women’s results and inform the surgeon of the look you’re going for instead.
Consider the implant shape you want also, a teardrop shape will give you less upper pole fullness (less rounded shape at the top). There are also extra high, high, moderate and low profile options to consider. Basically the higher the profile, the smaller in width the implant is across your chest, but the more the implant projects outward.
The width of your chest will aid the surgeon with advising you how to chose your implant shape and projection options. A very broad person, may find a extra-high profile implant gives them a desired rounded shape, but the breasts are positioned too far apart for example. A narrow woman might end up with too much side boob if they use a low profile implant.
There is so much debate on Bustmob particularly about this subject and which placement is the ‘best’. Personally, I believe that there is a placement type that is best for you and your circumstances. From what I can gather, surgeons have their favourite type of placement also and some will only perform one option. I believe choosing a surgeon who regularly performs all types of placements and bases his choice on what is best for the person in front of him, rather than what they are more comfortable with, is the wisest option.
Under the muscle - The implant is placed beneath the pectoral muscles and above the chest wall. This involves cutting into the pectoral muscle and healing time is significantly longer. It is also more uncomfortable than going over the muscle. The pros of this placement type appears to be less chance of capsular contraction developing (see below) and some surgeons appear to believe it is less likely the breasts will sag as quickly. Under the muscle can also be a better option for women starting with less breast tissue, the implant is less likely to show visible rippling in this position. Sub-muscular placement is apparently the best option for radiologists for breast screening.
Unfortunately, this placement can be prone to animation deformity. This is when the pectoral muscles squeeze and move the implant when they are activated. This seems to be a particular issue for women who are more active, for example when in the gym, but can also happen with some women when they move their arms up above shoulder height. Whether or not you end up with animation deformity seems to be a bit of luck of the draw.
Over the muscle - The implant is placed between the pectoral muscles and the breast tissue. This is a good option for gym-goers, as they are less likely to get animation deformity. I know some surgeons will assess your pectoral muscles before making their decision as to which placement to recommend. The recovery time is much less in regards to pain, and the implants and skin all seem to settle ‘drop and fluff’ much quicker with over the muscle placements. Overs are a better option for women with more existing breast tissue initially, and choosing a slightly larger implant can help to slightly lift your breasts as a result (although I believe this to be fairly minimal)
However, choosing this option can put you at a higher risk of capsular contracture, and there is more chance of visualising rippling of the implant. Some argue that over the muscle implants can sag quicker, but this remains debatable.
Sub-facial - This option places the implant under the breast tissue and above the muscle within the connective tissue that covers the pectoral muscles. Supposedly better for rippling and a more natural look.
Along with placement options, there are also a multitude of insertion techniques. These can be where the implant is inserted via the armpit, the breast crease, or via the nipple.
What can go wrong?
There are risks with every surgery and breast augmentation is no different. A general anaesthetic is in itself a risk, and then you also may be unfortunate enough to develop an infection at the operation site.
If the operation and healing goes well, there may be other things you are not happy with. Perhaps you will not like the look of your new augmented breasts, feel disappointed with your results. You may noticed your implants look too far apart, or even too close together. You may experience reduced sensitivity to the nipples that may or may not return. It is possible to have increased sensitivity.
You may experience some rippling of the implant. This happens when the skin covering that area of the implant is quite thin, with perhaps little to no fat coverage.
Implant rupture is a possibility which can cause discomfort and an abnormal appearance of the breast. It is possibly also to have a silent rupture, when you are not aware of it happening.
Haematoma - a collection of blood under the skin at the surgical site. Surgeons often leave drains in situ for 24hrs or more post-operatively in case this should occur.
Another possibility is developing capsular contracture. This is possible at any point after surgery, but is most likely to develop within two years, but can occur later. This happens when the capsule that the surgeon makes for the implant to sit in, becomes overdeveloped with scar tissue, causing the implant to be squeezed and even displaced. It can range from visually troublesome, to incredibly painful.
Another unfortunate development could be lateral displacement, when the pocket the implant sits is not secure enough around the implant, causing the implant to shift to either side, particularly when lying down. It is also possible to ‘bottom out’ when the implants pocket at the bottom does not adequately hold the implant in place and the implant slips to a lower position, causing your nipples to move too high up on your breast and giving a very unnatural result.
Other irritating developments can be the formation of stretch marks, and even having the implant flip inside you.
Breast Implant Illness - This is a term used by patients and doctors to diagnose a wide range of symptoms that develop immediately or even years after surgery. Ranging from muscle pains, concentration problems, anxiety, depression and skin rashes. There is no clear evidence that implants cause these symptoms, but studies suggest there may possibly be an increased risk of developing autoimmune disorders such as rheumatoid arthritis, scleroderma and sarcoidosis after breast implantation. The FDA currently states that breast implant illness is currently not recognised as a diagnosis, but further research is currently being done.
Breast augmentation can increase a persons confidence, sense of empowerment and feelings of femininity. But is it not without risk, and even the maintenance of implants deserve consideration before making your decision, for example implants only have a recommended life-span of 10-15years, then you will need to consider whether or not to do it all over again.
I would love to hear your experiences and any suggestions for this article. If anyone would like to contact me personally for further information, I would love to hear from you via my forum 'Breast Implants - the pros and cons'.
There is more money being spent on breast implants and Viagra today, than on Alzheimer's research....
This means, by 2040, there should be a large elderly population with perky boobs, huge erections and absolutely no recollection of what to do with them!!