Breast augmentation remains a very popular plastic surgery procedure, but having the best result from breast implant surgery requires understanding your options and making the right decisions. It is a highly personal choice and the details should be personalized to you as well. There is more to it than just size and type of implant. Here is a brief guide to what questions to ask, implant options and placement, and how to feel empowered that you are making the right decision.

What questions to ask your plastic surgeon about breast implants

 

How will you guide the decision about implant size? Our approach is to start with measurements such as the base diameter of the breast, which determines the maximum width of the implant. The implant profile and volume can then be selected based on your individual goals. We use VECTRA 3-D simulations, as well as trial implant sizers in a bra. There are also ways to make sizers that you can try in the comfort of your home, so you can really think about what size you desire. Inspiration photos are also helpful to guide the decision. The choice is then confirmed at the pre-op visit, so there is no pressure to make a hasty decision.

 

Will you use a funnel to insert the implants? An uncommon but difficult to manage complication is capsular contracture, a hardening of the tissue layer that forms around the implant. The chances of this occurring are reduced by using an insertion funnel (Keller funnel) so this should be routine.

 

Should the implants be over or under the muscle? There is more to this part of the decision than meets the eye. In reality, there are really 4 options: subglandular (behind the breast, in front of the muscle); subfascial (in front of the muscle but with the muscle fascia layer over the implant); split muscle (partially under the muscle) and dual plane (under muscle but with the muscle partly detached). Dual plane is the most common method, though the one most likely to cause distortions with muscle activity and weakening of the muscle. The basic trade-off is that under muscle gives coverage and a natural contour, but at the potential cost of animation deformities that can be avoided by going over. Over muscle placement can look unnatural in thin women. Where muscle coverage is needed, Dr. Baxter prefers the split muscle method, and if over muscle is preferred, then the subfascial approach is best. (Dr. Baxter has been doing the split muscle technique and subfascial for more than 20 years.) We are having great results with subfascial placement using Motiva implants. 

 

How will I know if the implants need to be replaced? Although silicone gel implants have a lifetime warranty, there is the possibility that a rupture could occur. This is typically a silent event with no obvious signs, so it is a good idea to have them evaluated every few years. We offer this at no charge with a quick ultrasound exam. (Saline implants do not need this.)

This isn’t a complete list of questions but a good starting point. Ultimately we want you to make the right decision for your lifestyle, your aesthetic goals, and your safety. Be skeptical if any practice that says they do it the same way every time, because there is no one technique or type of implant that is optimal for each individual. 

 

Interested in learning more about breast augmentation? Contact Phase Plastic Surgery today!