June 29th, 2012 Dr. Mele
With the introduction of high-strength, highly cohesive, gummy-bear, silicone gel breast implants comes the ability to make breast implants with an intrinsic teardrop shape. Since the “ideal” breast has a teardrop shape, a breast implant that mimics this shape seems ideal, but is it?
Teardrop Shaped Breast Implants
Teardrop Shaped Breast Implants give Plastic Surgeons the ability to better influence not only the size, but to a limited extent, the shape of the breast too. By preferentially adding volume to the lower pole, a flat breast can become more teardrop shaped. By altering the vertical and horizontal diameter of the breast implant, a better match for taller and wider chests is possible.
Teardrop Shaped Breast Implants Before and After Photos
Breast Augmentation Before and After Photos using shaped breast implants.
The Breast Augmentation shown above was performed with Teardrop Shaped Breast Implants. These particular breast implants are taller than they are wide to better fit a taller torso. The teardrop shape allows for a gradual increase fullness from the upper aspect down to the lower breast. The asymmetrical cross-section allows more augmentation at the base, without adding excess width. Enhanced filling in the lower pole allows for enhanced projection beneath the nipple and better definition of the curve below the breasts. The importance of this is greatest when there is very little native breast tissue. The teardrop shaped breast implants pictured above were placed via an incision in the inframammary fold (the crease beneath the breast).
Round Breast Implants
Round Breast Implants can also give a teardrop shaped Breast Augmentation. Round breast implants add volume to the upper and lower pole of the breasts. When the pre-surgical breast is flat up top, but has fullness in the lower pole, placing a round breast implant can get a teardrop shaped breast augmentation. The best results for round breast implant breast augmentation are seen when the breast implant is placed behind the pectoralis major muscle (submuscular breast augmentation).
Submuscular Breast Augmentation with Round Breast Implants
The pectoralis major muscle helps to taper the augmentation in the upper pole of the breast. This results in a smoother transition from chest wall to breast, and helps minimize the abrupt half-a-coconut appearance more often seen in subglandular breast augmentation – when the breast implants is placed in front of the muscle.
Submuscular Breast Augmentation Before and After Pictures – Round Breast Implants
Breast Augmentation Before and After Pictures: Submuscular breast augmentation with smooth round breast implants. Notice the smooth transition from chest to breast at the top of the breast. The abrupt, well- defined transition is saved for the lower pole of the breast.
The above patient has a small amount of breast tissue before her Breast Augmentation. By placing a smooth round breast implant behind the muscle, a larger and teardrop shaped breast is created. An abrupt, sexy curve is maintained along the bottom of the breast. When enhanced upper pole fullness is desired, a pushup bra can be used to make the upper breast more full or even round.
Subglandular Breast Augmentation with Round Breast Implants
If enough breast tissue exists in front of the muscle, it is possible to get a teardrop shaped breast augmentation with round breast implants placed in front of the muscle. However, when less breast tissue is present, the shape of the implant begins to dominate. This is most often seen in female body builders. Since they have very little body fat, and breast tissue, there is very little to disguise the breast implant.
Female body builders, who have had breast augmentation, often have the breast implants placed in front of the muscle. This subglandular placement minimizes breast implant motion during competition, when the chest muscles are flexing maximally. The result of breast augmentation in front of the muscle can be seen monthly on the covers of muscle and fitness magazines, i.e. fairly round breasts.
They go by various less than flattering names including the “fake look” or “bolt ons.” The main problem is that the chest of a body builder is both overdeveloped, and lacking. The chest muscle is large; however, the breast tissue is smaller than the average woman’s. The combination results in the need to use larger breast implant volumes under thinner “soft tissue” coverage, and makes for rather obvious breast implants. In this situation, rounder implants give rounder results, and this can happen, to a lesser extent, even when the breast implant is placed underneath the muscle.
Submuscular Breast Augmentation with Round Breast Implant (Thin Coverage) Before and After Pictures
Submuscular Breast Augmentation with thin “soft tissue” coverage.
