Patients after a breast augmentation tend to be thrilled with the results, and not solely because an increase in volume. That which many desire is in fact shape, and even many who enter a consultation with a plastic surgeon may not even know that this might be even more important than volume. A shapelier breast can change the look of the entire torso, making a woman appear thinner, younger and more perky.
It is important to realize that a breast implant can only “augment your pre-existing shape and architecture,” explains Dr. Kristi Hustak, a board certified plastic surgeon of Houston. Patients may come into a consultation with a photo of their “perfect breasts,” but the plastic surgeon has to work within the confines of a patient’s individual anatomy. If your natural breasts are wide set, but you want lush cleavage, you may be disappointed. One of the keys to any successful surgical outcome is managing expectations. With a breast augmentation, this means understanding your natural breast shape.
Dimensional Planning & Breast Augmentation
Plastic surgeons today are able to customize more than ever before when it comes to breast augmentation. That said, the one thing that they can not change is individual architecture. Women come in all shapes and sizes, and every body has different chest measurements. Dimensional planning is the concept of working within the confines of your specific dimensions.
Most patients today come into their breast augmentation consultation with “desire pictures.” These are a fantastic tool for communicating goals to aplastic surgeon. They are also a great jumping off point for a conversation about what can and cannot be achieved with your unique body. Sometimes, it is going to be “very difficult to get you from point A to point B with an augmentation alone,” explains Dr. Hustak. Surgeons definitely have some tricks up their sleeves, and there are add on procedures that can help you achieve your dream, “but generally, we have to respect your own architecture and your own natural shape and then from there, build off of that,” she explains.
Wide Set Breasts Will Always Be Wide Set
As an example, a patient whose natural breasts are wide set is still going to have wide set breasts after a breast augmentation. It isn’t possible to give touching cleavage without a bra. If a surgeon tries to correct wide set breasts with an implant, it’s likely a patient will receive secondary issues, such as:
- dynamic distortion
- rippling
- visible implants
- symmastia
Dynamic distortion is a condition that occurs when the patient flexes her muscles and the implant gets pushed in funny directions. While it may be possible to avoid this by placing the implant under the breast tissue, not the muscle, most of these patients are thin. Placing the implant over the muscle puts thin patients at higher risk for rippling and visible implants. And last, trying to create cleavage in wide set breasts with a implant may stretch out that section of skin, causing the breasts to touch. This is known as symmastia, a difficult problem to fix.
Relationship Between Breast Shape & Augmentation
It’s vital to see a plastic surgeon who is going to spend time talking with you about the limitations of your pre-existing shape in terms of getting you where you want to go. Dr. Hustak has even gone so far as to set up a photo gallery for her potential breast augmentation patients in which she breaks down the 10 most common breast shapes. These include:
- round
- muscular or athletic
- bell (more natural relaxation in your lower pole)
- side set (wide sternum)
- east/west (nipples pointing to the side)
- relaxed
- tear drop
- asymmetric
Round and athletic-shaped breasts look great no matter what you do, but the other subsets can be more difficult. With asymmetric breasts, for example, patients needs to know that breasts are sisters, not identical twins. “There is a degree of asymmetry with every single woman’s breasts,” explains Hustak. “I have never seen exactly symmetric breasts.” And though yours will be closer in size post augmentation if you were asymmetric before, you will still be slightly asymmetric after.
It’s All About the Shape
“We can customize bras that we buy for breast shape these days, so I think it’s important that we can customize how you would look after a breast augmentation based on your breast shape,” explains Dr. Hustak. Whenever someone comes in for a breast augmentation consultation, she likes to take the “before” pictures, and then sit down and talk. She will have you try on different implant sizes. This will help give both of you a guide as to what you are really thinking in terms of volume. From there, the two of you will discuss whether or not your desired volume is realistic with your anatomy.
Together, you will come up with a plan including the type of implant that is right for you, implant placement, and whether or not you need any adjunct procedures, such as fat grafting, to thicken up your breast envelope, nipple realignment or even a breast lift. The goal is to safely get you as close as possible to your dream breast, but to do this, the surgeon must work with the shape of your native breasts, not against it.