Everybody recognizes beautiful breasts, but just how do surgeons create them? Breast surgeons are artists that understand that augmented female breasts must have certain aspects and ratios for a natural and beautiful look.
Many patients start the breast augmentation consultation by telling me what they don’t want. One of the most frequently described — and thoroughly rejected — appearance is one often described by prospective patients as two grapefruit halves, or two half coconut shells, stuck to the women’s chests.
Highly visible clues of breast augmentation include the amount of cleavage, the degree of breast softness and the natural profile. Actually, a well done breast augmentation will enhance a woman’s natural cleavage, maintain the breast softness and improve her breast profile.
But, with apologies to Sigmund Freud, what do women really want? At least when it comes to creating beautiful breasts?
THE ART OF BREAST AUGMENTATION
Beautiful breasts can be created through breast augmentation with careful planning, precise surgical technique and years of experience. Women want natural-looking breasts, with an appropriate size, shape and feel that fits harmoniously with their frame and anatomy. Anybody glancing at the finished enhancements would think the woman’s bosom was created, not by the surgeon’s hand, but by nature.
The perfect breast augmentation, according to one sculptor and admirer of the classic female form, results in a breast that slopes gently down from just below her shoulder bones to the peak of the breast at the nipple. That nipple should be largely in the middle of a teardrop-shaped breast mound.
The most appealing breasts have some perkiness and gentle arcs that sweep down from the nipple to the base of the breast, along with some natural cleavage in which the breasts come together naturally over the breastbone, a long plate of bone that physicians know as the sternum. When you look front-on, you should see just a little rounded curve at the sides of the breasts – not enough bulge to interfere with a golf or tennis swing or if you are into contact sports, a left jab or right cross.
Many breast augmentation patients have drooping breasts due to child bearing and nursing – this reduces breast volume and stretches the internal supporting ligaments. Many patients are a little older and the natural aging process has taken its toll in a similar way. Some women are just born with less breast tissue and feel their smaller breasts are out proportion to their bodies and self image.
I start the consultation by first listening to my prospective patient’s concerns about her breasts – a most important step that many plastic surgeons forget. We talk about the cup size, breast shape and what they don’t like about there breasts and what they find attractive. We then examine and measure her breasts and determine the amount of breast tissue and any chest asymmetry. I then take ten separate measurements. For example, I measure the distance from the breastbone notch to her nipples, the distance from the nipples to the center of her chest and the breast width – a critical dimension.
Only then do we begin to discuss the variety of available implants. Choices include size, three profiles of projection, (how far from the chest the breast will project) and implant filler (saline or silicone). Implants can be partially or completely filled. “Over-filling” will results in a breast that is slightly firmer to the touch while an implant that is filled below the maximum will results in a softer breast.
Women have a choice of placing the implant over or under their chest muscles. However, 95 percent of my patients opt for the under muscle position, a location which offers many advantages
A critical part of our planning is determining proper implant size. I help my patients determine the proper implant size well before she enters the operating room. I ask the patient to try on the implants we have selected. She places the implants atop her existing breast and snuggly beneath a surgical compression bra. This reveals a very close approximation of the final breast size. The final breast size is usually seen several weeks after the breast augmentation when the swelling is almost gone.
The Procedure –