In the above patient, a smooth round breast implant was placed behind a thin pectoralis major muscle. With thinner soft tissue coverage, the upper pole of the breast can become more abrupt. In many cases, a teardrop shaped implant can provide a smoother transition.
Subglandular Breast Augmentation with Round Breast Implant (Thin Coverage)
With the Breast Implants in front of the muscle, there is less “soft tissue” coverage. The result is an even more obvious breast implant, and the larger the implant, the more obvious the augmentation. There can be advantages to this technique, and the tradeoffs may be worthwhile when evaluated on an individual basis.
For body builders, placing the breast implant in front of the muscle minimizes the deformity seen with flexion, and this is good for competition judging. Prepectoral placement also allows for lower placement on the chest, which can sometimes obviate, or at least delay, the need for a breast lift with breast augmentetion.
Subgladular Breast Augmentation with Round Breast Implant (Thin Coverage) Before and After Pictures
Submuscular Breast Augmentation with Round Breast Implant (Thin Coverage) Before and After Pictures
The above patient had her breast implants placed in front of the muscle via a periareolar incision. In her case, the risk of a flexion deformity was minimized, and a breast lift was not necessary. By placing the breast implant in front of the muscle, the implant could be placed at the inframammary fold (lower than the lower edge of her well developed pectoralis muscle) to fill the lower pole of the breast and avoid a double-bubble deformity. A dual-plane approach could provide similar positioning, but with a greater risk of flexion deformity. The cosmetic result could be enhanced with a teardrop shaped implant, or submuscular placement for a woman who is not a body building competitor.
Breast Augmentation Options
Breast Augmentation has evolved a great deal over the last 50 years. There are many options available to you in terms of incisions, breast implants and breast implant placement. While this blog, and my other websites, are designed to give you a good idea what the options are, they cannot take the place of a well thought out, in person, consultation with a Board Certified Plastic Surgeon. If you are considering Breast Implants seek a Board Certified Plastic Surgeon with a broad experience in multiple techniques of Breast Augmentation.
I realize this blog reaches around the country and the world. Referrals from friends, family or your primary doctor should be coupled with a visit to the agencies in your area that license physicians and surgeons and your National Plastic Surgery Professional Societies. In the US, just click on what you want to do:
Check if your doctor is Board Certified by the American Board of Plastic Surgery.
Check if your doctor is Board Certified by another American Board of Medical Specialties board. You will need to register to use this site, but it is safe, free and fast.
Check if your doctor has an unrestricted California Medical License. Read the disclaimer and click “Continue to Search” at the bottom. If you are not in California, Google your local medical board for a link.
If you are in the San Francisco Bay Area, I would be happy to see you in my Walnut Creek, CA office. Just give us a call at (925) 943-6353, or use the contact form to the left.
Posted in Breast Augmentation, Breast Implant Options, Home | No Comments »
June 8th, 2012 Dr. Mele
The next generation of breast implants is still searching for its generic name. They have been called cohesive gels, gummy bears, highly-cohesive gels, form-stable, memory-gels and the latest entry is, high-strength silicone gel. Whatever the final name, the main difference between these new silicone gel breast implants, and their predecessors is the stuff inside. While “new stuff inside” already sounds like marketing, it’s not very descriptive when compared to the current terminology. Let me see if I can explain how we got here.
The "New Stuff Inside" is Sientra's High-Strength Silicone Gel.
Left - Implant is cut in half. Since the gel does not flow, there is no leaking.
Center - Pressure on the shell causes the gel to evert, but it still acts like a solid.
Right - Pressure is released and the implant returns to its original shape. Still no leaking.
Cohesive Silicone Gel Breast Implants
When the concept first hit the market they were termed cohesive silicone gel breast implants, with emphasis on the cohesive gel. Most silicone gel breast implants have two components: a solid outer shell, and a soft center.
