Breast Augmentation: What techniques and methods can be used?

Wilberto Cortes Plastic Surgeon | Plastic and Reconstructive Surgery Houston, Texas

Dr. Wilberto Cortes is a plastic surgeon who practices in Houston, Texas. He received numerous awards and distinctions during college and graduated Magna Cum Laude. As he pursued his dream of becoming a plastic surgeon, he was accepted at Ponce School of Medicine, a U.S. accredited medical school located in Ponce, Puerto... more

Breast Augmentation

If your breasts are smaller, flatter, poorly shaped, or asymmetrical, the breast augmentation procedure may help treat the condition. Many women want to have bigger and shapelier breasts, but not all women have this look naturally. This is where breast augmentation surgery comes in. Breast augmentation is the most popular and effective plastic surgery procedure to increase the size of the breasts and make them shapelier.

Breast augmentation is a major operation. There are two methods to augment the breasts: breast implant surgery and fat transfer to the breasts. Breast implant surgery is more common and popular among women in the U.S. Each of these methods involves the use of different surgical and incision techniques. In this article, we will discuss the methods of breast augmentation and the techniques used for each method.

Breast implant surgery

Breast implant surgery is a very popular plastic surgery procedure to augment the breasts. The surgery involves the use of prosthetic implants to make the breasts fuller and shapelier. There are two types of breast implants: silicone and saline.

The silicone implant is more commonly used. It is made of a silicone shell that comes pre-filled with silicone gel. On the other hand, the saline implant comprises a silicone shell, which is filled with a saline solution after inserting it inside the breasts.

Both of these implants come in different sizes and shapes. The size and shape ideal for you would be determined during the consultation with the plastic surgeon. The doctor will examine your breasts and know your aesthetic goals before recommending you an ideal implant size. Be sure to choose an implant size and shape that complements your overall body outline and can be easily accommodated by your breast dimensions.

The silicone implant provides more natural and long-lasting results. However, the implants and the achieved results are not permanent. The implants would rupture or leak after 10-20 years. You would be required to have the ruptured implants removed and replaced after a rupture or leak.

Anesthesia administration: Breast implant surgery is performed under general anesthesia. A board-certified anesthesiologist will administer the anesthesia. The anesthesia will keep you comfortable throughout the surgery. Under general anesthesia, you will remain asleep throughout the operation.

Incision techniques for breast implant surgery: In the second step of the operation, incisions will be placed on your breasts in order to insert the implants inside. The choice of incision would determine the shape, size, and visibility of the resulting scar; therefore, you must be sure to ask the doctor what type of incision would be placed on the breasts during the operation. You may ask the doctor how the resulting scars will look like.

If the plastic surgeon is experienced, trusted, and board-certified, he will explain the incision to you, the reason for using the specific incision, and how would the resulting scar appears. A good surgeon will always place the incisions in places where they are less visible and can be easily camouflaged.

Incision techniques for breast implant surgery

1. Inframammary incision – Under this technique, the incisions are placed underneath the breasts so the resulting scars can be hidden. In other words, the resulting scar will appear on the fold where the base of the breast meets the chest wall. The incision is relatively shorter, which would result in the development of a thin scar of 1-2 inches. The scar would be perfectly camouflaged within the fold. This is one of the commonly used incision techniques because it comes with many benefits. It involves a wider access point, which lets the plastic surgeon insert even bigger implants inside the breasts with greater accuracy.

2. Periareolar incisions – Under this technique, the incisions are placed around the areola. The doctor will ensure to place the incision around the exterior edge of the darker skin surrounding the nipple. As a result, the scar will be perfectly camouflaged within the natural alteration in the skin color. This incision technique is mostly employed where a breast implant surgery is performed in association with some type of breast lift.

3. Trans-axillary incisions – This technique involves incisions in the armpit. This technique is used where the patient wants a perfectly hidden scar. However, this incision is used when you are getting a saline implant. A silicone implant cannot be inserted through a trans-axillary incision. Under this technique, a tiny incision is placed within the patient’s armpit, and the implant is inserted inside the breasts with the help of a special camera and special instruments. There will be no scar on the breast. In order to achieve better results with this method, the plastic surgeon must be highly experienced in the trans-axillary incision technique.

4. Trans-umbilical incisions – This technique is less common. Under this technique, an incision is placed in the abdomen of the patient, and the implant is inserted into the breasts through the abdominal incision. Again, this technique is suitable only for the insertion of the saline implant. You will not get any scar on your breast if this technique is used.

Implant placement techniques

After inserting the implants inside the breasts, the plastic surgeon will place them in the intended pockets. There are two options when it comes to placing the implants inside the breasts: sub-glandular placement and sub-muscular placement.

• Sub-glandular placement – Under this technique, the implant is placed over the breast muscle but under the mammary gland. This placement option is less popular because the risk of capsular contracture, implant palpability, and implant rippling is higher.

• Sub-muscular placement – Under this option, the implant is placed underneath the breast muscle and the mammary gland. Most plastic surgeons recommend this option because it offers more tissue coverage to the implants, thus reducing the risk of implant rippling and palpability and capsular contracture.

Closing the incisions

After placing the implants in the intended pockets, the plastic surgeon will suture and close the incision. You will notice some improvement in the shape and size of your breasts right after the intervention; however, complete outcomes would be noticeable after the post-operative swelling has disappeared, the incisions have fully healed, and the implants have settled. This will take a few months. The final results would show in the form of bigger, voluptuous, and shapelier breasts. 

Fat transfer breast augmentation

Fat transfer breast augmentation is also a reliable and effective method to augment the breasts. Unlike the implant surgery that uses foreign objects to add projection to your breasts, the fat transfer procedure involves the use of your own body fat to enhance your breasts. In order to qualify for this procedure, you need to have excess fat in your body.

With this method, you can increase your breast projection to a mild degree. Its primary goal is to make the breasts shapelier rather than increase the breast size considerably. The results of the fat transfer are relatively more natural than implant surgery because it uses your own body fat to enhance your breasts. The surgery is also relatively safer. 

Fat transfer surgery technique

Fat extraction: The surgery starts with the removal of excess fat from different areas of the body. The common fat donor sites include the abdomen, sides, flanks, thighs, back, and upper back. Liposuction is performed on the fat donor sites to extract the fat. Special techniques are used for fat removal to ensure the majority of the fat is removed unharmed and alive.

Fat processing: In the second step, the centrifuge technique is used to treat the removed fat. During the process, the impurities, damaged and dead fat cells, and fluids are removed. Only the healthy, alive, and best quality fat cells are retained for transfer to the breasts.

Fat grafting: The last step involves the actual transfer of the fat cells to the breasts. The fat cells are carefully grafted in the breasts with a tiny needle. This step involves meticulous work and calls for attention to detail. Besides specialized surgical techniques, the plastic surgeon will use his sense of aesthetics and artistry to deliver you the desired outcomes. The final outcomes of this intervention would transpire after a few months.

Breast augmentation

Breast augmentation is a plastic surgery procedure to make the breasts fuller and shapelier. There are two methods to perform breast augmentation. These methods have been explained in detail above. Each method involves different surgical techniques. The surgical techniques have also been discussed at length in this article. During the initial consultation, patients should be sure to ask their plastic surgeons what method and techniques of breast augmentation would be used in the operation. Also, make sure to choose only a board-certified plastic surgeon to perform your breast augmentation surgery.