Breast augmentation surgery will always make a dramatic difference in the size of your breasts but the final shape may be a different matter. It is common for me to see patients who bring in pictures of what they want their breasts to look like, taken from magazines and internet sites. And while these images are tremendously helpful to me in understanding what size breast a patient wants, such pictures can also be misleading to the patient if they believe that their breast shape may look the same as that illustrated.
In general, the final breast shape after implant placement is heavily controlled by what your breast shape was before surgery. This may be hard for some patients to envision as their breast may be flat, droopy, or otherwise undesireable. But the components of one’s breast that may not be well appreciated when they are smaller, will become much more appreciated when they are larger. And we as plastic surgeons can not alter significantly the basic blueprint of the breast shape. For example, if you have little breast tissue (A or small B cup) and your breast skin is tight, you will likely end up with a rounder shape to your breast no matter what size implant or what type implant projection is used. As another example, if you have a a droopy breast where the nipple hangs over the breast fold, you will likely have a crease (temporary or permanent) above the new lower breast fold after surgery. Since an implant requires that your existing breast fold must be lower (so that the implant is not too high and the nipple is centered on the implant), your lifelong lower breast fold skin crease may take a while to go away after surgery. Or in some cases, this skin crease may not completely go away at all. As a final example, slight asymmetries between the breasts (while maybe small and unnoticeable before surgery) may become accentuated as the breasts get larger. This can affect the symmetry of the horizontal level of the nipples or the horizontal level of the lower breast fold.
It is critically important for every patient to take a critical assessment of their breasts before breast augmentation surgery with their plastic surgeon at the time of their consultation. Besides noting breast differences, it is also important to have a realistic assessment of what the final breast shape may be. Discuss with your plastic surgeon what you like about the breast shapes you have viewed and whether your breasts will have that final look. Breast implants make the breast bigger but your chest skin, nipple shape and position, breast width, and the level of the lower breast fold are far more important to the final breast shape than the surgical technique used to place them.
Dr. Barry Eppley
Indianapolis, Indiana