By Shahram Salemy, MD
The American Society of Plastic Surgeons has recently noted that more women than ever before are opting for some type of breast enhancement procedure. Traditionally, women think of getting implants as the only way to enhance the look of their breasts, but this is actually not the case. In fact, breast lift surgeries are outpacing implant surgeries by 2 to 1.
You may have seen terms like breast lift, breast augmentation and breast implants used interchangeably. To help shed some light on these procedures, this article will explain the differences and who can benefit most from each.
Breast Augmentation and Breast Implant
What is it?
Breast augmentation and breast implant surgery are two names for what is essentially the same procedure. These cosmetic surgeries involve placing silicone or saline implants into the breast in order to enhance size, shape and volume. You may also see fat transfer referenced under the umbrella of breast augmentation, but this option is less common.
Who is it for?
All breast implants are FDA-approved for healthy patients who meet minimum age requirements. Healthy patients who are at least 18 years old may opt for saline implants, but they are not eligible for silicone until they turn 22.
Breast augmentation is primarily for women who hope to increase the overall size of their breasts. The procedure is also beneficial to patients who want volume or shape enhancements. Women who have experienced pregnancy or significant weight loss may also opt for this surgery to restore lost fullness.
What’s the end result?
The end result depends on many factors, including the size, shape and material you choose for your implants as well as your overall body shape. However, the general end result of breast augmentation is perkier, fuller breasts that are more symmetrical and appealing.
Most women report that their clothing and bras fit better, and many feel a lasting boost to their self-confidence.
Breast Lift
What is it?
A breast lift does not involve implants at all. Rather, the surgeon manipulates the existing breast tissue in order to lift and tighten the breast. This gives your breasts a more natural contour and improves any sagging, drooping or mild asymmetry you may be experiencing due to factors such as age, pregnancy or illness.
Who is it for?
Breast lifts are most beneficial to women who are only seeking to restore some of the natural youthfulness of their breasts. Because this procedure does not add volume, it gives a very natural look and feel, which is a nice option for women who already have a
good amount of natural breast tissue. It simply makes the breasts look firmer, perkier and more youthful.
What’s the end result?
The end result of a breast lift is much more subtle and natural than an implant surgery. You can think of it like turning back the hands of time to when your breasts were optimally firm and perky. However, it will not increase the fullness of the top of your breasts or increase your cup size – something only implants can do.
Can I get breast implants and a breast lift?
It is becoming increasingly popular for women to combine breast augmentation with a breast lift procedure.
Women who have had children often benefit the most from this combined procedure because of the significant changes their bodies undergo during and after pregnancy. It’s common for mothers to experience a loss of shape and volume after giving birth and breastfeeding, making such women who want to increase the fullness and perkiness of their breasts excellent candidates for a lift plus augmentation.
How do I know which procedure is right for me?
It can be difficult to know exactly which procedure or combination of procedures will help you achieve your aesthetic goals. Consulting with a professional, board-certified plastic surgeon will help you make that determination, get a realistic idea of what can be
achieved, and tailor a treatment that’s specific to your unique body and goals.
Whether you opt for breast augmentation, a simple breast lift or a combination of both, you can feel confident in knowing that you will be on the path to looking and feeling your absolute best.
Five common breast augmentation questions answered by Rod Rohrich, MD, FACS
1. Why do you put breast implants below the muscle?
There is very good scientific evidence in medical literature to show that breast implants look more natural and feel better if placed below the muscle. It also does not obscure mammography and there is good evidence-based data to support that the implants stay softer longer by a significant margin if placed below the muscle.
2. Does the number of cc’s in a breast implant correlate with the breast size?
It usually does not since it depends on the size of breast that you are beginning with. The resulting cup size does not directly correlate with the implant size. Just as different sizes, whether it is a B, C, or D cup, vary from patient to patient and from retailer to retailer, there is no way to guarantee that one will have B, C, or D cup breasts after implants.
The goal is to make them proportionate to the patient’s chest wall diameter, the amount of breast tissue the patient has and the size and shape. It is very important not to over-augment patients, as they will then have further movement of their breast tissue out to the outside which will cause distortion and the breast will look too large for the patient’s body and chest wall.
3. How can one breast be hard and the other breast be soft?
Yes, this can occur since it is not known what is the real cause of capsular contracture (breast implant hardness). It is uncommon for capsular contracture to occur, especially with saline implants below the muscle, but if saline implants do get hard they will begin getting hard earlier than later – usually in the first several months.
If silicone implants get hard, they will get hard progressively over time. One can attempt to do early aggressive breast massaging for perhaps 6-8 weeks. However, if capsule contracture develops then a simple inferior capsulotomy or release of the scar tissue may be all that is needed, especially with saline implants, to restore shape and symmetry. This is done easily as an outpatient under IV sedation.
4. What is the potential for loss of nipple sensation on one side and not the other?
It is not uncommon to have some sensory changes after breast augmentation, especially if there is a larger implant. Most of the time, sensation does return, especially if placed below the muscle, therefore, one should wait 3-6 months for the sensation to return. However, it is acceptable to have some nipple sensation loss with breast augmentation. The ratio of sensory loss from breast augmentation is 5-10% with the inframammary fold incision having the lowest ratio of nipple sensation loss.
5. How do you make cleavage with breast implants?
It is somewhat a myth that breast implants will create significant cleavage. It depends more on the shape of your breasts and the diameter of your breasts preoperatively, as well as the degree of breast augmentation and the amount of breast tissue that you have. Often, if you have an average chest wall size, there is a better chance for having improved cleavage. However, it is not a guarantee and just increasing the size does not necessarily increase breast cleavage. It is actually counterintuitive since the implant actually pushes the breast to the side, diminishing the amount of cleavage one would anticipate .