The Breast Implant Shell
In the most basic terms, the shell of a breast implant is designed to contain the filler. The shell of saline filled breast implants and silicone gel filled breast implants are very similar. Both are made of tough, yet flexible, silicone elastomers. The main difference being that saline breast implant shells have a valve built into them to allow the plastic surgeon to fill them during surgery. Silicone gel filled breast implants are filled and sealed at the factory, so no valve is necessary.
Breast Implant Fillers
There are currently two FDA approved fillers for breast implants in the United States: Saline and Silicone. Until recently, the terms saline implants and silicone implants were the only two terms we needed to describe a woman’s options for breast implants.
Saline Breast Implants
The saline in saline breast implants has not changed. It remains a sterile, physiologic solution of 0.9% NaCl in water. This is ideal as it is about the same saltiness as our bodies. Under normal circumstances, the saline stays inside the implant. However, saline was chosen as a safe filler just in case a leak develops.
Saline is used intravenously to hydrate us in cases where we are unable to drink. The same saline is used, right out of the IV bag to fill breast implants. The fill volume can be adjusted during the surgery. If the saline ever leaks, it simply hydrates the body. The additional fluid is quickly absorbed and circulates just like we drank it. There is no reaction to saline, but unfortunately, the implant deflates and will need to be replaced.
Silicone Breast Implants
Silicone breast implants are filled with silicone gel, a clear viscous fluid. The modern medical grade silicone gel used to fill breast implants does not flow like water, but is still classified as a liquid. New silicone filled breast implants are more like solids in that they can be made in specific shapes and will hold these shapes. This is the property that makes them unique, and this is where the generic name games begin.
Cohesive Silicone Gel Breast Implants
The first attempt at differentiating the new breast implants was to add the word cohesive in front of silicone gel breast implants. Cohesive means to adhere or stick together, which describes the way the gel resists flow and even though soft, lacks the ability to flow associated with liquids. It was an excellent choice except for one thing. All silicone gel is cohesive, even liquid forms of silicone tends to stick to itself. Instead of this term being reserved for the next generation breast implants, every company making silicone breast implants started emphasizing that silicone is cohesive.
Highly-Cohesive Silicone Gel Breast Implants
The next attempt was to add the word highly in front of cohesive silicone gel breast implants. The point being that the gel in highly cohesive silicone gel breast implants was more than just sticky. It stuck together like a solid. Again, a good word, but hard to strictly apply to only the new breast implants without confusion.
Gummy Bear Breast Implants
Derived from the analogy of slicing a Gummi-Bear candy, the new implants have also been dubbed Gummy Bear Breast Implants. The implants are soft, like fresh Gummi-Bears, and when cut in half, they act like solids. It is a good analogy, because the comparison is familiar. While people do not have experience with gummy bear breast implants, most do have experience with Gummi-Bear candy. The term has proliferated on the Internet; however, the manufacturers do not like it. Probably, this is because their lawyers tell them they can’t use it. Instead, each manufacturer has come up with their own term that describes the Gummi-Bear phenomenon.
Form-Stable Silicone Breast Implants
I first heard the term Form-Stable Silicone Breast Implants in association with Allergan’s 410 series. The term form-stable is used to describe the ability of the breast implant to maintain its shape. Unlike liquid filled implants, form-stable breast implants resist being deformed. If a form-stable breast implant is compressed, it will change shape; however, when the pressure is released, the implant returns to it original form. An extreme example of this is illustrated above. Even without the shell, the contents of a form-stable breast implant will return to its original shape.
Memory Gel Breast Implants
Mentor markets their entire line of silicone breast implants as Memory Gel Breast Implants. This includes the original, more liquid like, silicone gel filled implants, as well as their contour profile gel (CPG) models. The idea being that the implants have memory. Not the type of memory associated with what happened during summer vacation, but the engineering term of shape memory associated with plastic deformation. Essentially, it’s the same thing as form-stable.
