Breast Implants
This page is intended to give you a useful way of thinking as you research your options as well as dispelling some common myths. This section is somewhat of a mini-version of Dr. Tavin's breast augmentation/implant consult and is more informative than simply viewing before and after pictures, but rather serves as a resource for advice.
Most women arrive thinking they want to increase their breast size so they could wear a particular bra cup size. This way of thinking is actually exactly the opposite of the way women should approach breast enlargement.
All women know that there are certain brands of bras that fit them better than others. How can a plastic surgeon offer to place implants so that the woman can wear a “C” cup after surgery? Is that a Victoria’s Secret “C” cup, a Bali“C” cup, or a Wal-Mart “C” cup?
Most women have a mental image of how they would like to look after surgery. I have my patients “try on” different implants in front of a mirror to let them choose how they would like to look. You wouldn’t buy a pair of fancy Christian Louboutin or Jimmy Choo shoes without trying them on first. Since implants are a long-term investment, and in the same price range, why wouldn’t you try them on before purchasing? After surgery, my patients buy the size and brand of bra that fits their new look, not vice versa.
Breast Implant Size
No one implant correlates with a particular postoperative breast size or shape or bra cup size. Just because you like the way your friend looks with her 300 cc implants does not mean you will look the same with the same size implants. Rib cage size and shape, actual breast tissue volume, chest muscle thickness, thickness of fat layer, and elasticity of skin all contribute to the size and shape of a woman’s breasts.
Breast Implant Cohesiveness
Over the past several years implant manufacturers have developed more cohesive implants with thicker gels meant to address the issue of rippling and lack of upper pole fullness. Some of these newer implants are referred to as “gummy bear implants”. There is a trade off- to achieve more upper pole fullness and minimize rippling, these implants are somewhat firmer than the standard gel implants. Doctor Tavin offers patients the opportunity to squeeze samples of each of these implants to help them choose the implant that meets their goals and even mimics the “feel” of their own breasts. We now have the ability to work in four dimensions with our breast augmentation patients-volume, width/height, projection, and feel.
Breast Implant Placement
Another important factor in choosing the right breast implant is placement. You will need to decide whether your implants will be below or above the chest muscle. There is certainly less postoperative discomfort (we surgeons don’t like to use the word “pain”) when implants are placed above the muscle.
Breast implants are squeezed a little flatter when placed under the pectoralis muscle, but this is preferable to visible implant edges that can appear when implants are placed above the muscle in women who are very thin and start out with very little breast tissue.
Most women have slight differences in size and shape of their breasts. These differences will likely remain and may even be accentuated by breast enlargement.
All implants have solid silicone shells (outer walls). The implant is filled with either saline (salt water) or silicone gel (that has the consistency of Jell-O). If the implant will make up half or more of the volume of the enlarged breasts, silicone filled implants will usually feel softer and more natural than saline. All women will form a wall of scar around a breast implant. In some women, for reasons we do not know, the scar can thicken and harden (known as capsule contracture). Capsules can harden, implants don’t. Hard capsules may require further surgery.
Breast Implant Replacement
No implant lasts forever. That said, there is no truth to the Internet myth that implants should be replaced every ten years. With proper care, and as long as the implants do not have any signs of distress, they can remain inside the body.
Textured implants will still sit up when a woman lies down. Some women may prefer this look, but it's important to note they do wear out sooner than smooth walled implants so be prepared to have textured implants replaced.
Breast Lift
Did pregnancy or breast feeding get you down- literally? A woman’s nipples should be at the summit or high point of the breast. If not, the breasts should be lifted. This can be done at the time of implant placement or at a later surgery.
Breast implants alone may not be sufficient. Trying to center nipples that are too low over implants that are too large is never a successful long term solution. On Earth we cannot outlaw gravity or aging. Bigger is not always better. Even Pamela Anderson has decided to downsize a bit. A breast lift can help defy the effects that age or gravity have on the human body and can refresh your overall look.
To learn more about breast enhancements, contact our office. Women over 35- don’t forget you need a mammogram before surgery.
