Breast augmentation is an operation that achieves its goal principally through the use of an implant. Whether it is a saline or silicone breast implant, both achieve enlargement of the breast in a near instantenous manner. Traditionally, breast implants have been of a uniform round (oblong really) shape. When this breast implant shape is seen in an upright position in a patient, it really becomes more of a teardrop shape as the saline or silicone gel shifts position inside the malleable containment bag with more of it in the lower half of the implant. This filler material shifting is why a round breast implant acquires the same shape as an anatomic breast implant in the vertical position. This now well-recognized observation is why the appeal of anatomically-shaped breast implants has fallen out of popularity.
Breast implants today have now added a new wrinkle to their shape, that of projection or profile enhancement. Borrowing from the idea of changing the inherent shape of the implant containment bag, changing projection allows a breast implant to shift its volume outward while making the base of the implant smaller. Currently, breast implants (saline and silicone) come in three projections (low, medium, and high) for every single size. The high projection implants have a smaller base diameter and more outward projection than the medium or lower projections.
What is the value of breast implant projection? In theory, more fullness of the upper breast can be achieved with high projections and less of a tear-drop in a side view. This is of use in women who want larger implants but whose base measurement of the implant exceeds the width of their own breast. High projection implants allow bigger implants to be placed without having them be too wide or get in the way of arm movement. They are also of value for the patient who is interested in a rounder breast shape as opposed to a more ‘natural’ tear drop breast shape.
While adding the choice of projections to the many different breast implant sizes, this has tripled the number of available breast implant options.While the shape of a breast implant is important, it does not solely determine the final breast shape after implant augmentation. How tight or loose one’s breast skin is and how much breast skin one has probably plays as important a role in determining breast shape as that of the implant.
Dr. Barry Eppley
Indianapolis, Indiana