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Once you have chosen to undergo breast augmentation with implants, you will be faced with many decisions. What size implant are you interested in? Would you rather have silicone or saline implants? What exactly is a gummy bear implant? Where should your implants be placed, under the muscle or on top? Where should your incisions be placed? What implant shape will be best for my anatomy? How can I imagine what I might look like after surgery?

Being faced with all of these choices may seem daunting, but it doesn’t have to be. Every option will provide safe and effective results, and it is our goal to help you determine which choices best fit your desires and lifestyle. Since these decisions result in slightly different aesthetics, it is important to understand how they can alter your outcome.

Portrait of female doctor choosing mammary prosthesis with her patient

Material Choice

Breast implants are available in either silicone or saline. The different implants may offer a different feel in breasts that do not have as much tissue. On the other hand, in breasts with more tissue and coverage, you might not feel either implant.

Silicone implants consist of a silicone outer shell filled with silicone gel and will provide you with a more natural appearance as they both look and feel more like your natural breast tissue. Gummy bear implants are a type of silicone implant that have the firmest gel and may be round or tear-dropped shape in order to provide a more natural appearance and to keep a certain shape. Two other types of silicone gel implants offer a softer feel.

Saline implants consist of a silicone shell filled with sterile saltwater (saline). A smaller incision is often made since the implants are filled up once inside the body and can be adjusted if there is significant asymmetry of the breast sizes.

Sizing Options

The size of your implants will affect your appearance more than any other decision. Breast implants come in a variety of sizes that range from minimal enhancement to a full breast makeover. Every woman undergoing augmentation knows they want fuller, more voluptuous breasts, but the degree of enhancement is something you should take some time to consider. When choosing an implant size, you should consider both your body frame and lifestyle.

A woman who has a small frame will have more sizing limitations if they are trying to maintain a natural look. Small to moderate implants on a small frame can create significant enhancement without altering the overall balance of the body and without creating posture complications. Just as naturally large breasts can put a strain on your posture, so can overly large implants.

Women who are very active (such as athletes, women who participate in vigorous exercise multiple times a week, or bodybuilders) may want to choose smaller implants as these implants will not affect their ability to exercise or participate in the sports and activities they love.

Implant Placement

When it comes to placing your implants, you can decide between subglandular (above the muscle) or submuscular (below the muscle) placement. This choice will affect the final appearance of your breasts. Many women choose to have their implants placed beneath the chest muscle to allow for a more natural look and feel.

Submuscular placement does, however, create a higher chance of implant distortion when the pectoral muscles are flexed, and therefore may not be ideal for bodybuilders or extremely athletic women. If this sounds like you, you may want to consider subglandular placement. Placing the implant above the muscle creates an augmented look with more cleavage but wrinkling may be more visible.

Incisions

While the incision location will have the least impact on your visible results, it will affect the scar that results from the surgery. The periareolar incision (incision made around the areola) will provide the least amount of scarring since the scar is camouflaged by the areola. This choice, however, will have the highest risk of affecting your ability to breastfeed in the future.

Other options include the inframammary incision (along with the breast crease) or the transaxillary incision (in the armpit). While these incision options will not affect your milk ducts, they will create more visible scarring outside of bikini line areas.

Dr. Chin will determine which incision would be optimal for your breast shape since redraping the tissues adequately over the implants may be done better through certain incisions.

Implant Shape

There are shaped implants (teardrop) that can add different dimensions to the breast. However, the shaped implants can turn and rotate distorting the breast shape. Round implants can rotate but since they are circular, the shape is consistent. Based on the anatomy of your chest and your desires for side breast, projection, cleavage, and fullness different profiles are available to give you the shape of the breast you desire. The diameter or width, as well as the projection, are used to determine which implants best fit your anatomic dimensions. Different shapes allow different sizes to be chosen.

How Will I Look After Surgery?

Dr. Chin will take a computer photograph using the VECTRA® XT 3D computer simulation of your chest and can choose from a variety of implant sizes and shapes and “morph” your breasts so that you can get an idea of what your breasts may look like after surgery. This also allows him to point out differences in your breast size, shape, and symmetry and to help you understand the limits of your anatomy, chest dimensions, and breast tissue so that you can choose from implant sizes that suit your body and desired look.