High-Strength Silicone Gel Breast Implants
The new kid on the block, Sientra, is taking a swing at it with the term High-Strength Silicone Gel Breast Implants. The emphasis here is not so much on shape, although they were the first US manufacturer to get FDA approval for their shaped breast implants. The emphasis is on the strength of the bonds inside the silicone that allow the gel to maintain its shape. The pictures above illustrate what happens to even the most severely damaged breast implant when it is compressed. The gel is liquid enough to deform to pressure, but it high strength silicone gel has memory, making it form-stable.
What’s in a Name?
In the words of Gertrude Stein, “A rose is a rose is a rose.” When is comes to breast implants, however, many names apply. If you are considering Breast Augmentation, it is important to understand these differences. While terms like form-stable, memory-gel, highly cohesive and high-strength silicone gel are helpful, gummy bear is still the most accessible word for most people.
Maybe you have a better word to describe these new breast implants? Hopefully, after reading this you have a better feel for what we Plastic Surgeons are saying. If you have questions about gummy-bear breast implants, be certain to tune in to KRON4 at 11:00 AM on Monday, June 11, 2012, for my live show and call in with your questions. I can also be reached at my office for consultations at (925) 943-6353.
Posted in Breast Augmentation, Breast Implant Options, Home, Uncategorized | No Comments »
February 23rd, 2012 Dr. Mele
One of the more frequently asked Breast Augmentation questions at my Walnut Creek Plastic Surgery Office is regarding the difference between Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants.
Gummy Bear Breast Implants
Cohesive Gel vs. Highly Cohesive Gel
All silicone gel is cohesive. It’s a property of the gel that means it likes to stick to itself. Less cohesive gel is more like a liquid; however, the more cohesive the gel, the more it behaves like a solid. All silicone breast implants currently approved in the US are filled with cohesive silicone gel. They are manufactured to remain soft, but more toward the solid end of the spectrum. Since the gel is cohesive is resists flow, or gel migration in case of a leak. When cohesive gel implants are punctured, the gel does not run out like water. When the implant is squeezed, the gel mushrooms out of the hole, and often retracts back inside the implant when the pressure is released.
Gummy bear (Gummi-bear) form-stable or highly cohesive gel breast implants are soft solids. They cannot leak, and hold their shape. The consistency is like that of a stress ball. Soft enough to squeeze, yet they go back to their original shape when the pressure is released. Since they are solid, they require a larger incision during the breast augmentation surgery. Since they are shaped, when they rotate, they can distort the shape of the breast as described below. These are not currently FDA approved, despite the fact that they are almost the same as the current cohesive gel implants, and that all the information the FDA requested was supplied several years ago.
The Differences Between Cohesive Gel & Gummy Bear Breast Implants
Both Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants have two components:
- A solid silicone shell
- A soft silicone interior
So what is the difference between these two types of silicone gel breast implants?
The Outer Shell
The outer shell of both Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants is made of a tough flexible silicone solid. The shell is made to resist damage and inhibit gel bleed. This is less of an issue with the Gummy-Bear implants, as the center, while soft, is essentially a solid and does not flow. For silicone gel implants, the greater the resistance to damage, the fewer leaks. Moreover, reducing gel bleed means the gel cannot seep between the molecules of the shell and leak out, like helium escaping a balloon, just much slower.
Since most Gummy Bear implants are shaped, most the shells of Gummy Bear Breast Implants are textured (fuzzy). This allows the breast implant’s surface to adhere to the inside of the capsule that forms around the implant, like velcro. This adherence is very important for shaped breast implants, because it reduces the risk of the implant rotating into a less flattering orientation. When a shaped implant is properly aligned, a tear drop shaped breast augmentation is the result. This will provide maximum fullness and projection at the bottom of the breast where is belongs. A shaped implant is most important in cases of breast reconstruction, but may be helpful when the volume of natural breast tissue is very small. When a shaped implant rotates, and this can occur as much as 10% of the time, the bottom rotates outward, around to the sides, giving an odd lateral fullness and reduced cleavage. Texturing and precise surgical technique are important to minimize rotational deformities.
When an implant is round, texturing is not necessary to prevent rotation. The shape of the breast is not affected by the implant’s rotation. With silicone gel filled implants, gravity tends to bring the more liquid center down, no matter how the implant’s shell may spin. Cohesive gel implants are most often round, and round implants do not usually require texturing to prevent rotational deformities.
