What Can Breast Augmentation Address?
Breast augmentation may be considered by patients seeking to:
- Increase breast volume
- Restore fullness after pregnancy or weight change
- Improve balance between breasts of different sizes
- Increase upper-breast fullness
- Improve breast proportions relative to the chest and body
- Correct selected developmental differences
- Replace or revise existing breast implants
The procedure cannot guarantee a particular cup size, perfect symmetry, a scar-free result, or a specific appearance.
Breast implants add volume but do not always correct loose skin or a low nipple position. When breast drooping is a significant concern, Dr. Robey may discuss a breast lift with or without implants.
What Are the Main Breast Augmentation Options?
The appropriate option depends on your goals, anatomy, breast tissue, skin quality, degree of drooping, health history, and willingness to accept the risks and maintenance associated with each choice.
Saline Breast Implants
Saline implants have a silicone outer shell filled with sterile saltwater.
For cosmetic breast augmentation, FDA approval begins at age 18 for saline-filled implants. If a saline implant ruptures, it generally loses volume as saline leaks from the shell.
Silicone Gel Breast Implants
Silicone gel-filled implants have a silicone outer shell containing silicone gel. Implant cohesiveness, size, shape, profile, and other features vary by manufacturer and model.
For cosmetic breast augmentation, FDA approval begins at age 22 for silicone gel-filled implants. A rupture may not produce an obvious visual change, which is why long-term rupture screening is discussed with patients receiving silicone implants.
Fat Transfer to the Breasts
Fat transfer uses liposuction to collect fat from another area of the body and transfer selected fat cells to the breasts.
It may be considered for a more modest increase in volume or for selected contour concerns. Fat survival is variable, and the procedure has its own risks and limitations.
Breast Augmentation With a Lift
A breast lift may be considered when loose skin, a low nipple position, or breast drooping will not be adequately addressed by implants alone.
Combining a lift with implants adds scars and may change the risks, recovery, and cost of surgery.
How Are Implant Size and Profile Chosen?
Implant selection should not be based on cup size alone. Bra sizing is not standardized, and the same implant can look different on different patients.
During surgical planning, Dr. Robey may consider:
- Chest and breast width
- Existing breast volume
- Skin and tissue thickness
- Breast asymmetry
- Nipple position
- Degree of skin looseness
- Implant width and projection
- Desired degree of fullness
- Lifestyle and physical activity
- Risk of visible or palpable implant edges
- Long-term effects of implant weight on the tissues
- Whether a lift or another procedure should be considered
Implant sizers or other planning methods may help you discuss your preferences, but they cannot guarantee the final appearance or exact postoperative cup size.
Implant Placement and Incision Planning
Breast implants may be placed beneath the chest muscle, above the muscle, or in another tissue plane selected for the patient’s anatomy and surgical plan.
Each placement has potential advantages, limitations, and tradeoffs involving:
- Tissue coverage
- Implant visibility or palpability
- Rippling
- Movement with chest-muscle contraction
- Recovery discomfort
- Mammographic imaging
- Future revision surgery
- Capsular contracture
- Long-term breast-tissue changes
The incision location also affects the scar, surgical access, and some risks. Dr. Robey will discuss the incision and implant position recommended for your anatomy.
No placement or incision can eliminate all implant-related risks.
When Additional Internal Support May Be Discussed
Some patients with thin, stretched, or weakened tissues may be offered an additional internal-support material.
Possible materials may include absorbable synthetic mesh, acellular dermal matrix, or the patient’s own tissue.
When additional support is proposed, ask:
- Why it is being recommended
- What material would be used
- Whether the proposed use is FDA-cleared or an off-label use
- What evidence supports the recommendation
- What risks are specific to the material
- Whether the material can become infected or require removal
- What alternatives are available
- Whether it adds cost
- Whether it changes future imaging or revision surgery
Additional support does not eliminate gravity, aging, tissue stretching, implant complications, or the possibility of future surgery.
