The Surgeon Minute

Choosing Implants that Look & Feel Natural

Choosing Implants that Look & Feel Natural

Are you considering breast augmentation but are concerned the implants will look too obvious? Many women who undergo breast augmentation would prefer the transformation went undetected. “Most of my patients tell me that they want a natural looking breast augmentation,” shares board certified plastic surgeon Dr. Brooke R. Seckel of Boston.

In order for an augmented breast to fly under the radar, it should look, feel and move the same as a natural breast. If you’ve ever hugged someone and felt rock-hard breasts push against you, odds are you could tell they weren’t natural. Natural breasts are soft to the touch and move with a woman’s body as she moves. Unfortunately, some implants can result in a breast that is “locked in place,” according to Dr. Seckel. Here he shares his expert tips for achieving a result that will keep them guessing.  

Expert Tip #1: Fit the Implant to Your Body – Don’t Go Too Big!

You already know you have a dress size and a shoe size. You might not have realized it, but you also have a breast size. Breast size doesn”t refer to your bra, it refers to the base width measurement of each breast. While you may already have an idea of the size of implant you want, it”s very important to trust your surgeon to guide you to the right fit for your measurements.

During the consultation, Dr. Seckel determines the base width of each breast using a tool called a caliper. He then matches the width of your natural breast to the width of a breast implant. “If we choose a breast implant whose base width matches the base width of the breast, we’re going to get a natural looking breast,” says Seckel.  “If you choose a larger one, then the implant becomes visible.”

The 4 steps to a natural breast augmentation.

Expert Tip #2: Choose Smooth, Round Silicone Gel Implants

There are two choices for the material inside of an implant: saline or silicone. Saline implants are much more prone to wrinkling and rippling and do not feel as natural as soft silicone gel.  

When it comes to choosing a silicone implant, there are more choices today than ever before – beginning with the type of shell on the outside of the implant. Dr. Seckel recommends smooth gel implants for the most natural result. In his experience, textured implants are not as forgiving as they tend to lock into place and don’t move as naturally, due to their thicker, textured wall. Smooth implants, he adds, are more flexible, adjusting to your body as you move.  

While anatomically-shaped gel implants, also known as gummy bear implants, can offer a natural shape to the breast, the silicone gel in shaped implants is cross linked to be firmer than the gel used in smooth, round implants. For this reason, Dr. Seckel recommends the smooth round gel to achieve the most natural and softest feel.

Implant Decisions:

  1. Saline vs. Silicone
  2. Smooth vs. Textured
  3. Shaped vs. Round

Expert Tip #3 Place the Implant Below the Chest Muscle

“Studies have shown – experience has shown – when you place the implant under the chest muscle you’re providing additional coverage,” says Seckel. “But, as importantly, every time you move your arms you’re giving the implant a little massage, and that helps it keep soft.”

Natural breast augmentation before and after.

This brings us to an important question concerning breast implants: why do some implants begin to feel hard over time? The answer is a condition called capsular contracture. Your body forms a capsule of scar tissue around each implant after surgery. In most cases, that scar tissue is soft and thin, like a tissue, and you never even know it’s there. However in some cases, that scar tissue begins to tighten and squeezes the implant. This contraction gives the impression that the implant is hardening.

There are many techniques surgeons perform to reduce the risk of capsular contracture occurring. For round gel implants in particular, the gentle massage of muscle movement around the implant could contribute to lowering the risk of capsular contracture occurring.

Another important benefit to placing the implant below the muscle is the additional tissue coverage. The more of your body”s natural tissue that covers the implant, the more natural the implant will look. If you place a round implant above the muscle, the odds of your breasts looking round greatly increase. By placing the implant below the muscle, the muscle helps to both cover and shape the implant. The result is a gentle slope towards the top of the chest where the muscle covers the implant and more fullness below the nipple where the muscle does not reach. “A breast should have fullness under the nipple areola,” explains Dr. Seckel, “but it shouldn”t just be jutting out, it should sort of swoop or fall down over the crease under the breast.”

Natural breast augmentation - Dr. Brooke Seckel.

Expert Tip #4 Place the Incision Below the Breast

In order to put the implant into the breast, an incision must be made. Some surgeons place the incision around the areola while others use incisions in the armpit or belly button. Dr. Seckel recommends inserting implants through an incision hidden in the fold below the breast. “When you go through the areola you raise the risk of capsular contracture, or hardening,” he explains. “Going underneath the breast you have less chance of capsular contracture. The breast will fall over that incision and hide that incision very well.”

Clear, detailed discussions with your surgeon, precise measurements, access to the latest implants, and realistic expectations all factor in to creating the most natural-looking breast augmentation possible. The conversations and decisions made over the course of the consultation will ultimately be what decides how great the results will be, how long it will remain great, and how natural it will appear. Trust in a board certified plastic surgeon to guide you through the consultation process so when the day of surgery arrives, all of the parts are ready to go and just need to be fit together.

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