The Soft Interior
The biggest difference between Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants is the filling. Both types of breast implants are filled with medical grade silicone. The difference is the viscosity of the gel. Cohesive gel implants have a viscosity somewhere between liquid and solid. The silicone gel inside a Cohesive Gel Implant does not flow like water. It will not squirt, or even freely run, if the tough outer shell is punctured. The cohesive gel likes itself, and wants to remain together. It can be forced out with pressure, so it is not a solid; however, the newer cohesive gel implants are much easier to remove after a rupture than their more liquid-like predecessors.
While both resist flow, a gummy bear implant’s filling is the consistency of its namesake. It is a soft solid that has memory. It can be compressed, but will return to its original shape spontaneously. Even when cut in half, the semi-domes will maintain their shape. If compressed, they will flatten, but when the pressure is released, the semi-dome shape will return. The term for this is form-stable. The form stable breast implants’ inability to leak offers a significant advantage.
Gummy-Bear Breast Implant Availability in the US
For San Francisco Bay Area Breast Implant patients the wait for FDA approval of the gummy-bear breast implants continues. Each March, there are rumors of impending approval, and in 2012, the rumors are again stirring. There has been a long delay between fact finding and decision making, but eventually the US should follow the lead of the rest of the world.
As much as I would like the FDA to make its decision, I am thankful for our FDA. It protected American women, and American Plastic Surgeons, from the recent European and South American problems with low quality Poly Implant Prothèses (PIP) breast implants. The PIP implants were made with non-medical grade silicone, and have failure rates of 10% at one year. This does not compare well with the US manufacturers’ breast implant failure rates of less than 1% at 3 years. Faulty PIP implants were used in about 300,000 women in 65 countries, and the recommendation is that they should all be removed or replaced. If you had breast augmentation surgery abroad, it is in your best interest to find out if your breast implants were manufactured by PIP. If so, find a Board Certified Plastic Surgeon near you for breast implant removal or replacement.
PIP saline filled breast implants were briefly available in the US. Since I have only used FDA approved breast implants, I never performed breast augmentation using PIP saline implants. I have had to replace them though, as they too leaked more frequently. Gummy-Bear highly cohesive silicone breast implants seem less controversial. They have the obvious benefit of not leaking, and much more specific scientific information is available about their safety. So FDA, if you’re reading this, how about a decision this March?
Posted in Breast Augmentation, Breast Implant Options, Home | No Comments »
November 25th, 2010 Dr. Mele
San Francisco plastic surgery patients have an extensive new local resource encompassing all aspects of cosmetic breast enhancement surgery. I have consolidated my years of experience, and the common questions that my patients ask, to create a site that is both informative and understandable. If you are considering cosmetic breast surgery, SanFranciscoBreast.com is a comprehensive collection of consumer information.
The web site is illustrated with videos and before and after pictures. The list of topics covered is long and includes:
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Breast Augmentation
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Breast Augmentation Lift
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Breast Augmentation Revision
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Breast Lift
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Breast Reduction
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Gynecomastia Reduction – Breast Reduction for Men
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Specialty Breast Procedures – Correction of Other Breast Abnormalities
SanFranciscoBreast.com is a specialty site dedicated to all aspects cosmetic breast surgery. Since the site is focused only on the breast, it gives me the opportunity to describe each procedure in detail, and to provide you with specific information to help you make an informed decision.
Posted in About Dr. Mele, Breast Asymmetry, Breast Augmentation, Breast Implant Options, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Men), Breast Reduction (Women), Capsular Contracture, Home, Inverted Nipples, Nipple Reduction, Tubular Breasts | No Comments »
December 1st, 2009 Dr. Mele
The base width diameter (BWD) of the breast is an import measurement for selecting the best breast implant. For my San Francisco Bay Area breast augmentation patients to achieve the best breast augmentation, the width of the breast must correlate with the width of the implant.
