Achieving Natural Results in Breast Augmentation
The image of a beautiful breast will vary greatly, dependent upon a woman’s perspective and tastes. I have found in consultation with patients that it is actually easier to have a woman describe what they don’t want their breasts to look like…and then work from there to figure out exactly what is acceptable to them. As I consult with patients here in Indianapolis on breast augmentation, I emphasize the following points.
In general, the focus on what is achievable in most breast augmentations is primarily on mound creation (big or small), mound shape (round or tear-drop), and cleavage….in exactly that order. Many variables of a breast we as plastic surgeons cannot control, such as the quality of the skin, how widely spaced are the breasts, breast asymmetry, differences in nipple shape and position, the chest wall shape, and the length of the torso.
Mound size is, obviously, highly influenced by the size of the implant. While any implant size can be placed in most women, it is desireable that the base diameter of the breast implant not exceed the natural width of one’s breast base. This keeps from having the breast implant being too far to the side. If more size is needed than one’s breast base diameter will accomodate, then a high-profile type implant should be used. More implant going forward, less to the side. The same principle applies to loose skin or saggy breasts, a higher-profile implant will pick up slightly more skin.
Mound shape, while influenced by a breast implant’s projection (low, moderate, high) is also controlled by the quality and amount of the overlying skin. The tighter and smaller a woman’s breasts are to begin with, the more likely the final breast shape will be more round, regardless of the implant projection used. Looser, more sagging breasts will just not end up with a round, very full breast, unless the breast implant is exceedingly large. While it is good to have different breast implant projection styles, it is my opinion that the amount and quality of the breast skin is the single most important issue that controls a round vs tear-drop breast shape after breast augmentation.
Cleavage is always an issue for most women, as no woman wants a wide space between the two breast implants. It is important to remember, however, that in most cases cleavage is ultimately made by a bra. It is unusual to create, by the placement of breast implants, a lot of cleavage. It is difficult and often ill-advised to release a lot of the pectoralis muscle to get the breast implants very close. Quite simply, widely-spaced breasts will end up with breast implants that are not that close together.
Understanding these basic issues of what breast augmentation can do is important in providing a patient with realistic expectations after breast augmentation. The key point is…you can make a woman’s natural breast bigger through breast implants, but breast augmentation can not alter some of the features that nature has already given the breast.
Dr. Barry Eppley
Indianapolis, Indiana