Choosing implant size in breast augmentation

Choice of right implant size is most decisive in breast augmentation surgery.

Although generally it is a procedure heralds an extremely high degree of patient satisfaction, many patients tell me that that if they did the procedure again they would go to a larger size.

To request a smaller size is very unusual.

Most patients tell me the like the swollen look directly after the operation, and are a bit disappointed with the size decrease once the swelling goes. Dissatisfaction with breast size remains the number one cause for re-operation in breast augmentation.

I tell every patient not to go into breast augmentation requesting a specific breast size and cup size because fixation on a ceratin cup size, which differentiates from the final size, can lead to dissatisfaction with your final result.

I routinely show patients pictures of the effects certain implant sizes have on certain breasts,making clear that the result of a breast enlargement cannot be bought “off-the-shelf”

I avoid the use of sizing implants, except for special request. since the look distracts from the final result.

Cup size measurement is extremelyinaccurate but as a rule of thumb every 150-200 cc’s of volume you will go up a cup size. Bear in mind that is a rough estimate.

Remember that breast augmentation cannot or only moderately alter anatomical fix points such as distance between nipples and gap between breasts, these things can be influenced, but not on a “you-wish-I–deliver”basis. Some anatomical variables have to be taken into account.

I personally regard breast augmentation as one of the operations with the highest degree of patient satisfaction, and as long as abovementioned considerations are taken into account, I intend to keep it that way.

Dr.Alexander Amir  Aslani, MD, EBOPRAS

Hospital:
Chief Surgeon and Head of Department
Department of Plastic, Aesthetic and Reconstructive Surgery
Hospital Quiron Malaga
Avda.Imperio Argentina, 1
E-29004 Malaga
Spain
www.quiron.es

Private practice:
Cirumed Clinic
Avda.Ramon y Cajal 7-4°
E-29601 Marbella/Malaga
Spain
Phone:+34 607 307 515
info@cirumed.es
www.cirumed.es

Incision placement in breast enlargement

What is the perfect incision placement for breast augmentation ?

Well, there is none. There is different options, the most popular ones being

1.The armpit. This is a very elegant approach, implying the the breast implant is brought in through an incision in the armpit. I personally have used it for quite a while and on very special patient request I still do, but a few points have to be taken into account. Firstly, the skin of the armpit can impossibly be made sterile, so there is a higher risk of infection, secondly, I have had patients who, after axilar breast enlargement, reported certain restrictions in movement to me. This has to be taken into account.

2.The nipple. In planning breast enlargement, I guess half of the patient is very keen to have their incision through the nipple and half are terrified just by the thought of that. there are really very different views on that. Since I personally only use cohesive gel implants, a certain size of the nipple is necessar. This does not have to be excessive but should be sufficient to accommodate a 3cm cut along the lower nipple border.The scar will fade with any of the three incisions mentioned, but probably quickest here.

3.The inframammary crease. Great advantage of this incision in breast enlargement is that it heralds the smallest risk of infection, and the inframammary fold can be planned very accurately.Length of incision is normally around 3-4 cm.

Case example from our practice:

Patient with very little breast tissue and small nipple

Athletic, desire for substantial augmentation

Patient requested cohesive gel implants

Therefore nipple no suitable option

Post op result

Inframmary, submuscular augmentation

300cc moderate profile round coheisve gel implants

6 months post op inframmary incision not visible

Preoperative A cup, postoperative C-cup

There are some exotic variations like endoscopic approaches through the  bellybutton just to name one example, who I feel make restricted sense from the physiological point of view since when placing a foreign body large dissection pathes make the procedure somewhat more risky.

In Spain, breast augmentation remains the most popular aesthetic surgical procedure.

Dr.Alexander Amir  Aslani, MD, EBOPRAS

Hospital:
Chief Surgeon and Head of Department
Department of Plastic, Aesthetic and Reconstructive Surgery
Hospital Quiron Malaga
Avda.Imperio Argentina, 1
E-29004 Malaga
Spain
www.quiron.es

Private practice:
Cirumed Clinic
Avda.Ramon y Cajal 7-4°
E-29601 Marbella/Malaga
Spain
Phone:+34 607 307 515
info@cirumed.es
www.cirumed.es