Breast Augmentation Blog

Going under the knife. Where to cut?

Submitted by Liz S Admin on Sat, 09/15/2012 - 10:29

There are various kinds of plastic surgery that can be performed. Ranging from abdominoplasty (“tummy tuck”) to rhinoplasty (“nose job”), but one of the most popular ones, especially among women, is breast augmentation.

Deciding on what type of breast implants to use is not the only difficult decision to make. Plastic surgery after all is a surgical procedure that requires making incisions on the skin. Scaring is typical after an incision is performed and it is unavoidable. Deciding where an incision will be done will determine where the scaring will be located. In a breast augmentation, the three commonly performed incisions are the infra-mammary incision, the peri-areolar incision, and the trans-axillary incision.

The infra-mammary incision is an incision that is done in the breast fold, which is the crease under the breast where it meets the chest. This is the most common incision in that it offers the plastic surgeon direct visual access making it easier to place the breast implants. Both silicone and saline breast implants can be inserted through this incision. If using silicone breast implants, this incision is preferred, especially if they are large sized ones.

The peri-areolar incision is done on the lower border of the nipple, where it will be hidden between the darker colour of the nipple and the lighter colour of the skin. Both implants can be inserted, but the size of silicone implants may be restricted depending on the border and size of the areola. This incision also gives the plastic surgeon direct visual access.

The trans-axillary incision is an incision done in the armpit. The scar can be noticeable when a woman wears sleeveless clothes. Saline breast implants are preferred over silicone breast implants when this incision is done. It is very hard to position large silicone breast implants and there is no direct visual access for the plastic surgeon. Small silicone breast implants are a better option when using this incision.

Regardless of the incision that is made, a scar will follow. It is an unavoidable end result of a breast augmentation but after obtaining the desired breast size, shape, and look, the scaring will be forgotten with time as the new breasts will steal the spotlight.

Cup Size Dilemma: Local Anesthesia?

Submitted by Liz S Admin on Fri, 08/31/2012 - 00:13

Having the chance to increase a cup size or two is quite invigorating. The problem is, not knowing which breast size would look best. A woman can only imagine what her breasts would look like in a B-cup or a C-cup, but will only see the physical change after the breast implants have been inserted. To make a wise decision and have a satisfying result, it is important to consult with an experienced board certified plastic surgeon before surgery. Use his knowledge and experience to guide you in your decisions. An experienced surgeon will listen diligently and will work to find the appropriately sized implant to safely achieve your desires. An interactive rapport with your breast specialist is important. Inadequate communication is the most common cause of angst and upset from either too large or small implants.

Be sure to know your doctors credentials. Do not assume that the doctor offering breast augmentation is a board certified plastic surgeon. Some may not even have had formal surgical training in a reputable institution. Because of their limited surgical training, access to deliver full anesthetic and surgical procedures may be restricted. Some unscrupulous providers attempt to conceal this deficiency by promoting local anesthesia for breast augmentation. Such marketing schemes are touted as less expensive and more accurate breast implant sizing under local anesthesia so that the awake patient can participate in final implant sizing while on the operating table. 

The purpose of putting patients under general anesthesia is so that they won’t feel any pain during the procedure. A patient is rendered unconscious and the body relaxes. Another type of anesthesia is called local anesthesia and only a part of the body becomes insensitive to pain.  An anesthesiologist is required on site when performing surgeries that require general anesthesia but not local anesthesia. With local anesthesia expense is reduced as there is no longer a need to pay for an anesthesiologist. But is it safe? Without the specialist in anesthesia, the doctor performing the procedure now is responsible for the anesthesia as well as the technical aspects of surgery. It’s very risky in fact when a doctor promotes the use of local anesthesia during breast augmentation. Unfortunately, this downplays the seriousness of surgery. Surgery has inherent risks. 

Not only is pain better controlled by general anesthesia, a stable controlled environment permits the plastic surgeon to focus his efforts to achieving the best aesthetic outcome under safe conditions. Sure it would be great to see the doctor model the breast implants and check them in an overhead mirror, but what happens if something were to suddenly go wrong during the surgery? Would it be worthwhile afterwards? Even under local anesthesia, a patient is still a bit fuzzy in the head. Are they really making a wise decision when choosing their breast implants? It’s almost like drinking and driving which leads to impaired vision and judgment.


It’s risky business when a doctor promotes the use of local anesthesia to improve breast sizing during a breast augmentation.

Q: I Am 5'0, 125 Pounds is 440 in One Breast & 480 in Another Too Big for my Petite Frame?

Submitted by Q-A from clee on Wed, 06/22/2011 - 11:57

Met w/a surgeon today. I am 5'0, 125 pounds, chest width 34, hips 36.5, waist 30. Told him I liked the 400-450 implants after trying them on. At first he thought that would be too big for me. Then he changed his mind & recommended 440 in one & 480 in another due to one breast being larger than the other with a high profile implant (saline). Do you think I will look to big on a petite frame...should I go smaller?

