Breast Anatomy—How It Affects the Breast Augmentation Technique

About 307,000 breast augmentation procedures were conducted in 2011, according to data released by the American Society of PlasticSurgeons.  But despite the growing popularity of this surgery, many patients are still not aware that their breast anatomy and even their overall body frame can affect the final outcome.

Breast Anatomy:

* Areola complex

This is the pigmented part of the skin, and at its center is the nipple which contains tiny ducts responsible for breastfeeding and are very sensitive to manual stimulation.

The edge of the areola can be used as an incision site during breast augmentation, allowing doctors to create a “pocket” and insert the implant.  And while this technique hides the scar, the tradeoff is the higher risk of temporary or permanent loss of sensation which happens if too much nerves are severed.

Fortunately, patients can choose from other breast augmentation incisions including breast crease, underarm, and navel.

* Cooper’s ligament and connective tissue

They support the entire breast and define its shape.  But after several pregnancies and weight loss, they start to become slack, leading to sagging appearance.

Breast implant alone cannot correct sagging, although this can further improve the appearance of the bust after a breast lift surgery.  Combining these two procedures are particularly ideal for women who have drooping breasts and want to add more volume in their chest.

* Inframammary fold

Also called breast crease, it separates the breast mound from the lower chest wall.  Meanwhile, this area is a great incision site because it allows plastic surgeons to work close to the chest, making it easier for them to position the implants; for this reason, the technique is ideal for patients with existing breast deformity.

However, the inframammary fold incision is more ideal for women with a defined breast crease as it can prevent them from having a high- or low-riding scar.

Most board-certified plastic surgeons are very familiar with inframammary incision technique that unsightly scars rarely happen.

* Chest width

This breast anatomy dictates the right implant profile which is the projection off the chest wall.  In general, petite women should use high-profile implant that has small base but offers more protuberance.

By contrast, patients with a wider chest width should use low-profile implants which have a broader base but offer less protrusion.

Meanwhile, patients can choose moderate-profile implants that provide projection according to their amount of filling (which is measured by cubic centimeter or cc).

Silicone Breast Implants Do Not Increase the Risk of Cancer

In the early 1990s, silicone breast implants were pulled out of the market due to concerns that they might increase the risk of breast cancer and systemic diseases.  But in 2006, the US Food and Drug Administration has lifted the moratorium after extensive studies found no link between using the devices and serious illnesses.

The FDA’s decision to lift the moratorium is supported by many oncologists; in fact, silicone breast implants are increasingly becoming popular among post-cancer patients who have breast deformity following their mastectomy (partial or complete removal of their breasts).

Meanwhile, leading LosAngeles plastic surgeon Dr. Tarick Smaili believes that silicone breast implants are reasonably safe both for cosmetic and reconstructive surgeries.

“Silicone breast implants have been subjected to the most rigorous examinations which have proven that they are reasonably safe.  Another bonus is that they can provide a very natural appearance since they are filled with a cohesive silicone gel that replicates the feel and look of breast tissue and fats,” Smaili said.

Because post-cancer patients who had mastectomy often have a limited amount of tissue, silicone breast implants are usually more ideal than saline implants which have a watery consistent (because it is only filled with a sterile mixture of salt and water).

The mastectomized breast has a very low risk of cancer recurrence so placing implants during reconstructive surgery has become a common practice.

However, Smaili warns that breast implants can make it difficult to conduct mammogram and “physical” breast examinations.

“A breast augmentation patient should go to a technician who has an extensive experience in conducting mammogram screening on women with breast implants.  Also, more views are necessary to get a more accurate and clearer result,” Smaili said.

But despite more difficulty to do mammography, the plastic surgeon advised women with breast implants aged 40 years and older to undergo screening at least every year.

“In this way, their doctors can immediately diagnose any cancerous lumps even before the condition gets worse,” he added.

Meanwhile, mammography is not only performed on older women (with or without implants) but also on younger patients with silicone breast implants that are prone to “silent leak,” a condition in which the cohesive gel drips out of a damaged or ruptured shell without causing any visible signs.

But in the long run, silent leak can lead to inflammation of the tissue, pain, and visible breast deformity.

The FDA recommends mammography every two years for patients with silicone breast implants; on the other hand, this is not a requirement for younger women with saline version because a rupture would immediately show visible signs. 

Breast Contour After Augmentation Mammaplasty

When discussing breast implants, the size is not the only issue patients should focus upon.  They should also bear in mind that the shape and profile of the device, in addition to the appearance of their chest and amount of tissue and fat, can have a significant impact on the final result of breast augmentation surgery.