I am often asked what is the best breast implant profile or best breast implant volume for a certain bra size. The answer depends on many specifics, but the base width diameter (BWD) of the breast is one of the most important measurements used to determine the optimal breast implant diameter.
 This patient desired restoration of her lost breast volume. Note the patient's left breast is higher than her right breast prior to breast augmentation. |
 After breast augmentation. Breast implant diameter was selected to enhance cleavage without overly enhancing width. |
There is more to choosing the best breast implant than just picking an implant with a diameter that matches the chest, but it is a great place to start. While no implant is the perfect breast implant, choosing one that is proportional to the body is the best way to get a full and natural result.
It’s like Goldilocks. If the beast implants are to wide, they will hang over the sides and you will be bumping into them with your upper arm. If the breast implants are too narrow, they will tend to fill the outside of the breast and leave a space between the beasts. If the implants are just right, the breast can be filled over the entire base width and create a naturally full cup.
After choosing the appropriate beast implant diameter, the volume can be adjusted by choosing the appropriate profile. Low profile breast implants are flatter than high profile breast implants. The larger the volume desired, the higher profile selected and the more projection obtained.
 Prior to breast augmentation. The breast maintains a low projection but more volume is desired. |
 After breast augmentation. Enhanced projection is obtained by using a higher profile implant. |
When I trained as a Plastic Surgery fellow at Saint Francis Memorial Hospital in San Francisco, California, only moderate profile saline breast implants were available for breast enlargement. Today, saline breast implants come in three different profiles: Low, Moderate and High. The variation in projections is even greater for silicone breast implants with five profiles available. When the form-stable gummy-bear beast implants are finally approved, even more choices will be available.
Choice is good. When you are choosing, be certain to pick a Board Certified Plastic Surgeon who can help you make the most of your options.
For more information on how to choose the correct breast implants see these links:
How to Choose the Correct Breast Implants: Size
How to Choose the Correct Breast Implants: Silicone vs. Saline
Posted in Breast Augmentation, Breast Implant Options, Breast Implant Revision Surgery, Home | No Comments »
July 22nd, 2009 Dr. Mele
Pictured above are a silicone filled breast implant (left) and saline filled breast implant (right)
So which filler is better Silicone or Saline?
That has been the question since the introduction of the modern breast implants in the 1960′s. All the latest breast implants are made with a silicone shell. The difference is what is placed inside the shell to give the desired boost in breast volume.
The first breast implants were developed in 1962 by two Texas plastic surgeons Thomas Cronin and Frank Gerow with Dow Corning. These were smooth tear dropped shaped silicone implants filled with a cohesive silicone gel. They had a Dacron patch on the back to fix the orientation. This was necessary because they were smooth and could spin, thus losing the desired orientation.
Saline filled implants followed a few years later. A French plastic surgeon, Henri Arion, was the first to use them. He was trying to make an implant that could be placed through a smaller incision. Unlike silicone breast implants which are pre-filled, saline filled breast implants are filled after insertion. The shell can be inserted through a smaller opening without the risk of damaging the implant. A filling tube is left attached to add the desired volume. A valve built into the implant allows the tube to be removed without the saline leaking.
Since the mid sixties little has changed. The shells are more durable and less leaky. Texturing was added, eliminating the need for the Dacron patch for shaped implants. The cohesiveness of the silicone gel has been modified. The implants have received ongoing FDA approval and remain safe and effective for augmenting the breast.
In my Walnut Creek breast augmentation practice I am often asked which is better – saline or silicone gel? If there was a clear advantage then in a free society the better implant would be used more frequently. In the case of breast implants, even with the recent silicone gel breast implant controversies the use is about 50:50 with the edge going to saline.
In other words, about half the San Francisco breast augmentations patients are choosing saline and half are choosing silicone gel breast implants. This is because both implants have advantages and disadvantages. I go into detail about saline breast implants vs silicone gel breast implants on DrMele.com, but here are the top five advantages and disadvantages of saline and silicone gel filled breast implants.