A: Might be large for your stature

There is a great deal of subjectivity to the desirable sizing of breast implants in augmentation mammoplasty. One good rule of thumb is to choose implant dimensions not to exceed the base width of your natural breasts. This will prevent your augmented outer edge of the breast from bulging outward toward the inner aspect of your arm. I would recommend you review with your surgeon the implant footprint dimensions against your breast base dimensions so that the breast base width is not exceeded.

Q:How long after"Popping" the Implant with Needle Should You Wait to Get Explant?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:20

I want to get my D cup size 10 year old implants removed as soon as possible. I was unhappy from day one but have been afraid to do it. I'm now psychologically prepared for the surgery and for what I'm going to look like after and it's well worth it to me. My question is - I plan to have them "popped" in a couple weeks in-office. After they are deflated with the needle, how long should I wait to get the actual implants removed? I don't know if I want a lift or not.

A: Popping them before surgery brings on more risk

Popping them before surgery brings on more risk. Proceeding straight to surgery for removal is preferable. If there is a desire to minimize the scar, the implant can be deflated under direct vision at the time of explanation.

Q: 3 Important Rules After a Breast Augmentation?

Submitted by Q-A from clee on Fri, 06/17/2011 - 00:59

While recovering from breast surgery, what are the top 3 things rules that patients need to follow.

A: Breast Augmentation Recovery and Healing

There are many extrinsic factors/rules that may influence your outcome following a breast augmentation. However, prioritizing it to the 3 most important "rules" necessitates it to be specific to your personal situation.

Q: How Many CC Will Make These Sad Boobs Happy with out a Lift?

Submitted by Q-A from clee on Thu, 06/16/2011 - 23:50

I know immediate answer is Lift them , But if I was to just want to go large and get the lift in say 5-10 years what size CC would fill them up? I am going to get the nipple reduced either way, Thank you

A: For a desirable outcome refocus on the breast lift

For a desirable outcome, refocus on the breast lift. An augmentation will not correct ptosis and may actually accentuate problems with continued sagging of breasts.

Q: What Breast Lift is Recommended if You Already Have an Augmentation?

Submitted by Q-A from clee on Wed, 06/15/2011 - 03:02

i am 26 years old, 136 pounds, and 5'2" with a 450cc breast augment. my breasts just seem too saggy and i am unhappy with them. i want a lift to perk them up and would like to know what lift would be recommended.

A: Nipple position is not improved by breast augmentation

Sagging with low nipple position on the breast mound is not improved with breast augmentation. Depending on the degree of descent of your nipple a breast lift may offer improvement to your breast appearance.

Q: 6 Weeks Post Op from Breast Lift with Implants- Rash on Nipples & Breasts

Submitted by Q-A from clee on Wed, 06/15/2011 - 02:57

real scaley. the skin around my nipples is a red rash. my incision goes around my nipples, down my breasts, and across the bottom. this appeared about 2 weeks post op

A: Most likely cause is contact dermatitis

It is difficult to be precise with the diagnosis without more information (i.e. photos). The possible causes include low grade skin infection, skin maceration and irritation, allergic contact dermatitis. Based on your description contact dermatitis is highly probable. A return visit to your surgeon is advised.

Q: Is It Possible to Get a Slight Reduction and Add a Small Implant to Get Upper Pole Fullness?

Submitted by Q-A from clee on Tue, 06/14/2011 - 19:12

I'm a saggy 36DD and would like to be a full C/small D, but I really love the fake look that implants give, so I want implants for upper pole fullness. Is this possible?

A: Implants with mastopexy are reasonable choice for the smaller breast

Implants with mastopexy are reasonable with smaller ptotic breasts with upper pole flatness. While this technique can be used with large breasts, the heavy weight of a large breast makes a recurrent deformity or "waterfall" deformity from descent of the breast tissue over the implant a potential long-term problem. In the large breast with flat upper pole, I recommend a superior pedicle breast reduction similar to that of the vertical mammoplasty as described by Lejour. Depending on your breast size and shape desires options to consider include that of a small implant versus a superior pedicle reduction mammoplasty.

Q: Augmentation and Lift 4 Years Ago. Will Breasts Sag if I Remove Implants?

Submitted by Q-A from clee on Sun, 06/12/2011 - 21:54

I Have Had my Implants Aprox 4 Years I Got 390cc with a Lift Done I Want Them Removed Will I Still Sag Even with the Lift I Had?

A: Depends on your residual breast tissue

Following implant removal, sagging might occur if the size of implants is vastly larger than your normal breasts, if you have lost weight, if you had children, amount of breast tissue you have, your skin elasticity, and aging.