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Breast Enhancement - Background and Technique

I have received so many requests for information and background on breast enhancements that I've felt more or less obliged to collate the information I have to hand and give some pointers on how it's done. Please take good note that this is purely a personal collection of information and certainly shouldn't be taken to be medical advice. There are dozens of resources on the web and probably local to you too. If this is something you are considering you must take qualified medical advice.

Secondly: several people who have contacted me have taken away the impression that this is a major or principal interest for me, but in fact it's not. I (like many others) happen to like the message that enhanced breasts give; it says that the girl really cares about her appearance, that she knows her breasts are an important part of the overall image she projects and for me, at least, large and obviously artificial breasts allow her to say to everyone who sees her "look at me - I'm a sexual woman and proud of it". A deliciously sexual and overt statement if ever there was one.

The basics

Lots of people still think that silicone (not silicon) implants are in the standard. In fact in the USA, the Federal Drug Administration ruled in 1992 that silicone gel implants should no longer be available to the general public. There is still some controversy about the decision which was based on numerous allegations that these implants could lead to connective tissue diseases. As a consequence most modern implants are made from silicone rubber shells filled with saline (salt water) solution. US regulations don't apply in the rest of the world and this is no place to try to untangle the various regulatory regimes. The consensus is broadly that silicone feels more natural than saline but despite the unproven nature of the risks of silicone on balance saline is lower risk.

Implants are available in a range of shapes and sizes which you should discuss with your surgeon since different anatomies call for different choices. The size of the implant for normal procedures varies from 120cc (very modest) to 850cc which is large. Larger implants are a specialist item and you may want to look around for surgeons who have specialised in supplying them to exotic dancers and porn starts. Massive implants will most likely be in the 1000cc to 1500cc range. Extreme custom implants can be resourced up to 3000cc but you will find that you have moved close to fantasy land. If anyone cares to send me links or information about even larger implants I will be happy to include them. Implants may be smooth or textured. The textured ones were developed to reduce the risk of Capsular Contracture, a complication where the normal scar tissue which forms around the implant contracts and compresses it. Apparently there is little evidence that the texturing works.

The registered size of the implant isn't necessarily the amount of saline that the surgeon will fill them with. An implant of any given advertised size, say 500cc can be under-filled or over-filled to create differing effects. It's very common for an overfill of 10% to 20% to be done because that firms up the implant and reduces the risk of it wrinkling when it's in place. The more overfilled the implant is, the harder it will feel and less natural it will look. Implants may be filled at the time they inserted or in some cases (expander implants) the filling tube will be left available to the surgeon so that they can be allowed to settle and then topped-up to make them larger after the operation.

Implant Location

Implants can be placed over or under the muscles on the chest wall. Over-the-muscle tends to look more fake whilst the under-muscle implants look more naturally shaped. There are implications for wrinkling and implant life (they don't last for ever) depending on which placement you choose. Bodybuilders and athletes sometimes choose over-the-muscle because of discomfort felt by under-muscle placement but there are many other factors to take into account. These illustrations should help in understanding:


Over

Partial Under

Fully Under

Procedures

The implant can be inserted into the body in four ways: two leave scars on the breast, the other two leave scars away from the breast. All of the incisions are small because the implant is empty when it's inserted and filled afterwards. The incisions can be below the breast, around the areola, in the armpit or via the navel (TUBA). Recovery periods vary but most women can return to work in 3 or 4 days after the surgery. There is always some discomfort but it rapidly fades. The appearance of the new breasts just after surgery is noticeably different from their appearance once they have settled and the body has adjusted to the implants. One thing that's commonly found is that women comment that they wish they had gone bigger, so don't be shy about asking for large, even if you think that medium would do!
Below the Breast
This is a common technique. The cut is made where the crease of the breast meets the chest. It's easiest for the surgeon to place the implant exactly where it should go but it leaves a scar in the breast area and if you choose larger implants later the scar could be pulled up and get more noticeable.
Round the Areola
The areola is the dark ring around the nipple, not the nipple. The surgeon cuts round the lower part to make the placement and the scar usually heals well but it may be noticeable. You can see it on lots of pictures if you look hard and it might be more pronounced if it doesn't heal well. The surgeon has good control over the placement this way.
Via the Armpit
This is trickier for the surgeon and has the advantage that any scars are hidden away where you aren't likely to see them and it's harder for the surgeon to place the implant correctly. Revision of the surgery may need to use another incision somewhere else and leave another scar.
Through the Navel
The incision is done in your belly button and a tunnel is made under the skin towards the breasts. Again the scar is hidden well but any revision surgery may need to make an incision somewhere else. The tunnels under the stomach may take a while to settle and temporarily be noticeable or cause discomfort. It may not be a method approved by the implant manufacturers. Here's an illustration of the procedure.

Choosing a Surgeon and Costs

There are numerous surgeons who perform these kinds of procedures. The obvious thing to do is shop carefully and make extensive enquiries about the surgeon's experience and track record. Prices will vary but as a guideline 3,000 to 10,000 dollars/euros/pounds (at 2004 rates) is a guideline. You can use the web to find directories of doctors or resources like Yellow Pages. Take time to do your research because the homework you do will pay off later.

Before and After

For examples of what can be done, here are some paired before and after photos.

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