Saline Breast implants
Advantages
- Peace of mind for those who are unsure of silicone gel
- Leaks are easily detactable
- Increased projection when desired
- For purely cosmetic breast augmentation can be used at age 18
- Slightly lower capsular contracture rate
Disadvantages
- Higher risk of rippling
- More easily palpable (feels less natural in most cases)
- Increased projection when not desired
- Stiffer result
- Slightly higher leakage rate
Silicone Gel Breast Implants
Advantages
- Softer more natural feel
- Lower risk of rippling
- Decreased projection when desired
- Moves more like a natural breast
- More profiles (shapes) available
Disadvantages
- Leaks are harder to detect
- Decreased projection when desired
- Slightly higher capsular contracture rates
- Body makes scar in response to a leak
- For purely cosmetic breast augmentation can be used at age 22 or older
There are other aspects to consider in specific situations so it is important to discuss these differences with your Board Certified Plastic Surgeon during your initial consultation. Board certification can be checked easily on-line for free on the American Board of Medical Subspecialties site. Also all members of the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) are Certified by the American Board of Plastic Surgery.
These are the premier surgical societies for plastic surgery in the United States and I am proud to be an Active Member of both ASAPS and ASPS. I also have Certified and maintain Board Certification with the American Board of Plastic Surgery and with the American Board of Surgery. When I add a post about how to choose a plastic surgeon, I will add the link here, but I consider Board Certification, and Membership in the ASAPS and ASPS three of the most important prerequisites. It is also a good idea to check you Plastic Surgeon’s standing with your state’s medical board. Here is the link for the physician license lookup for the Medical Board of California.
Posted in Breast Augmentation, Breast Implant Options, Breast Implant Revision Surgery, Capsular Contracture, Home | 2 Comments »
July 16th, 2009 Dr. Mele
If you are considering breast augmentation, size matters. Every day in my Walnut Creek cosmetic plastic surgery practice I get asked. “What breast implant volume is right for me?” While it’s a simple questions, there is no simple answer. The correct answer comes from a thoughtful discussion of goals, an objective measurement of the body and a dash of art.
Breast Augmentation Before and After Pictures
Factors to consider before breast augmentation are: desired breast size, location of scar, location of implant, type of implant, the chest wall anatomy and of course the natural breast tissue, Additional information can also be found on DrMele.com. A Board Certified Plastic Surgeon can help you with the options. This blog post concentrates on the most subjective of these aspects, the size.
There is no textbook answer when it comes to choosing breast size. There are formulas and graphs of breast volumes and dimensions; however, there is no table which translates your current dimensions and desired size into the “correct” implant. Certain rules of thumb do apply, and these can guide the selection of an appropriate implant.
A wise family practice doctor once told me, “If you listen to your patient they will tell you what is wrong.” It may seem too simple, but the most import question I can ask if you are considering breast enlargement is, “What size would you like to be?” By carefully listening the the answer I can learn the range of results desired. Most patients are looking to increase their bust one or two cups sizes. Some are seeking to restore volume lost during pregnancy or weight loss. Others are seeking what nature has not provided. What ever your motivation, it is important to think about the desired size and be honest with your response.
Trial the size. Play with it. Go bigger. Go smaller. Get a bra that is the desired cup size and try it on. Pad it out and wear it. Get used to the size. See what clothing works best. In this way you will learn what truely makes sense for you.
I encourage you to then bring the result with you to your consultation appointment. If you are using a Ziplock® full of rice to stuff your goal bra, bring it in. If you see a picture of a bust that looks good to you, bring it in. If you see before and after pictures that apply, bring them in.
Most my patients are looking for a proportionate result. Something that matches their body — often plus but occasionally minus a little bit. It is important that you are comfortable with the size, because this a a big step towards the ultimate goal, which is for you to be comfortable with the result of your breast augmentation. A little homework can really help get you where you want to be.
Posted in Breast Augmentation, Breast Implant Options, Breast Implant Revision Surgery, Home | 1 Comment »