Before And After Photos
27-year-old woman. 5'3" 120 lbs. 1 child. 32-B bra. 300cc moderate plus profile textured gel implants were placed under the muscle through an inframammary fold incision. Currently wearing a 32-C bra. Photos taken 10 months postoperative.
34-year-old woman. 5' 10" 155 lbs. 4 children. 34-B bra. 425cc moderate plus profile gel implants were placed above the muscle through an inframammary fold incision. Currently wearing a 34-D bra. Photos taken 6 months postoperative.
50 years old. 5'2" 138 lbs. Has 5 children, and recently lost 25 lbs. Previously wore C-cup bra. 350cc moderate plus profile gel implants were placed above the muscle, and a vertical-glandular mastopexy was performed. Currently wears D-cup bra.
41 year old woman 5'4" 120 lbs. who lost 20 pounds over past year. She has had 2 children and wears an 32A cup bra. She is seen 8 months after placement of 480cc Ultra High Profile implants below the muscle. She now wears a 32DD bra.
32 year old woman 5'6" 145 lbs. who has had two children. She lost volume with the pregnancies. She is wearing a 34C bra, but does not fill the cups. Post-op photos are 7 months after placement of 300cc Moderate Plus Profile silicone implants above the muscle. Note filling of upper pole and subtle lifting effect that is achieved.
26 year old woman. 5'5" 140 lbs. 2 children. 36-B bra. 400cc moderate plus profile gel implants placed under the muscle through an inframammary fold incision. 1 year post-operative and currently wears a 36-D bra.
37 year old woman. 5'8" 125 lbs. 2 children. 34-B bra. 400cc moderate plus profile gel implants were placed under the muscle through an inframammary fold incision. Currently wearing 34-D bra.
41-year-old woman. 5'4" 125 lbs. 2 children. Postoperative photographs taken 6 months after placement of smooth round moderate plus gel implants under the pectoralis major muscle through an inframammary fold incision. She is currently wearing a D-cup bra.
41-year-old woman 5'3" 129 lbs. 2 children. Postoperative photographs taken 1 year after placement of smooth round high-profile saline implants under the pectoralis major muscle through an inframammary fold incision. A 300cc implant was filled to 300cc on the right and 310cc on the left. She is currently wearing a C-cup bra.
40-year-old woman. 5'7" 155 lbs. 1 child. Postoperative photographs taken 5 months after placement of smooth round moderate plus saline implants in the subglandular position through an inframammary fold incision. Left periareolar breast lift was done to improve symmetry of areola size and shape. A 425cc implant was filled to 445cc on the right and 425cc on the left. She is currently wearing a DD-cup bra.
38-year-old woman, 5'4" 117 lbs. 2 children. 34-A bra preop. 300cc high profile gel implants were placed under the muscle through an inframammary fold incision. She has textured implants due to her work out regimen. Mastopexies were suggested to the patient, but she is happy at this time. Currently wearing a 34-C bra. Photos taken 6 months postoperative.
40-year-old woman, 5'5" 150 lbs. 1 child. 34-B bra preop. 350cc moderate plus profile gel, textured, implants were placed above her muscle through an inframammary fold incision. Currently wearing a 34-C bra. Photos taken 6 months postoperative.
37 year old woman. 5'7" 145 lbs. Has 1 child. Previously wore B-cup bra. Textured 400cc moderate plus profile implants were placed above the muscle. Currently wears DD-cup bra. Photos taken 6 months postoperative.
73 years old. 5'2" 154 lbs. Has 1 child. Previously wore a B-cup bra. Textured 450cc moderate plus profile implants were placed above the muscle, and a vertical glandular mastopexy was performed. Currently wears D-cup bra. Photos taken 2 months postoperative.
30 year old woman. 5’2”, 127 lbs. A-cup bra. Patient chose Sientra HSC+ 355 Moderate Plus implants, placed above the muscle through an inframammary fold incision. Her left breast was slightly larger than her right, so she had a small reduction/lift done only on her left breast. Currently C-cup bra. Photos taken 1 year post-op.