NIPTUCK Magazine: ABC of Breast Augmentation

Everyone’s breasts are different and not all breast augmentation surgery is the same.

The following article hopes to enlighten us on the in and outs of one of plastic surgery’s most popular procedures.

Author: Craig Rubenstein


What is a breast?

The breast is made up of fatty tissue, glandular tissue, milk ducts, blood vessels, nerves and lymph ducts, covered with skin. Below the breast lies the pectoralis major muscle. A breast implant can be placed either partially under or over this muscle, depending on the thickness of your breast tissue and its ability to adequately cover the breast implant.

It is fatty tissue that makes the breast feel soft and gives its shape. The shape also depends on the elasticity of the skin. Young breasts are composed of a lot of glandular tissue and little fatty tissue, which makes it firm. The glandular tissue gradually makes way for the fatty tissue, which is much less firm. This is why breasts become a little flabbier over the course of time. Pregnancy and breast-feeding also affect the shape of the breasts. As you get older, gravity will cause the upper part of your breasts to become “emptier”, which means that the breasts droop more. Breasts contain no muscle tissue, so there is no point in doing exercise in order to enlarge them.

How are breast implants used?

A breast implant is inserted either under the breast tissue (subglandularly) or under the greater pectoral muscle (subpectorally). The incision for the insertion is made typically either in the fold of the skin under the breast, around the areola (the area around the nipple), or in the armpit.

Your surgeon can explain more to you about the various techniques and methods and can help you to decide which is the best and most suitable method for you.

Different breast implant shapes

Because every woman is unique, implants also exist in different shapes and sizes. Some implants are round, while others are shaped more like a teardrop which closely resemble the natural shape of a breast.

  • Round implants
    Round implants fill out the existing breast tissue by adding volume, particularly to the upper part of the breast, resulting in a ‘rounded’ look.
  • Anatomical implants
    Anatomical or teardrop implants are shaped more naturally to follow the body’s natural lines. The implants fill out the existing breast tissue by subtly increasing the upper part of your breast whilst adding more volume to the lower part of your breast.

Both types of implants can increase the size of your breasts. It is up to you which shape you’d prefer to achieve the look you desire.

Your body in balance

Once you have chosen a particular shape, the next question is how big do you want your breasts to be? You will probably choose a size that complements your figure. Most women want the firmer and fuller breast they used to have, or always wanted, but never developed, in proportion with their figure. Many women think of their breast size in terms of the cup size of their bra. For example, if you are currently a 32A, you would probably like to be a full 32B or C after augmentation. But that is not the only consideration. You may also have ideas about minimising the space between your two breasts and how you can bring your breasts into proportion with the overall shape of your body. Discussing what you have in mind with your surgeon is important, so that he or she can take your expectations into account when the implant size and shape is selected.

A natural look

For a natural look, you will probably want your new breasts to be in balance with your body as a whole. Breast width, height, and projection are all important considerations. The width of your breasts is what will determine the size of the space between the two breasts (cleavage). Breast width also determines the outer curve of the breasts, a contour that is essential to the balance between breasts and hips. Discussing your personal preferences in terms of your breast width, height, and projection can help clarify for him or her what you see as the ideal shape and size for your new breasts.

Limiting factors

Implant size may be limited by your existing breast tissue characteristics. For example, the elasticity of your skin or the amount of existing breast tissue you have may keep you from increasing your breast size as much as you might like. The skin needs to be able to cover the desired implant completely. Implants that are too large for the quantity of the skin and breast tissue available may remain visible or palpable below the skin.

This may spoil the effect that you want to achieve. Furthermore, you would face a greater risk of surgery complications. Your surgeon will explain any limitations during your consultation.

Silicones and safety

Silicones have been in use for over 50 years in various applications, both in everyday life and medicine. Silicone is one of the most extensively researched materials used in medicine and have been subjected to extensive safety testing. Silicones are also widely used in the pharmaceutical and food industries, and in many medical devices such as pacemakers, heart valves, suture materials, lubricants and coatings for hypodermic needles and syringes. Silicones are even found in puddings, cake mixes, soft drinks, lipsticks, body lotions, suntan creams, deodorants, hairsprays, bedding, clothing, tissue and baby- care products.

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Last updated: 18/05/2018
Author profile image
Dr Craig Rubinstein - MBBS, FRACS (Plast)
Dr Craig Rubinstein MBBS, FRACS (Plast), a Specialist Plastic Surgeon, is one of Australia's most respected Melbourne Surgeons for Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction surgery and Abdominoplasty procedures. Using advanced surgical techniques to gain better body contouring and natural-looking surgical results, Dr Rubinstein is highly regarded by peers and patients for best-practice Clinic Patient-care and patient education strategies. He published a chapter on corrective surgery for Breast Asymmetry (see: https://clinicalgate.com/breast-asymmetries/) Dr Rubinstein, a Melbourne University medical graduate and current FRACS Specialist Plastic Surgeon, is renowned for his skill and precision with breast enhancement procedures. With over 20 years experience in female cosmetic procedures, he has performed over 7,000 breast enhancement surgery procedures including breast augmentation, breast lift and breast reduction, and thousands of Abdominoplasty procedures for women after pregnancy or weight changes (post-obesity/post-bariatric surgery).Qualifications/Training Fellow of the Royal Australasian College of Surgeons (FRACS) The Australasian Society of Aesthetic Plastic Surgery (ASAPS) The Australian Society of Plastic Surgeons (ASPS) The Australian Medical Association (AMA) American Society of Plastic Surgeons (ASPS) The International Society of Aesthetic Plastic Surgeons (ISAPS)Founder: Cosmetic Surgery for Women and Men - Plastic Surgeons Group Bio Page: https://plasticsurgeons.com.au/dr-craig-rubinstein-plastic-surgeon/