Breast augmentation is a very personal decision that over 2 million U.S. women have made and an additional 300,000 women choose to have done each year in the U.S. alone. Each woman has different goals and desires and there are choices available which can help a woman achieve those goals.
Implant Size: This is the most obvious choice. Implants range from relatively small to very, very large. The size of the implant added to the size of the breast will determine the final breast size. Every woman has a size that she would like to be and there are enough implant choices to achieve nearly all desires. However, choosing a large implant can have certain consequences. Discuss these details with your plastic surgeon.
Implant Shape: Traditionally, most breast implants are round and this gives a perfectly satisfactory result for most women. There is also the option of a shaped implant. These implants are typically fuller at the bottom and can be taller than wide or wider than tall depending upon the build of the woman. They offer the greatest benefit when the size of the implant is large compared to the size of the breast or when the breasts are naturally small. There is a common misconception that these implants can give the breasts the appearance of sagging. They do not.
Silicone or Saline: Implants can be filled with silicone or saline (IV fluid). Both these implants are safe. The silicone implants are softer and tend to offer a more natural look to the breast. Saline implants tend to be slightly firmer and tend to create a more rounded appearance to the upper portion of the breast.
Placement of Incision: There are three common choices for the incision used to place a breast implant. These are under the breast, around the areola, and in the armpit. It is a personal choice but I think many plastic surgeons would agree that the incision under the breast offers the most straightforward approach with the most consistent and reliable results.
Placement of the Implant Above or Below the Muscle: Breast implants may be placed either above the chest wall muscle (pectoralis major) or below this muscle. There are advantages and disadvantages for each approach and one method may be preferred depending upon the woman’s build and implant choice.
When consulting your plastic surgeon about a breast augmentation, discuss each of these choices with your doctor. Ask questions and with your surgeon decide which of these choices would be best for you. For the best results, seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery (www.surgery.org) will all be board certified in plastic surgery and have demonstrated an interest and competence in cosmetic plastic surgery as well.