The most sophisticated approach to breast augmentation is through the armpit with a surgical camera (transaxillary endoscopic). Using this modern approach the space can be crafted under direct vision, with virtually no bleeding and no postoperative bruising. Most importantly, the shape of the breast is meticulously created. The other, older methods of insertion are technologically less advanced. Both silicone and saline implants can be placed through the armpit by a surgeon with skill and experience using this approach. The incision in the crease is the oldest method of placing the implants and puts a scar directly on the breast.
A round implant would be a better choice because they move more like breasts. The anatomic implants have a textured surface which makes them feel very unnatural. In addition, there is no benefit to anatomical. There is an X-Ray study that shows the implants from the side at 6 months. Standing, the round and the antomical implants have the same profile. When you lie down however, the anatomical implants do not change, which is unnatural. A round implant will change when you lie down, like a natural breast would.
HP implants, which are a more modern shape than moderate profile implants, fit most women better. They have a more appropriate base diameter and can be made to look very natural or very augmented, depending on where in the range the implants are filled to achieve a particular volume. High profile implants are the first choice in my opinion. I rarely find an indication to use moderate or moderate plus implants. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume, and where in the range the implant is filled.
There are many advantages to sub muscular dual plane placement and very many disadvantages to sub glandular placement. I would see no indication to do anything but sub muscular dual plane. Subglandular silicone implant placement is the historical approach to this surgery, and was widely used in the 1960's. The implant edges are more visible, the risk of rippling is higher, the implant is in contact with the non-sterile breast tissue so the risk of infection and capsular contracture is higher. The interface between the breast tissue and the muscle is blurred so the implant interferes with mammography more than sub muscular placement. The blood supply surrounding the implant is worse so the risk of capsular contracture is higher. The support for the implant is less so there is more long term shape abnormalities and sagging. The look of a sub glandular implant is much less appealing than a sub muscular implant. The placement of sub glandular implants makes any subsequent revision surgeries more complicated and less successful. There are no advantages to sub glandular implant placement.
The choice between saline and silicone is one that requires a complex discussion of all of the advantages and disadvantages of both implants. The issues to be considered are safety, density, mobility, rippling, rupture rate, consequences of rupture, detection of rupture, need for follow-up care, cost of follow-up, appearance, feel, sensation of heaviness, radio-density, mammograms, and costs, among other things. There are advantages and disadvantages of both products. The decision will ultimately be up to you based on what is appropriate for your particular situation. Beautiful results can be obtained with either implant.
The best way to determine the size that fits your personal perception of the perfect breast is to try on sizers. This way you can see how they fit on you, how they add to your current volume, and whether they fit your frame. Although the surgeon can guide you, only you will be able to tell what is the right size. Try on sizers. Measuring a diameter and then telling the patient what volume they can have (in high, moderate or moderate plus implants) in my mind is backwards. The patients should be allowed to choose the volume. Then the surgeon carefully considers the base diameter, projection, profile, manufacturer, and fill material that will achieve the patients goals of size as well as qualitative look (natural, intermediate, or bold upper pole fullness or projection), all the while taking into consideration the patient's anatomic features that will affect the outcome. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of implant. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size. There is no maximum. That is up to you.
Breast augmentation candidate, some advices:
Thanks for the question.
You are a good candidate for breast augmentation. In my practice for cases like yours I prefer to use the Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.Kind regards
Thank you for your question.If you feel that your breasts are too small, I recommend you contact a board certified plastic surgeon in your area to discuss options. Best wishes.
Breast Augmentation Candidate
To discuss the options for Breast Augmentation I recommend that you book an in-person consultation with a board certified Plastic Surgeon in your area.
All the best
Hi Sophie, From your foto it appears that you can increase the size of your breasts if you think they are too small.. At your consultation you can discuss the size you are interested in and see if it is achievable. There is a maximium reasonable size for all patients depending on the measurements of their breast and tissue characteristics. Bigger is not always better.
Breast Augmentation - Candidate?
Thank you for your question. Please discuss your concerns with your board certified plastic surgeon. Ask to see before and after photos to get an idea of what can be achieved with breast augmentation surgery. Hope this helps and good luck!
GreetingsThank you for your question, i recommed for you to have breast Augmentation.Breast augmentation operation is performed in order to increase the size of breast. Size and shape of breasts can often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic surgeon.
It is important for you to understand that you don’t always need a breast implant for breast augmentation. As it was also mentioned above you can also get bigger and natural breasts with Cihantimur Fat Transfer method. In this method we use own fat tissue of the patient in order to increase the size of the breast. Since this tissue is your own tissue there is no risk for any adverse effects. It is safe and fast operation that yields natural results without any incision.
from the photos you included, you are a great candidate for breast enlargement. this procedure will give you increased size and volume and projection. it is up to you to decide how much improvement you want. seek the advice of a BCPS.
Breast Augmentation using silicone implants
Hello, thank you for your question and photo. You're a great candidate for a breast augmentation using silicone implants. It is a safe procedure that can give you a well balanced and proportioned body. Search for a local certified PS for a correct treatment.
Breast augmentation alone
It looks like you are a good candidate for a breast augmentation. See a board certified plastic surgeon ASAPS member. Get Vectra imaging and try on implants on a tight bra. Good luck...