Background: In the pursuit of satisfying breast augmentation results, the most common denominator amongst patients is that of achieving the desired size. Too small or too large of an augmented breast size can lead to an unhappy patient and the need for revisional surgery. Women understandably spend the vast majority of their time before surgery contemplating size and many methods exist for trying to determine what that actually is before surgery.
By far and away, however, the vast majority of women want their breasts to look natural after surgery. Very few women come in and say they want an unnatural looking breast augmentation result. The concept of ‘natural’ is a qualitative description whose interpretation, however, is open to individual opinion which can be surprisingly diverse. What is natural to one patient may be seen differently by another.
But despite this somewhat vague term, natural breast augmentation can be quantitatively described. I define a natural breast augmentation by three parameters. First, a natural breast size is either one in which the patient originally had and lost (through pregnancy or weight loss) or one in which the size of the implant stays within their breast base diameters. Second, the shape of the breast is not completely round in that the upper pole of the breast is not as full as the lower pole. Third, the breast does not feel overly firm or tight and does not have palpable implant wrinkling or folds. These are natural implant results because they are what a normal breast looks and feels like.
Case Study: This 32 year-old female wanted breast implants to restore her breasts after having twins. Between the pregnancy and breast feeding, she felt she had lost much of her breast volume and shape, Her breasts had essentially gone flat. She emphasized that she did not want to be ‘too big’ and would be happy if she just had want she had before the children. (or maybe just a little bit more) She repeated the phrase of wanting a natural breast augmentation result.
Under general anesthesia, she had 355 cc high profile, high-strength silicone gel (gummy bear) breast implants placed in a partial submuscular dual plane position. Her lower inframammary crease incision was able to be used and was a size of only 3.5 cms because a funnel technique was used for insertion.
Her postoperative course was typical in that the implants initially were a little high early after surgery. But with the resolution of the swelling and some skin relaxation, the implants settled into the desired position rather quickly. She went back to work as a nurse in less than one week after surgery.
She felt that her breast were quite natural in appearance and feel. They were soft without any palpability of the implants. Their size was about what they were before becoming pregnant so it was perfectly natural to her. In fact, if she had to do it over again she might had gone just a little bigger.
· Natural breast augmentation is the combination of a soft breast-like feeling implant that keeps the new size well within one’s existing breast base diameter.
· Silicone implants, particularly the new high-strength gel material (gummy bears), give a very natural feel to the augmented breast.
· For the women who has lost breast tissue from pregnancy (involution), a natural breast augmentation is one that primarily restores the lost volume and returns the patient to their original size.
Dr. Barry Eppley