Breast Implant Selection

Proper Breast Implant Selection

The enhanced breast should be natural-looking and proportionate in size with the woman’s height, weight and overall body build. The implant should provide the breast with a gently sloping appearance and should be reasonably soft allowing the breast to move naturally with normal body movements. There is no “one size fits all” rule, nor is there “one shape fits all” rule in breast augmentation. Implant selection should be individualized to each patient.

But it is important to realize that breast implants simply make a woman’s breasts larger. When sized for a natural-looking result, implants do not alter the structural architecture of the breast.  The reality is that a woman’s individual anatomy will dictate her final appearance and result.  If you look carefully at the following pictures you can see how the enhanced post-op result closely resembles the pre-op shape.

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The pre-operative consultation should include a physical examination which focuses on the woman’s breast size, shape, and tissue characteristics. This biodimensional approach to surgical planning can dramatically reduce risks for undesirable results and complications following breast augmentation. After evaluating and quantifying a woman’s breast and tissue characteristics, it is important to explain how her specific desires could be affected or limited by those characteristics. Appropriate pre-operative sizing allows the surgeon and patient to communicate more effectively about the anticipated breast size. This improves a woman’s expectations for the result she will obtain, and minimizes complaints about improper sizing post-operatively.

Excessively large implants are arguably the single greatest cause of compromised results, morbidity, complications, and reoperations following breast augmentation. Women should understand the potential long-term effects of larger breast implants, and how that might impact their future risk for undesirable results, complications, and/or reoperations. For most women, limiting implant volume to less than or equal to 350cc would in all likelihood reduce the incidence of future complications and reoperations. Excessive enlargement by breast augmentation can cause stretching and thinning of the breast skin and subcutaneous tissue, implant edge visibility, implant palpability, or rippling, breast tissue atrophy, breast drooping, and excessive ‘bottoming out’ of the breast. Improved results in breast augmentation can be achieved by appropriate patient selection, detailed tissue evaluation, consideration of long-term implant-soft tissue interactions, and (optimal) implant selection based upon the woman’s tissue characteristics.

Breast implant shape  and size may be more important in thin individuals with small breasts, where the implant accounts for the major portion of the volume of the augmented breast. And it is in these women that the implant fill material may play a very important role in breast aesthetics; silicone gel-filled implants may produce a softer breast with less chance for implant visibility and rippling. Patients should understand the differences between saline- and silicone gel-filled breast implants so they can make an informed decision to select the type of implant they are comfortable living with.


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