Breast implant surgery, also called breast augmentation or boob job, is one of the most popular cosmetic procedures in the UK. Whether you have chosen to enhance your breast size, restore volume after weight loss or pregnancy, or correct asymmetry, breast implant surgery can be transformative. However, with every operation there inevitably comes some degree of scarring. We will guide you through how scars form, the factors that affect scarring, and effective methods to reduce and manage scars following breast implant surgery.

Understanding the Scarring Process

Scars result from the body’s natural healing response to injury. During breast implant surgery, small incisions are carefully made to place the implants, and these surgical incisions heal by forming scar tissue. Here is a simplified overview of the scarring process:

• Haemostasis: Right after an incision is made, the body initiates blood clotting to stop bleeding. This is the very first stage of healing.
• Inflammation: Over the next few days, your immune system works to protect the incision. White blood cells are recruited to fight off any potential infection, and localised swelling, redness, and warmth are typical.
• Proliferation (tissue formation): Fibroblasts, a type of cell, deposit collagen fibres in the incision site to repair the wound. This new tissue formation is essential for closing the wound and begins to create a visible scar.
• Remodelling: The collagen fibres reorganise over time to strengthen the tissue. Early scars may appear raised and red, but as the wound remodels, scars typically flatten and lighten. This process can continue for months or even years after the operation.

Understanding these steps is key to guiding your scar management plan. Different interventions—such as silicone gels or massage—can influence the final appearance and condition of the scar during these stages.

Factors That Influence Scar Formation

While almost everyone is prone to scar development, certain factors can cause variations in scar appearance:

1. Genetics Genetic predisposition plays a major role in wound healing and scar formation. Some people have naturally thicker or raised scars (keloids or hypertrophic scars), while others heal with fine, flat scars.
2. Skin Tone and Type Darker skin tones may be at an increased risk of developing hyperpigmentation or keloid scars. It is still worth noting that individuals of any skin type or tone can experience excellent scar healing with the right care.
3. Surgical Technique The surgeon’s approach to incision placement, suture technique, and overall surgical precision can have a notable impact on the visibility and size of scars.
4. Lifestyle and General Health Smoking, poor nutrition, and inadequate hydration can interfere with proper wound healing, leading to more prominent scars. Similarly, chronic conditions such as diabetes can affect how well incisions heal.
5. Post-operative Care Following your surgeon’s instructions about dressing changes, physical activity, and any scar management regimen will influence the final appearance of your scars.

Choosing the Right Surgical Technique to Minimise Scars

One of the best ways to reduce scarring is to plan your surgery with your surgeon. Various techniques and incision placements can be considered:

1. Inframammary Incision This is the most common technique where a small incision is made in the crease under the breast (inframammary fold). Once healed, the scar often lies in a natural skin fold, making it relatively discrete.
2. Peri-areolar Incision A circular incision made along the border of the areola can blend into the transition between areola and breast skin. Scar visibility can be minimised as it often merges with the colour change between the areola and the rest of the breast.
3. Transaxillary Incision This approach places the incision in the armpit, potentially avoiding scars on the breast itself. However, not all implant types or sizes are well-suited for this approach, and it requires very precise surgical skill.
4. Trans-umbilical or Endoscopic Approach A less common approach that places the incision near the navel. While it avoids visible breast scarring, it is more complex and not widely performed.

Immediate Post-operative Care

Proper post-operative care is crucial for setting the groundwork for minimal scarring. Below are essential steps to follow in the first days and weeks after your surgery:

