Best method for breast augmentation for older woman?

Question

I’m wondering what the best method of breast augmentation would be for aging skin ( woman in 60s) to ensure it looks as natural as possible ie don’t want the shape of the implant being noticeable under thinner skin?

Elisa A. Burgess, MD · Answer

We have many patients in the 50+ year old range that undergo breast augmentation. For many patients, they finally have a few minutes for themselves since their children are a little older. Many have started to or have undergone menopause, so their breasts are changing and losing volume. The skin may be a little loose so they want to undergo often a small breast augmentation to look comfortable in clothing and bathing suits. We have all kinds of natural styles of implants to customize a look for a patient. We even have Crisalix, a 3D imaging system so a patient can see what they might look like after augmentation.Make sure to visit someone with a lot of experience in breast augmentation that has board certification in plastic surgery.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Breast augmentation using an implant can have a natural look and shape in a wide age range of patients if good technique is used.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Donovan Rosas, MD · Answer

There numerous decisions which need to be made when considering breast augmentation: implant type, profile, volume, incision, over vs. under. Each will have an impact on the final outcome.While age does necessarily limit these choices, tissue quality varies with age and will be taken into account when making decisions.With regards to your specific question, when there is a concern surrounding a lack of native breast tissue/thin skin for camouflaging the device...submuscular is preferred. This will offer greater coverage and impart a more "natural" result.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Lawrence Scott Ennis, MD, FACS · Answer

Congratulations on doing something for yourself! I have had patients well into their 60's and 70's desiring breast augmentation. For my patients, I recommend the underarm incision for best results. Patients are curious about how this advanced Transaxillary Breast Augmentation procedure differs from typical breast augmentation surgery. The difference boils down to how the implant is placed. Rather than cutting an incision in the fold under the breast or around the nipple, a small incision is made in the crease of the armpit. An HD endoscopic camera is inserted to examine the pocket and then the implant is placed the under the pectoral muscle which offers an incredibly natural look.

Todd B. Koch, MD · Answer

In older individuals I would recommend smaller implants to keep the results as natural as possible.  If you have adequate soft tissue coverage I would place the implants on top of the muscle.  This approach offers less pain and faster recovery.  If there is any history of breast tissue pathology then I would place the implants under the muscle. Best of luck.

Adolfo Sesto, MD · Answer

Thanks for your question, Best method for Breast Augmentation at  any age is the submuscular placing of the implant. It will provide a very natural look and will avoid migration in long term .Member of the American Society of Plastic Surgeons (ASPS)Member of the International Society of Aesthetic Plastic Surgery (ISAPS)Certified Plastic and Reconstructive Surgeon.

Tom J. Pousti, MD · Answer

Thank you for the question.  I think it is in the best interests of most patients (all ages) seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 
On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Robert Whitfield, MD · Answer

It is important to have a physical exam first and foremost.  Thin patients are always going to be encouraged to have implants placed behind the muscle to help provide more tissue coverage for the device.

Best method for breast augmentation for older woman?

Answers (8)

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