The Surgeon Minute

Smooth, Round Implants for Natural-Looking Breasts

Smooth, Round Implants for Natural-Looking Breasts

Social media has had a huge impact on the way plastic surgeons do business. Not only do practices now spend a good deal of time marketing his practice to new patients, but these platforms have proven to be an ideal method for educating patients on the latest procedures and techniques, as well as answering their questions.

The downside to all of this available information on the web is that a lot of times, breast implant patients think that they want a “gummy bear” implant because it’s trending on social media – when, in fact, smooth, round implants may be the best choice to deliver a natural looking result. Dr. Sean Doherty, a board certified plastic surgeon in Boston, discusses why he prefers smooth, round implants, as well as detailing his favorite incision choice for patients.

What’s the Best Implant Choice for Your Breast Augmentation?

There are a growing number of decisions to make once you decide to have a breast augmentation. One of the more confusing choices is implant shape and texture. Part of the reason for this is that the “gummy bear” implant, which is a shaped, and often textured implant, has been getting a lot of press. Many patients think that because it is a social media darling, it is the right choice for them. It’s not, or may not be what’s best.

Gummy bear implants.

Dr. Doherty primarily uses a smooth, round implant in his breast augmentations because he feels, “that patients do quite well with those implants and have a nice, soft natural outcome,” which is typically what his patients want.

During the consultation, it is the job of the plastic surgeon to listen to your desires and then walk you through the implant options that will work with your anatomy to best deliver an ideal outcome. While Doherty likes all of the implant choices out there — they’re all safe and have been proven to deliver good results — he typically prefers smooth, round implants, “because it’s an easier procedure for me which leads to an easier recovery for a patient.”

Smooth, round implants.

There are also less things for him to worry about with this type of implant such as rotation. If a shaped implant moves, it is noticeable and may require surgery to fix it. If a round implant moves, it doesn’t adversely affect the look of your breasts.

The other thing about smooth, round implants is that once they are placed, they become shaped. “When I speak to a patient in the consultation for a breast augmentation, I show them that a round implant actually becomes a shaped implant when it’s placed underneath the muscle” explains Dr. Doherty. Basically, the pectorals muscle will push a round implant at the upper pole of the implant so that it becomes somewhat shaped.

Round implants behind the muscle.

Where Is the Best Incision?

There are three basic incisions through which a plastic surgeon can place your implant:

  • the trans axillary incision – through the armpit
  • the areola incision – around the nipple
  • the inframammary fold incision – beneath the breast

Doherty prefers the inframammary fold for many reasons.

  • It is safe
  • It gives direct vision and access to all of the anatomy that’s being treating
  • It has the lowest risk of complicatione

The challenge with the inframammary approach isn’t surgical, it’s the accompanying scar. It’s important to dial back the concern by helping patients understand what they can realistically expect with proper scar-care. The reality is that a well-designed scar that’s taken care of properly, “heals quite nicely,” explains Doherty. “Most patients, regardless of any procedure they do, don’t want a scar. And so, all patients need to understand that a scar is a permanent thing. It’s part of what they’re getting when they have a surgery.”

Round implants before and after.

And yes, the size and shape of your scar is certainly something that you need to consider when making your breast augmentation choices, but not at the expense of your long term results. The inframammary fold incision perhaps delivers a more visible scar, but it also has the lowest revision rate. Furthermore, every patient heals differently so this must be discussed during the consultation.

When Doherty first meets with his patients, he asks them about previous surgeries. Patients who have darker skin run a higher risk of pigmenting in their healing process so that needs to be addressed and watched. In general, the rule of thumb with scar care is:

  • Keep the wound clean
  • Keep it mildly moist
  • Let it be

Inframammary fold incision.

Breast Augmentation Recovery

A common problem in terms of healing for many breast augmentation patients, particularly younger patients, is becoming too active too soon. “Our younger patients need to be educated that being active too soon after surgery can increase their swelling, prolong their healing, and certainly compromise their incisional outcome,” explains  Doherty. If you are having surgery, it’s not only, “a financial investment, it’s a time investment and you need to let your body recover from it.” However, once patients are reminded that if they want their scar to look good, they need to relax. “It’s an easy sell,” says Doherty.

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