1. Follow Wound Care Instructions We will provide detailed instructions about caring for the incisions. This usually includes keeping the area clean, applying any recommended ointments, and possibly using a sterile dressing. Meticulous care helps prevent infection, a major factor that can worsen scars.
2. Wear a Surgical Bra or Support Garment Special post-surgery bras help reduce tension on the incision sites and keep implants supported. This support may prevent the incisions from stretching and help them heal more evenly.
3. Manage Swelling and Inflammation Using cold compresses, as advised, and keeping your upper body slightly elevated when resting can help minimise swelling. Reduced swelling promotes a more comfortable healing environment and may reduce inflammation-related scarring.
4. Gentle Mobilisation While bed rest is important initially, light movements, such as gentle shoulder rolls and short walks, promote better circulation. Good circulation speeds up healing and can reduce fluid build-up around the incision.
5. Avoid Smoking and Alcohol Smoking constricts blood vessels, diminishing blood supply and hindering wound healing. Alcohol, especially in excess, can also slow the recovery process. Avoiding these factors is crucial to optimal scar formation.
6. Attend All Follow-Up Appointments Regular check-ups allow Mr Nassab to monitor healing and quickly address any signs of infection or wound complications. Early intervention can prevent or minimise scar development issues.

Lifestyle Factors for Better Healing

An often-overlooked part of scar management is your general well-being. A healthy lifestyle can significantly improve wound healing and scar appearance.

1. Balanced Nutrition A diet rich in vitamins A, C, and E, along with proteins and minerals like zinc, supports new tissue formation. Vitamin C, for instance, assists in collagen production. Aim for a varied diet of fruits, vegetables, lean proteins, and whole grains.
2. Hydration Drinking ample water helps maintain skin elasticity. Adequate hydration aids in transporting essential nutrients and clearing away toxins that could hamper the healing process.
3. Exercise and Weight Maintenance While heavy exercise is off-limits until until 6 weeks post op, light activity after recovery can boost circulation and support overall health. Maintaining a healthy weight can reduce stress on your skin and help your scars remain less visible.
4. Sufficient Sleep Quality sleep is vital for healing because the body undertakes a host of restorative processes during sleep, including tissue repair. Strive for 7-9 hours of sleep each night.

Advanced Scar Management Techniques

Once your incisions have healed sufficiently, you can consider advanced techniques to further reduce scarring. This is usually possible after 2 weeks from your surgery once the dressings are all removed.

Silicone Products

• Silicone Gel and Silicone Sheets Silicone-based gels and sheets have become popular for their proven effectiveness in flattening and softening scars. When applied consistently, silicone creates a protective barrier that hydrates the scar, potentially reducing its thickness and colour intensity over time.
• Usage Guidelines Typically, silicone products are recommended for use once the incisions are fully closed and the risk of infection is minimal—often 2 weeks after surgery. Follow the application instructions diligently for optimal results.

Scar Massage

• Why It Helps Gentle scar massage helps break down the dense bands of collagen in a scar, preventing it from becoming raised and stiff. It can also encourage blood flow, distributing nutrients and removing waste products from the healing tissues.
• How to Perform Scar Massage Using clean hands or a recommended cream or lotion, gently place two or three fingers on the scar and apply light pressure. Move the fingertips in small circular motions across the scar for a few minutes.

Laser Therapy

• Types of Laser Therapy Several laser treatments, such as fractional CO₂ laser or pulsed dye laser, can improve scar texture and colour.
• What to Expect Each laser session takes place in a clinic, and multiple sessions might be necessary to achieve the best outcome.

Microneedling

• Procedure Microneedling involves using tiny needles to create micro-injuries on the scar surface. The controlled trauma prompts the skin to produce new collagen and remodel the scar tissue.
• Benefits It can help smooth out uneven scar tissue and reduce discolouration. Microneedling is often combined with topical serums or platelet-rich plasma (PRP) to further stimulate healing.

Corticosteroid Injections

• When Are They Used? In cases of hypertrophic or keloid scars, corticosteroid injections can help flatten and soften the scar tissue.

Breast Augmentation scar following surgery under the breast hidden in the breast fold.

Long-Term Scar Care and Follow-Up

While initial healing happens within a few weeks, scars continue to evolve for up to a year or longer. Proper long-term care can significantly influence the final appearance:

1. Protect Scars from Sun Exposure Scar tissue is more prone to sunburn and may darken when exposed to UV rays. Always apply a broad-spectrum sunscreen (SPF 30 or higher) to your scars, or cover them with clothing. This helps reduce hyperpigmentation and keeps the scar smoother and less noticeable over time.
2. Continue a Healthy Lifestyle Maintaining a balanced diet, staying hydrated, and controlling stress levels are important for overall health and thus contribute to better scar outcomes. Always keep an eye on your scars for any changes in texture, colour, or discomfort.
3. Be Patient Scar maturation is a long process. You may see improvements in the first few months, but complete scar “settling” often takes up to a year or more. Consistency in your scar management regimen pays off in the long run.

