For women, breasts are perhaps the most prominent feature of sexuality, making enlargements one of the most popular procedures today. Many women of all ages are choosing to either enlarge or reshape their breasts for aesthetic reasons.

Purpose of surgery varies. Some women feel their breasts are too small, or they may have reduced in size following weight loss or pregnancy whilst others feel their breasts markedly differ in size. Augmentation surgery assists with reconstruction following mastectomy and repairing birth defects such as Poland syndrome.

There are many factors to consider before opting for an enlargement. Your surgeon will assist you in deciding whether you are right for surgery. If you decide to proceed, there are essentially three choices to make: the types of implants, location of incision and placement.

Breast Implants

Since silicone implants was first introduced in 1962, breast augmentation has become more sophisticated and refined. Silicone breast implants comprise two parts. The outer case is thick and sturdy, comprising of several silicone rubber layers. The shell is filled with either semi-solid silicone gel or saline (salt and water mixture). The outer casing of modern implants is much thicker, making it less prone to rupture. The implant may be either teardrop shaped or rounded. The teardrop implants are stiffer in texture and therefore require a larger incision to insert.

Saline implants are filled after insertion into the breast. Once the filling tube is withdrawn, the outer shell valve closes. This method requires a smaller incision since the implant is deflated when inserted. Unlike their silicone counterparts, saline implants tend to feel less natural and more likely to wrinkle and/or leak and deflate. It is estimated that approximately 10 percent of saline implants deflate, requiring replacement. Your surgeon will help you make the right decision about which implants to use.

Incisions

There are several options regarding where incisions may be made to insert implants:

• Armpit – insertion through an incision in the armpit generates the most natural result, with scarring normally fading completely.

• Nipple – the surgeon will cut around the lower half of your areola (the dark skin around your nipple), making a pocket after cutting through the breast tissue. Areolar skin heals well.

• Under the breast – this method creates longer scars as the surgeon needs to incise along the fold where the breast meets the chest.

• Belly button – this approach is complicated and should only be undertaken by a surgeon with ample experience in this technique. The implant is inserted through an incision in the belly button. This method is only available for saline implants.

Placement

The implant may be positioned either behind the breast tissue and the chest muscle (submuscular augmentation) or underneath the breast tissue only (subglandular augmentation). There are advantages and disadvantages for both options, but generally the submuscular method is preferred.

Submuscular – positioning underneath the breast tissue and chest muscle provides the implant an extra layer of protection and reduces the formation of hard scar tissue. This procedure is however more painful.

Subglandular – being located above the pectoralis muscle enables the implant to be placed lower, thereby producing a more natural look while assisting with saggy breasts. This location reduces a layer of protection and makes the implant noticeable by touch. Any wrinkling may also be more visible.

The right sizing

Doctors will think about implants in cubic centimetres (cc’s) and not your cup size (A, B, C etc). Implant sizing ranges from 150cc to 600cc. To obtain a proportionate outcome, your surgeon will need to consider your body size and frame. Try to work out your cup size requirements first by testing them out with a bra and pair of plastic bags filled with rice or salt or even some socks.

As you can see, there are many considerations with breast implant surgery.  Your surgeon will guide you through the process including your expectations and motivations for change.