Breast Augmentation

Breast augmentation is a surgical procedure that enhances the size and shape of a woman’s breasts. This can be done to enlarge small breasts or help return post-partum breasts to their pre-pregnancy condition. Charleston Breast augmentation surgeon Dr. Terranova will explore several options to assure the most pleasing outcome for each patient. For instance, the breast implant can be saline or silicone, and can be placed under or over the chest muscle. Choice of incision sites will also be discussed before surgery. All these decisions are based on personal lifestyle and preferences as well as the pre-operative condition of your breasts.

Types of Breasts

This is not a one-size-fits-all procedure. Charleston breast augmentation surgeon Dr. Terranova tailors his approach to meet each patient’s unique needs. Women come to us with a variety of different concerns and cosmetic problems with their breasts, such as:

  • The Breast that is Simply Too Small – Some women’s breasts never develop to the extent that they would like. This is one of the most common reasons young women seek out breast augmentation. Before & After Photos
  • The Post-Pregnancy / Post-Nursing Breast – Pregnancy and nursing can take a toll on your breasts, stretching the tissues and causing them to lose volume once you have finished breastfeeding your child. The result is often a “flat” breast that appears deflated, with the nipple pointing downward. Before & After Photos
  • The Low-Slung Breast – Both pregnancy and age can cause breasts to descend too low on the chest wall, as the effects of gravity take over. This type of breast is still full, and the nipple still points forward, but the upper part of the breast appears too flat. Before & After Photos
  • The Tuberous Breast – Tuberous breasts are a developmental anomaly. If your breasts appear constricted at the base, with a tight and high inframammary crease and sagging of the nipples/areolas, you may have tuberous breasts.
    Before & After Photos

Breast augmentation procedures can also be combined with other cosmetic surgeries to transform your figure. This is popularly called a Mommy Makeover.

Breast Implants in Charleston, South Carolina

If you have overly small, “perky” breasts that never developed to the extent you wanted, your breast augmentation will be relatively straightforward. However, the surgeon must be careful not to put in place a breast implant that is too large. Some patients request a size that is simply not achievable without overwhelming the width of the chest wall and the capacity of the soft tissues to stretch and support the weight of the implant. The result in these cases is at best a significant disproportion and an obvious “done” look, and at worst, a long-term problem with implant descent (bottoming out) and even possible extrusion.

Our experienced Charleston breast implant surgeon Dr. Terranova understands these issues, and will recommend an implant size that will achieve your desires for improved body image and proportion without the poor results and long-term risks of an overly-large breast implant.

Types of Breast Implants

There are two basic breast implant types used in breast augmentation:

  • Saline breast implants – The saline implant has a silicone elastomer shell filled with saline (salt water).
  • Silicone breast implants – The silicone implant has a silicone elastomer shell filled with silicone gel.

Both are good implants, but there are significant and important differences. In the past, the safety of silicone implants has been in question. Standards for the type of silicone used in implants has made silicone a viable implant option once again. Visit our page on Silicone Versus Saline Implants to learn more about your options related to these common types of implants.

More Implant Choices

Up until a few years ago, the choice of implants for breast augmentation was relatively simple. Silicone or saline. Smooth or textured. Regular, moderate, moderate-plus, or high profile. Smooth silicone was preferred by most surgeons and patients. Moderate-plus was the preferred profile. The Goldilocks profile – – if you will. Moderate profile was usually not enough and high profile was often too much.

Now however, with the development of more highly cohesive (less fluid) silicone gels, the range of choices has expanded considerably. This means that choosing the “right” implant is not as straightforward as it once was.

There are two major considerations when it comes to these more cohesive implants.

The first is that this newer technology has allowed the production of the shaped, or anatomical, implant, also called the gummy bear implant because of its “feel”. The idea here is that since the “perfect” breast has the shape of a tear-drop, then why not make an implant in that shape? Sounds good, right? But it is not that simple.

If you take a typical round, silicone implant and hold it upright – – as it would be when a woman is upright – – the gel moves to the bottom of the implant, thus creating a tear-drop shape. So having an implant that is always tear-dropped shaped is not really necessary. Add to that the fact that these anatomical implants are textured, feel firmer than other implants, can rotate out of position, and are more expensive, means that they do not have a large role to play in primary breast augmentation.

In primary breast augmentation, there is already a breast. All we are doing is making that breast larger by enlarging the base diameter in providing more projection. The typical round silicone implant is perfect for that purpose. The case in which we wish to change the existing shape of the original breast with the implant is quite uncommon. In breast reconstruction following mastectomy, however, when all that is left is skin, then indeed the anatomical implant has made a great difference in providing natural looking results. But in primary breast augmentation, there are very few situations where the downsides of the anatomical implant are worthwhile.

The second major consideration, and the one where increased gel cohesivity has the most potential for better results is in improving upper pole fullness.

Remember what we said earlier. If you hold a regular style silicone implant in the upright position, the gel moves to the bottom of the implant causing it to take on a tear-drop shape. In general, this is what we want. But the other side of this is that there is very little gel left in the upper half of the implant and therefore there is not as much augmentation of the upper half (pole) of the breast as there is of the lower half (pole).

In many cases this is not an issue. But with age and after pregnancy, the breast can become “low-slung”. The breast moves downward along the chest wall creating a flatter, less full upper pole. A typical style silicone implant will augment a low-slung breast but will not – in some cases – provide the increase in upper pole fullness desired by the patient. At least not without using an implant that will make the breast itself much too large for the patient’s proportions and desires.

This is where the more highly cohesive implants have an important role to play. When this implant is held in the upright position, less of the gel moves the lower pole, leaving more of the gel in the upper pole and thus providing more upper pole fullness. Many of our patients prefer this result. The implant feels more firm than the original silicone implant, but most patients will accept this trade-off. And indeed, some of our patients even prefer it.

So there is more to discuss during consultation. And for some patients, more choices make any choice difficult. But for most of our patients, more choices make for better and more predictable results.

Contact a Charleston breast augmentation surgeon

If you have further questions, please contact Charleston breast augmentation surgeon William Terranova, MD today at 843-797-0440 to schedule your initial consultation with us. We are pleased to accommodate the needs of patients throughout Charleston, Summerville and Mt. Pleasant, SC.