Additional Tips for Scar Reduction

• Gentle Skincare Products: Use fragrance-free or mild skincare products around the scar to avoid irritation. Products containing harsh chemicals might aggravate sensitive healing tissues.
• Avoid Picking at Scabs or Strain on Incisions: Picking at scabs disrupts natural healing and can worsen scarring. Also, try to avoid tight clothing or bras that may rub vigorously against the scar.
• Consider Professional Advice for Supplements: Some individuals explore supplements like vitamin E, zinc, or collagen peptides for improved skin healing. Although certain patients find them beneficial, the evidence is not universally conclusive. Always discuss these options with your surgeon or GP first.

Conclusion

Scarring is an inevitable but manageable part of breast implant surgery. By understanding the biology behind scars and the wide range of strategies for scar care, you can significantly influence the final appearance of your incision lines. From the moment you decide on surgery, open communication with Mr Nassab is paramount—ask about incision options, recommended aftercare, and possible advanced treatments like silicone gels, laser therapy, or microneedling.

A tailored post-operative plan focusing on careful wound care, support garments, and healthy lifestyle practices can help set the stage for optimal healing. Over the long term, diligent use of scar management techniques—such as scar massage, silicone products, and sun protection—can further reduce the visibility of your scars.

Remember, healing is a journey that continues well after the immediate recovery period. Each body heals differently, and patience is key. With consistent care, guidance from Mr Nassab, and a long-term commitment to your well-being, your scars can become far less noticeable, allowing you to fully appreciate the life-changing benefits that breast implant surgery can provide.

Breast augmentation is one of the most frequently performed cosmetic surgical procedures worldwide. Part of the popularity of this procedure lies in its ability to address a range of patient goals—from subtle enhancements to more dramatic changes in shape and volume. When considering breast augmentation, one of the primary questions many individuals have is: what are the different breast implant sizes, and how do I choose the right one?

We will explore the importance of breast implant sizes, how sizes are measured, the relationship between volume (in cubic centimetres, or cc) and bra cup sizes, and the various factors that play a role in choosing the optimal implant. Mr Nassab will guide you in choosing the right breast implant size for your anatomy and desired look.

Introduction to Breast Implant Sizes

Breast implant size is typically expressed in cubic centimetres (cc), which is a unit of volume. Unlike bra cup sizes, which can vary widely among manufacturers, cc measurements remain fairly consistent across implant brands. Having a measurement in cc allows for greater precision when it comes to fine-tuning the desired outcome.

Choosing the right implant size involves a balance of factors, including your unique anatomical measurements, personal preferences, and lifestyle considerations. There is no single “best” size; rather, there is a range of sizes that might suit you depending on your body shape and your aesthetic goals. This is why a thorough consultation with Mr Nassab plastic surgeon in Manchester and Cheshire is crucial.

How Breast Implant Sizes Are Measured

Most breast implants are measured in cubic centimetres (cc). The higher the cc value, the larger the implant. Implants can range anywhere from about 100 cc (which would create a subtle increase in breast size) to upwards of 800 cc or more (for those desiring a notably larger bust).

A few key points about measuring implant volume:

1. Consistency Across Brands: Unlike bra sizing, where an individual can be a 34C in one brand but a 34D in another, cc measurements remain relatively uniform across implant manufacturers. This allows for a more precise conversation regarding volume.
2. Incremental Changes: Implants typically come in increments of 25 cc or 50 cc. Even small changes in cc can affect the final result. For example, the difference between 300 cc and 320 cc can be subtle but noticeable, especially for those with a smaller frame.
3. Profiles and Dimensions: In addition to volume, an implant’s base width and projection profile also help define the overall look. Two implants may have the same cc measurement but differ in how far they project from the chest or how wide they appear on the chest wall.