Breast implants come in two shapes: round in which all the sides are symmetric, almost resembling the contour of an M&M candy; and anatomical in which the lower portion has more volume than the upper part, leading to a teardrop appearance.

To date, round breast implants are more popular than the anatomical version not only because they are cheaper but also they are less likely to cause “aesthetic” problems.  In fact, they can rotate inside the breast pocket and the shape of the chest will still not appear distorted.

By contrast, contoured or anatomical breast implants can lead to deformity in case that they rotate inside the pocket.  And because of this risk, they only come in textured surface which aims to prevent gross movement; however, the same design that prevents implant rotation has its own downside including higher risk of rippling, traction wrinkling, and failure.

As mentioned earlier, implant profile—or its projection off the chest wall—also has an impact on the breast contour after the implant surgery. 

Patients should take note that by using the right implant profile, they can avoid having breasts that appear too pointy or “unusually round.”  Fortunately, most board-certified plastic surgeons today can tell which one can provide the most desirable and natural result by simply looking at the patients’ body-frame.

For instance, high profile implants, which offer more projection but come with a smaller base, can result to a pointy appearance if they are used by women with a wide upper body, thereby leading to a very unflattering appearance.  On the other hand, the design provides a natural outcome if used by patients with a narrow frame.

For patients with a broad torso, it has been sacrosanct to use low profile implants, which offer less projection but come with a wider base so they can fill up more space.

Aside from the implant type, the appearance of the breasts and amount of tissue and fat also affect the outcome of breast augmentation surgery. 

Patients with a fair amount of tissue and fat tend to enjoy a more natural result with the use of saline implant, which has a watery consistency.  By contrast, women with limited tissue and fat would likely end up having a dome-shaped breast if this implant type is used.

Fortunately, a dome-shaped breast can be avoided with the use of silicone implants particularly when dealing with patients whose tissue and fat are quite limited.  This is because the implants are filled with a cohesive gel designed to simulate the consistency of the natural glandular tissue.

Also, the breast contour after surgery is affected by the structure of the chest.  For instance, women who have a pigeon chest, which is associated with the protrusion of both the sternum and ribcage, should expect that it would be more difficult for them to achieve a prominent cleavage (both upper and medial cleavage) than patients in the general population.

Hottest Celebrity Breast Implants

Breast implant surgery is arguably the most popular cosmetic procedure among female celebrities, although not all of them are willing to spill out their secrets.  Meanwhile, these are the stars who made it to the list of hottest breast augmentation results.

1.     Hilary Swank

After her breakout film “Boys Don’t Cry,” some people have noticed that the actress bust size has increased, however, others just speculated that she might have hidden her “assets” earlier in her career.  But whether she is naturally busty or has sought the help of a plastic surgeon, she looks sultry and beautiful these days.

2.     Salma Hayek

Considered as one of the sexiest Hollywood actresses, Hayek’s mother once told her that the only roles she could get in movies was a servant due to her “weird accent.”  But apparently, she proved her mom dead wrong.

Aside from her exotic beauty and acting skills, perhaps the star’s curvy body, which is rumored to be partly the result of breast augmentation, has also helped her to be always on the limelight.  But in the last few years, some people have noticed her breasts seem to be growing larger.

However, there are some people who believe the actress is naturally busty and the seemingly larger breasts may be the cause of weight gain, but then again, this claim may not be too convincing since only breast implants can create such a dramatic change.

3.     Halle Berry

While the beauty denies going under the knife, not all people believe her claims.  According to rumors, she has gotten breast implants (resulting to a full 36C cup) earlier in her career.

In previous interviews, Berry was quoted saying that she may consider plastic surgery in the future, however, not all were convinced with this statement especially with rumors of nose job and breast augmentation surgery.

4.     Beyonce Knowles

While the singer-dancer is naturally curvy, photos taken between 2002 and 2005 show that there was a considerable increase in her bust size, which is rumored to be the works of breast implants.

While Beyonce denies having any cosmetic surgery, not all people are convinced especially when one photo with her arms raised revealed a small incision in her armpit—a possible proof that she had breast augmentation.

Underarm incision technique is particularly ideal for dark-skinned patients who are prone to keloids.  According to some studies, the armpit is less likely to develop raised scars.

5.     Carmen Electra

Former Baywatch star Carmen Electra’s breast implants probably catapulted her career and made her into a Hollywood sex goddess.  In fact, she has been featured in Playboy magazine four times.