Breast augmentation with implants is a very personal decision that many women think about for years before actually choosing to proceed with surgery. Many women considering breast augmentation have always been unhappy with the size and shape of their breasts and wish to improve the harmony between their upper and lower body. Other women were perhaps comfortable with their breasts at one time, but because of aging, pregnancy, or weight gain and loss, have become displeased with the changes in breast size and firmness they have experienced. Both of these types of women are perfect candidates for breast augmentation. Dr. Jaime Perez, a board-certified, plastic surgeon at the Plastic Surgery Center of Tampa offers a variety of surgical approaches and techniques to make each woman’s dreams of beautiful, perky breasts a reality.
While a seemingly simple procedure, there are actually many decisions to be made for those considering breast augmentation.
Breast Implant Size-
The first questions most patients ask when considering breast augmentation with breast implants, is “What size of breast implant should I get?” The answer, of course, varies depending on each patient depending on their goals, body habits, current breast volume, and degree of breast sagging. In the warmer climates of the United States, like Florida, Texas, and California, average implant size ranges from approximately 300cc to 425cc. In the Northeast and Midwest, the average breast implant size is slightly smaller, at around 250cc to 350cc. The average breast implant size is still smaller in other parts of the world like Europe and Asia, averaging 200cc to 300cc.
As a general rule, an average-framed woman within her ideal body mass index with an A- or B-cup breast size that desires to be a full C-cup size after breast augmentation will likely require at least a 300cc sized breast implant. Patients with a wider chest or more beginning breast volume will require a larger implant for each desired gain in cup size. Small-framed patients with small beginning breasts and a tight skin envelope will require a smaller breast implant.
How to Choose the Correct Breast Implant Size-
Dr. Jaime Perez and his staff at the Plastic Surgery Center of Tampa understand that each woman wants the best results possible when considering breast augmentation with breast implants. In order to choose the correct size, Dr. Perez listens carefully to each patient she meets in consultation to first understand their surgical goals, lifestyle, and particular concerns regarding breast augmentation. After a detailed and open conversation, patients view before and after breast augmentation photos of previous breast implant patients performed at the Plastic Surgery Center of Tampa. This allows Dr. Perez to understand the nuances and specific likes and dislikes of each patient considering breast augmentation. Dr. Jaime Perez then carefully examines each patient, taking note of current breast size, nipple position, skin tightness, and symmetry.
After this detailed conversation and thorough examination, Dr. Perez will have an idea of the breast implant size range appropriate for each patient to meet their desired postoperative breast size. Patients then try on a range of implants prior to the actual surgery date in order to further narrow down her ideal breast implant size. Finally, after gaining a thorough understanding of each patient’s desires, goals, and anatomy, and taking into account each patient’s preferences and input, Dr. Perez selects the best breast implant size, custom-fit for each patient, during surgery.
Silicone or Saline Breast Implants-
Silicone breast implants have been available for cosmetic breast augmentation since 2006. Since that time, the vast majority of breast implants placed by Dr. Jaime Perez at the Plastic Surgery Center of Tampa are silicone implants. Most patients and plastic surgeons feel that these newer, safe silicone breast implants provide a more natural feel than saline implants.
Silicone breast implants are best for patients with thin, overlying breast tissues, where the palpability and rippling often associated with saline breast implants could be an issue. Additionally, patients particularly concerned with the “feel” of their augmented breast will likely benefit from silicone breast implants. Because rupture of a silicone breast implant is difficult to detect by clinical examination, the U.S. Food and Drug Administration recommends routine monitoring of silicone breast implants with an MRI three years after placement, then every other year thereafter.
Saline breast implants are best for patient with an adequate amount of overlying breast tissue, particularly when placed in an “under the muscle” position. Patients who wish to have a very large breast implant placed through the normal, short 3-4cm incision, will also require a saline breast implant that can be inflated after it is placed inside the body. Furthermore, patients who want to be able to detect breast implant rupture on clinical exam or who are uncomfortable with silicone breast implants will be better served with saline breast implants.
Silicone and saline breast implants have similar rupture and complication rates. Dr. Jaime Perez helps each patient make an informed decision between silicone and saline breast implants that they will be comfortable with for years to come.
Breast Augmentation Scar Location-
Each woman’s body and desires are different, and thus not every woman should have the same incision or scar location when undergoing breast augmentation with breast implants. Dr. Jaime Perez is comfortable with each common type of breast augmentation scar placement and can individualize her technique to the patient’s anatomy and goals. At the Plastic Surgery Center of Tampa, Dr. Perez offers breast implant placement through an incision in the armpit, around the nipple, or under the breast.
Breast augmentation through an armpit incision (i.e. transaxillary breast augmentation) is best for patients with small breasts who have no sagging and lack a well-defined crease underneath the breast (i.e. inframammary fold). This approach for breast augmentation uses an endoscope for accurate breast implant placement and avoids scars on the breast.
Breast implants placed though an incision around the nipple (i.e. periareolar incision) are best for patients who may need a breast lift at the same time as breast augmentation or for those patients with a relatively large nipple diameter.
A breast augmentation scar placed in the crease under the breast (i.e. inframammary fold) is best for patients with a well-defined breast crease or a small degree of sagging. This approach allows the plastic surgeon direct access to the breast implant pocket.
Breast Implants Above or Below the Muscle-
During breast augmentation, breast implants can be placed above (subglandular) or below (submuscular) the pectoralis major muscle. In the United States, most breast implants are placed in a submuscular or subpectoral position. Dr. Jaime Perez is familiar with both breast implant positions and can recommend the best implant placement to give patients beautiful, long-lasting results.
Very thin patients with little overlying breast tissue generally do best with a breast implant placed under the pectoralis muscle. The overlying pectoralis muscle decreases palpability, visible rippling, and provides an additional layer of tissue to “camouflage” the breast implant. Some patients will experience varying degrees of breast implant movement with contraction of the pectoralis major muscle after breast augmentation.
Patients with adequate breast volume, a small degree of ptosis, or avid weight-lifters may choose breast implants placed above the pectoralis muscle. This location decreases breast implant movement with pectoralis major muscle contraction and may better correct small degrees of breast sagging while minimizing the need for a breast lift. Patients with very thin overlying breast tissue, however, are not good candidates for breast implants placed over the muscle due to increased implant palpability and visible rippling.