Understanding these measurement basics sets the groundwork for deciding on the optimal size for you. However, there are many more factors at play than just raw cc figures.

The Relationship Between CC and Bra Cup Sizes

One of the most common questions about breast augmentation is: “How do I go from my current cup size to my desired cup size?” Although it would be convenient if there was a simple formula that translated cubic centimetres directly into a certain bra cup size, it is more complicated in reality. Cup sizes are not standardised—a 34C in one brand may be a 34B or a 34D in another. Additionally, the shape of your chest wall, your natural breast tissue, and the distribution of your breast tissue can all impact what cup size you end up measuring after surgery.

Still, there are some general guidelines:

1. 130 to 150 cc per cup size: A rough estimate often cited is that each increase in cup size requires between 130 and 150 cc. However, this estimate can vary significantly from person to person.
2. Body Frame Matters: If you have a smaller ribcage (e.g., you wear a 32 band size), a 200 cc implant may appear more significant on you than on someone with a 36 band size.
3. Existing Breast Tissue: Women with a moderate amount of existing breast tissue may notice a smaller implant can achieve the same effect that would require a larger implant on someone with less starting tissue.

Because of these variables, it is best to remember that implant volume does not directly correlate to a specific bra size. Instead, your outcome can be visualised more effectively with sizers during your consultation with Mr Nassab or with 3D imaging systems such as Crisalix.

Factors to Consider When Choosing an Implant Size

Your Body Proportions

Your height, weight, shoulder width, ribcage circumference, and hip measurements all play important roles in determining the most harmonious implant size. A size that looks proportionate on a tall individual may appear too large on someone more petite, and vice versa.

Desired Aesthetic Goals

Are you aiming for a natural and subtle increase, or do you wish for a dramatic change in your appearance? Understanding the look you want to achieve can steer you toward a specific volume range. It may also influence your choice of implant shape (round or teardrop) and profile.

Lifestyle Considerations

Active individuals, particularly those involved in high-impact sports or heavy exercise regimes, might find extremely large implants cumbersome. A more moderate implant size may be preferable to maintain comfort, functionality, and ease of movement.

Existing Breast Tissue and Skin Elasticity

If you have tighter skin with limited elasticity, inserting very large implants may cause complications over time, including stretch marks or implant edge visibility. Conversely, those with more abundant breast tissue and good skin elasticity may accommodate larger implants more comfortably.

Common Breast Implant Sizes

In practice, most patients choose implants within a broad range of 200 cc to 600 cc. However, some go below this range for very subtle enhancements, and some opt for more than 600 cc for a dramatic change.

Smaller Implants (200–300 cc)

• Who might choose these? Individuals seeking a subtle enhancement or MiniAug—often those who are already happy with their breast shape but want a slight increase in volume. These are also popular among very petite women who do not desire an overly pronounced look.
• Advantages:
  • Natural appearance
  • Lower risk of complications such as visible rippling
  • Comfortable for an active lifestyle
• Considerations: If you have broad shoulders or a more substantial frame, smaller implants might look disproportionately small, depending on your aesthetic goals.

Moderate-Sized Implants (300–400 cc)

• Who might choose these? This range often suits individuals looking to go from, for instance, an A or small B cup to a full C or small D cup. It is a versatile choice that can offer a balance between noticeable enhancement and a natural look. The 300cc breast implant is one of the most commonly used sizes.
• Advantages:
  • More noticeable change compared to smaller implants
  • Can still maintain a relatively natural contour
  • Suitable for many body types
• Considerations: Every individual’s interpretation of “moderate size” differs. One person’s moderate might be another’s large, so a personalised evaluation is essential.

