When it comes to selecting implants for a breast augmentation, many women would like their end result to be a natural looking breast. There are, however, some women who are looking for an over-the-top, obviously augmented look. For Dr. Daniel Y. Maman, a board certified plastic surgeon in New York City, a natural result is the only option.
“When I see a patient in consultation for breast augmentation, we talk about a lot of different things, ” shares Dr. Maman. “First of all, I want to understand what the patient wants. Secondly, I want the patient’s aesthetic ideal to be aligned with mine. Meaning, I want all of my breast augmentations to look one hundred percent natural.”
With the use of several in-office tools and a careful decision making process, expert breat surgeons are able achieve a natural looking breast every time. Dr. Maman walks through his selection process that guarantees a natural result customized to each patient’s individual anatomy and desires.
Matching an Implant to Breast Measurements
Let’s say you have a friend who had a breast augmentation, and her implant choice looked natural on her, so you decide you want the same implant. Seems to be logical, right?
This type of thinking is problematic, explains Maman, making an analogy to shopping for designer shoes. After all, you would never purchase a thousand dollar pair of designer shoes just because they look good on someone else, if they are the wrong size for your feet, would you?
“You would never wear them,” says Maman. “The same is true for breast augmentation; we need to find the implant that fits your anatomy, that fits your chest wall, that not only looks good, but is comfortable for you.”
To begin the selection process, he takes several measurements of each breast. “I tell the patient, after taking very careful measurements, what range of sizes I think is going to put them into that natural range,” Maman explains.
Understanding the Science of Implant Selection
Within that range of natural sizes, there are a lot of other decisions to be made in order to customize the result to the patient’s specific needs and desires. “We can alter a lot of the parameters with every implant,” says Maman. “We can alter base width in the implant, I can alter projection in the implant, I can alter height of the implant, texture of the implant, shape of the implant, either anatomic or round, I can alter the fill pressures of the implant, fill viscosities of the gel, depending on which manufacturer we use, so there’s a lot of different factors that we take into account.”
Factors Taken Into Account When Choosing an Implant:
- Base Width: The horizontal “footprint” or width of the implant
- Projection: How far out from the chest wall the implant extends
- Height: How far vertically on the chest wall the implant extends
- Texture: The shell of the implant may be smooth or textured
- Shape: Implants may be round or anatomically (teardrop) shaped
- Fill Pressure: How full the implant shell is can affect wrinkling or rippling
- Silicone Viscosity: How firm or soft the silicone gel inside the implant is
Visualizing the End Result
After narrowing down the range of natural options, the next step is to visualize and compare the end results. The best surgeons utilize a 3D imaging system called Vectra Imaging. First, the Vectra computer creates a three dimensional image of the patient’s current chest. It then simulates an animation using the actual implants the patient and surgeon select.
“The patients get a very good idea of what they’re going to look like with different sized and different shaped implants,” says Maman. Through 3D imaging and discussions with the patient, Dr. Maman arrives at an understanding of whether the patient wants to be on the bigger or smaller end of sizing within that natural range.
A Truly Customized Experience
There are plastic surgeons who have a go-to implant that they use for everyone. With experienced, board certified plastic surgeons, the selection process is about much more than just fitting a particular implant to a patient. “My goal is to get the patient the best aesthetic result,” Maman concludes. “I’m not one of those surgeons that just has a closet full of the same exact implant that they just vary by size. It’s totally different. I really take it to a science and to an art.”
For Maman, the time invested in careful implant selection pays off with a track record of natural results. “The ideal situation for me is a patient that’s able to wear a low cut dress, or a bikini, or drop their kids off at school and for nobody to know that they actually had a breast augmentation.”