Breast Augmentation Before & Afters

If you’re considering breast implant surgery there are many decisions to make: How large should the implants be? Should they be round or teardrop shaped? Should the implants be filled with saline or silicone?

Each of these decisions should be made together with your plastic surgeon, and will depend on your age, weight, body type and personal goals.

Where are the incisions located for breast augmentation?

The choice of where the incisions will be made during breast augmentation surgery is a major decision that needs to be discussed with your plastic surgeon. Three common locations for breast implant insertion are: under the breasts (“inframammary incisions”), via incisions in the armpits (“transaxillary”), and through the areolae (“periareolar incisions”). Each location has its advantages and disadvantages. Your plastic surgeon will make a recommendation on which approach he or she feels is best for you based on your specific case and goals.

Inframammary incisions

The most common location for incisions during breast augmentation surgery is the natural fold under the breasts. This approach is called an inframammary insertion. After recovery, the scars from an inframammary implant insertion are concealed under the fold of the breast. With time these scars typically fade to match the color of the surrounding skin. Most plastic surgeons prefer inframammary insertion over the other options because the technique allows for a high level of control and accuracy -- minimizing the risk of error.

Transaxillary insertion

Many patients prefer the transaxillary approach to breast implant insertion. Transaxillary incisions are made in the armpits, far away from the breasts. The advantage of the transaxillary approach is that no scars are left near the breasts. Following this technique, only saline implants can be used, which are inserted empty and filled with saline once they have been positioned.

The transaxillary technique is popular among women who intend to have children, as it’s less likely to cause damage to the breast tissue compared with other insertion techniques. The risks associated with transaxillary insertion are that the technique is more likely to cause nerve damage or result in malposition or asymmetry.

Periareolar incisions

A periareolar incision is made around the outside of the areola. This technique is popular because the scars tend to heal extremely well. These scars, placed right at the border between the areola and the breast skin, often heal to the point where they are nearly invisible.

Periareolar incisions are not optimal for patients with very small areolas. For patients with average to large sized areolas, insertion through the areolas is a good choice and can be used with both saline and silicone implants.

Breast enlargement through a periareolar incision comes with a slightly higher risk of capsular contracture than the more common inframammary incision.  

What are the different shapes of breast implant?

Breast implants come in two basic shapes: round and teardrop. During your initial consultation, your plastic surgeon will likely discuss the pros and cons of each implant shape and make a specific recommendation based on your body type and cosmetic surgery goals.

Round breast implants

The most common choice of implant shape is the round implant. Round implants result in well-rounded, beautifully shaped breasts which are less likely to be felt internally. Round implants can either have a smooth or textured exterior. 

Shaped breast implants

Shaped implants (also called “anatomic implants”) are saline or silicone implants which have a more natural teardrop shape. They also have a textured surface which allows them to bind more cohesively to the surrounding tissue after implantation. This binding action keeps shaped implants positioned correctly after breast augmentation, minimizing the risk of rotation.

Which sizes of breast implants are available?

Breast implants come in a wide variety of sizes, ranging from small (140cc) to 800cc -- the maximum size legally available in the United.States. The amount of projection in a breast implant determines the distance the breast will extend outwards from the body. Typically breast implant projection is classified into low profile, moderate profile, and high profile shapes.

Keep in mind that it's not possible to go from a starting 'A' cup size to a 'DD' cup with just one augmentation procedure. Patients wishing to go from small to very large sizes are advised to undergo multiple procedures over a period of several years. 

Overfilling saline implants

While it's not possible to buy implants in the United States that are over 800cc, some doctors and clinics will "overfill" implants to extra large sizes of 2000cc and higher.

The decision of whether they’ll do this is obviously up to each individual plastic surgeon, taking into account the patient's age, body frame, overall health and existing bust size.

Overfilled breast implants can carry additional risks, including back pain, infection, capsular contracture, rupture and loss of sensitivity.

Botched breast augmentation surgery

There are potential risks associated with breast augmentation surgery, including rippling, capsular contracture, implant deflation and scarring. In the event something does go wrong, you should talk to your plastic surgeon about a revision surgery -- although you may have to wait six months or more before a revision is possible.

Always consult with a board-certified plastic surgeon to ensure you get the best results.

Related cosmetic procedures

Other common plastic surgery procedures to improve or repair the contour of the breasts include breast lift surgery and breast reconstruction surgery.

A fat transfer mammoplasty is a different type of breast augmentation procedure which transfers fat from one location of the body to the breasts in order to improve their contour.

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