5.3. Larger Implants (400–600 cc and beyond)

• Who might choose these? Patients desiring a more dramatic transformation may opt for this range. This size bracket also suits women with broader shoulders or more robust frames who want the enhancement to appear proportionate to their body. Often patient going for a larger size may already have implants and so need to consider going slightly larger for more volume.
• Advantages:
  • Significant volume increase
  • Can create a curvier silhouette
  • Ideal for those specifically wanting a fuller profile
• Considerations:
  • Increased weight on the chest
  • Potential for greater wear on skin and supporting tissues over time
  • May look less natural, depending on initial body proportions and personal preference

Implant Profile: How It Affects Appearance

When discussing sizes, the conversation invariably moves to implant profile. Profile refers to how far the implant projects forward from the chest wall when viewed from the side. Common profile categories include:

1. Low Profile: These implants have a broader base and project less, offering a more subtle look.
2. Moderate Profile: A midpoint option that balances base width and forward projection.
3. High Profile: These implants have a narrower base and project further, creating a more prominent cleavage.
4. Xtra High Profile: Provides the greatest projection and is often used for patients looking for a very pronounced look or who have a narrower chest wall.

Two implants with the same volume (cc) can appear very different if one is low profile and the other is high profile. A high-profile 300 cc implant can look more prominent than a low-profile 300 cc implant because of how the volume is distributed.

Implant Shape: Round vs. Anatomical (Teardrop)

Breast implant sizing is also influenced by implant shape. Round implants are typically circular in shape and can create more fullness in the upper pole of the breast. Teardrop (anatomical) implants mimic the natural slope of the breast, with a gentler fullness at the top and more volume at the bottom.

• Round Implants: Often come in a wider range of profiles, can move slightly in the implant pocket without distorting breast shape, and are generally considered a popular choice for patients seeking a rounder, fuller look.
• Teardrop Implants: Provide a more natural slope, but if they rotate in the pocket, there might be some distortion of shape. They are well-suited to patients aiming for a more subtle, anatomical breast contour.

While shape is a separate consideration from volume, it can significantly influence how a particular size appears. A round 300 cc implant and a teardrop 300 cc implant will create subtly different final aesthetics on the same individual.

Achieving Your Desired Bra Cup Size

Though we emphasise that there is no direct formula for translating cc to cup size, many individuals do want a ballpark sense of what final cup size they might wear post-surgery. Some plastic surgeons use sizers or 3D imaging to help you visualise potential outcomes. During a consultation, you might be able to “try on” different implant sizes using specially designed sizer bras. This can give you a more concrete sense of how you feel about the look and weight of different implant sizes.

It is also valuable to bring photos or images that demonstrate your desired outcomes and your undesired extremes. This visual reference helps communicate your aesthetic goals in a way that might be clearer than simply saying, “I want to be a C cup.”

Potential Risks and Complications Related to Implant Size

Just as breast augmentation carries general surgical risks, the size of the implant can introduce additional considerations:

1. Rippling: Larger implants with thin tissue coverage can sometimes exhibit visible rippling at the edges.
2. Bottoming Out: Larger implants can put more strain on the lower breast pole, potentially leading to downward displacement over time if the tissues are not adequately supportive.
3. Neck, Back, and Shoulder Strain: Implants that are disproportionately large may contribute to posture issues or discomfort, particularly for those who engage in frequent exercise or physical labour.
4. Revisions: Patients who choose a size they later feel is either too big or too small may seek revision surgery, which comes with additional costs, recovery, and surgical risks.

Tips for Making Your Decision

When facing the variety of breast implant sizes, here are some final pointers that may help you find the best fit:

1. Be Realistic About Your Starting Point: If you begin with very little breast tissue or have a tight chest wall, jumping too many cup sizes in one surgery might not be advisable. Gradual improvements can reduce strain on your tissues.
2. Focus on Proportions Over Cup Size: Rather than fixating on a specific letter in a bra size, think about overall harmony with your body. This is generally we approach sizing recommendations.
3. Consider Your Long-Term Plans: If you plan on having children or if you intend to lose or gain weight in the near future, these factors might influence your implant choice. Weight fluctuations can affect the appearance and longevity of breast implants.
4. Try on Sizers: Taking advantage of sizers, imaging, or even placing silicone ‘try-on’ inserts in a bra can give you an immediate sense of the difference between, for example, 300 cc and 350 cc.
5. Discuss Surgery and Recovery Implications: Larger implants may have a slightly longer or more uncomfortable healing period because of the greater stretching of tissues. Smaller implants might involve less discomfort but may not achieve the dramatic fullness some patients are looking for.
6. Seek Multiple Opinions if Needed: It is perfectly valid to get a second (or third) opinion if you feel uncertain. Different surgeons might have varied approaches, and you should find someone whose philosophy and aesthetic style resonate with you.

