Breast augmentation surgery remains one of the most popular cosmetic plastic surgery procedures. Fortunately there have been some recent developments for your benefit. It has been 10 years since silicone (gel) filled implants were again made available for cosmetic surgery. While they had remained available for reconstruction after mastectomy, the FDA released them again in 2006 for general use after exhaustive studies failed to prove conclusively that serious medical risk existed with gel implants. While saline filled implants are still widely used, their numbers have decreased in favor of the gels which feel more natural, may feel lighter and have less rippling. One of the obstacles to gels is that they are pre-filled and may require a longer incision to place than saline implants which are filled at surgery. This problem has been addressed quite simplistically with a clever invention known as the Keller Funnel which acts as a lubricated “pastry funnel” type device to allow insertion through a smaller opening. A more recent and significant development has been the availability of “anatomic” shaped implants (rather than round) especially in the US.
A recent study regarding the aesthetics of breast augmentation has been quite “eye opening” in the plastic surgery community. Drs. Patrick Mallucci and Olivier Branford of the Cadogan Clinic in England published the paper, “Population Analysis of the Perfect Breast: A Morphometric Analysis”, in the prestigious Plastic and Reconstructive Surgery journal in September 2014.
Their methods involved assessing a cross section of observer’s aesthetic judgment of breast appearance and attractiveness. The key variable was the relative balance of upper to lower breast fullness and its impact on breast attractiveness. The authors had postulated from an earlier study that a ratio of 45% upper and 55% lower was the most “ideal”. In their survey of over 1300 viewers, this ratio was judged to be the most appealing. Clearly, beauty is in the eye of the beholder and therefore many variations on that balance are to be expected. Interestingly, many plastic surgeons and patients opt for more upper fullness (a more “fake” look). Certainly, surgeon judgment and skill is most important to achieve great results with any type of implant, including round (most common) and shaped (less common). However, especially in light of the widely quoted study of Drs. Mallucci and Branford, the recent more widespread use of shaped (“teardrop” or “anatomic”) gel implants in the US (they have been available for much longer in Europe) has the potential to achieve the more ”perfect” aesthetic balance of enhanced lower fullness without an overly rounded and full upper breast appearance.
Typically breast augmentation surgery is performed in a certified office operating room or an outpatient surgery center. The procedure takes around one hour and the recovery is quick. Most women return to work within 3-5 days, most routine activities within 7-10 days and may resume regular exercise by 3-4 weeks.
If you are considering surgery, it is best to “do your homework”. Speak to your family physician or Ob/Gyn for recommendations of plastic surgeons certified by the American Board of Plastic Surgery with a good reputation in the community. Ask family or friends for referrals. Research on line can be overwhelming as there is a glut of information and it can be difficult to sort out. Two trusted sources of information are the American Society of Plastic Surgeons (www.plasticsurgery.org) and the American Society for Aesthetic Plastic Surgery (www.surgery.org). Finally, schedule at least one consultation, bring all of your questions and be sure that they are all answered to your satisfaction before proceeding. A minimum of two visits with your plastic surgeon is recommended prior to surgery.
