Call it the Kardashian effect: Today, everyone wants to talk about butt lifts, injectables, implants, and of course, dermal fillers and Botox. There’s also a lot of discussion surrounding nonsurgical treatments to melt away or freeze off fat. But in an age when posting personal cosmetic treatments has become the norm, why isn’t anyone talking openly about breast augmentation?
Though doctors are witnessing a rise in patients’ requests for noninvasive aesthetic procedures, breast augmentations are still among the most popular surgical procedures. Over a quarter million breast augmentation surgeries were performed last year, according to the American Society of Plastic Surgeons. That number is up by almost 30% since 2000, so it’s clear that women are still seeking bigger breasts. At the same time, however, we have also noticed an increase in women wanting smaller implant sizes (i.e., more C-cups than DD-cups). Throughout the United States, medium to full-size B cups are starting to trend as well. The desire for a more natural look is clearly driving this shift in preferences. At Dr. Conrad Tirre’s office, more young women are requesting a subtle, rather than obvious, change in their breast size. New technology is also helping to facilitate this change. Today, patients have a number of different implant types to choose from.
While breast augmentation is considered to be a major surgery, under-the-muscle breast augmentation is minimally invasive and therefore does not require an extensive healing period. An experienced plastic surgeon can create a breast pocket for the implant with extreme precision, dramatically reducing post-surgical bruising, bleeding, pain, and inflammation. Furthermore, under-the-muscle placement usually yields more natural results, particularly when working with gel implants.
Many patients report a reduced need for opioid painkillers after expediently performed under-the-muscle breast augmentation. They also typically experience less scarring after healing is complete and rarely request revision surgery. As such, we strongly recommend under-the-muscle breast augmentation to the vast majority of our patients. There are, of course, some exceptions. Women who naturally have a substantial amount of breast tissue may experience better results with over-the-muscle implants, for instance.
To lift or not to lift, that is the question
For most patients, planning breast augmentation surgery is fairly straightforward. However, if you are older (over 40), have had multiple pregnancies, or have lost a significant amount of weight, you may need to plan for a breast lift as well.
If a patient has minimal breast sag and minimal excess (but good quality) skin, then implants alone can provide the lift needed without additional surgical lifting. This is particularly true when the implants are being placed below the muscle. If the patient has minimal sagging, then placing the implant under the breast will ensure perky, natural, and firm results.
If the patient has poor skin quality, stretch marks, too much sagging skin, low-resting nipples, or there appears to be a disengagement between the skin, gland, and chest wall, then a lift is mandatory to achieve the best cosmetic outcome. While most women who fall into these categories are older, some young women do as well. As stated above, if you have had multiple pregnancies, chances are high that the repeated expansion and contraction of the breast tissue has resulted in loose skin, stretch marks, and the loss of breast volume (especially in the upper portion of the breast). Women under 40 who have lost a significant amount of weight also frequently struggle with flat, drooping breasts. If you have battled obesity in the past, you will almost certainly need a breast lift along with implants.
Mastopexy incisions vary based on certain variables. It is therefore important to have a detailed discussion concerning incisions during your consultation in order to ensure the best breast augmentation outcome. Understanding the relationship between the skin, the breast glands, the muscles, implants, and chest wall is critical.
Some surgeons avoid combining breast lift and augmentation surgery owing to the added complexity this represents and this is often done as a staged procedure. We can discuss this more at the time of the consultation.
Less is more
In the United States, 38,000 women had their breast implants removed in 2015. Plastic surgeons see this trend continuing as hundreds of thousands of women are visiting breast implant removal forums in the online community.
It seems that nowadays, women are either downsizing their implants or removing them altogether. Of course, many of these women had their implants placed at a time when the culture seemed to demand bigger breasts and implant technology was inferior. Additionally, many patients do not listen to their cosmetic surgeon’s advice and opt for larger implants even when their frames or existing breast tissue simply won’t accommodate them. This results in stretched skin and unnatural-looking implants that patients end up disliking and having removed. To save time, hassle, and expense, we recommend that you adhere to your surgeon’s recommendations. Remember that you can always choose to upgrade to larger implants during a later revision, without stretching your skin or enduring unnatural-looking implants in the interim.
Explant patients cite implants wearing out
Implant removals or implant exchanges were highest among women 35-50 years of age. One factor driving this substantial exchange rate is simple “wear and tear.” Unfortunately, older implants tend to wear out more than modern day implants. Lifestyle changes also play a role. Most older women are no longer hitting local nightclubs or rushing to happy hour after work, but rather taking their kids to soccer practice. Very large breasts that are no longer being enjoyed in the way they once were can feel cumbersome, making revision surgery desirable.
Decades ago, breast implant manufacturers recommended implant replacement every ten years. Because of the then-current propensity for larger breasts and the inferior implants of the day, this advisory made sense. Today, however, implants often last much longer than this. As a result, most young women who opt for implant explantation are merely looking for a change in look or feel.
Natural look and active lifestyle
Today, a greater number of women wish to balance having a voluptuous figure with other considerations. While women are still undergoing breast augmentation in droves, we have noticed a strong focus on keeping healthy and active, too. As such, many women choose more modest implants so as not to impair their ability to exercise. While it’s possible to stay in shape after having large implants inserted, there’s no arguing the fact that heavy breasts make high-impact exercise more challenging.
Breast augmentation has always been popular, and most cosmetic surgeons foresee little change in this area, regardless of society’s shifting preferences. Women will always want to increase their self-confidence, improve their figures and proportions, and boost their body image. If you’re interested in having your breasts augmented, feel free to book a consultation with us. We’ll be happy to help you define your goals for your breasts and guide you through the surgical process. We look forward to meeting you.
This article originally appeared on ASPS.org via Kevin Tehrani, MD | New York, NY