The Importance of a Personalised Approach

No two patients are the same, and no single implant size is universally ideal. A personalised approach that accounts for every aspect of your lifestyle, anatomy, and aesthetic preferences is paramount. Your final decision should leave you confident that the result will appear balanced, attractive, and closely aligned with your vision.

It is also crucial to maintain open communication with your surgeon. Be clear about what “too large” or “too small” means to you. Sometimes, photos of what you consider an ideal look can help bridge the gap between surgical measurements and personal perception.

Recovering From Breast Augmentation of Different Sizes

While the recovery process for breast augmentation shares many similarities across different implant sizes, the size can still impact your experience:

1. Pain and Discomfort: Larger implants may cause more immediate postoperative discomfort due to the greater stretching of the breast tissue and skin. This discomfort usually subsides within a few weeks.
2. Supportive Garments: Regardless of size, you will likely be advised to wear a supportive surgical bra. For larger implants, consistent use of support garments can help the tissue heal properly and reduce swelling.
3. Activity Levels: Most patients can resume light activities within a week or two, though strenuous exercise, especially involving the chest muscles, should be avoided for four to six weeks or as directed by your surgeon.
4. Long-Term Care: Regular follow-up appointments will help ensure your implants are settling well, and we can monitor for any signs of complications. Larger implants may require more vigilant support, such as wearing a supportive bra even at night.

Final Thoughts on Selecting the Right Breast Implant Size

Choosing the perfect breast implant size is a highly personal decision. It goes well beyond trying to jump from one cup size to another; it involves a careful evaluation of your body shape, cosmetic preferences, health considerations, and lifestyle. With so many options available—from modest 200 cc implants to sizes exceeding 600 cc—there is truly something for everyone.

What truly matters is finding a skilled plastic surgeon like Mr Nassab who prioritises patient education, realistic expectations, and individualised results. By understanding how implant sizes are determined, and by recognising how factors such as implant profile, shape, and your personal anatomy interplay, you can make an informed, confident decision. The aim is not just to achieve bigger breasts, but to ensure the results enhance your natural proportions and leave you feeling comfortable in your own skin.

Breast augmentation has long been one of the most popular cosmetic procedures worldwide, sought by those looking to enhance breast shape, size, and overall appearance. An approach known as preservation breast augmentation has been gaining traction although it is has been around for some time. This method focuses on maintaining as much native breast tissue and anatomy as possible during the augmentation process, thus preserving blood flow, supporting tissues, and natural contours. By doing so, patients can potentially benefit from fewer complications, a smoother recovery period, and more aesthetically pleasing results that complement their natural breast structure.

We will delve into the concept of preservation breast augmentation, discuss how it differs from traditional methods, explore potential benefits and risks, and answer the most frequently asked questions surrounding this procedure. You will be equipped with a more thorough understanding of preservation breast augmentation and how it might align with your aesthetic goals.

Breast Augmentation

It is important to have a basic understanding of the traditional breast augmentation approach. Typically, a breast augmentation involves creating a pocket for an implant within the breast. This pocket can be made either beneath the chest muscle (submuscular placement), beneath the breast tissue (subglandular placement), or partly beneath the muscle and partly beneath the breast tissue (a dual-plane approach).

Traditional Breast Augmentation Techniques

Submuscular (Under the Muscle)

With submuscular placement, the implant is positioned partially or completely under the pectoralis major muscle. This approach can offer a more gradual slope to the upper breast and is thought to reduce the risk of certain complications, such as capsular contracture. However, it may be associated with a slightly longer recovery time and a greater degree of postoperative discomfort.

Subglandular (Over the Muscle)

In a subglandular procedure, the implant is placed beneath the breast tissue but above the pectoralis major muscle. This can lead to a more defined upper-pole fullness, quicker recovery, and less discomfort. However, it may potentially increase the risk of visible rippling or capsular contracture if proper technique is not followed or if there is insufficient soft tissue coverage.

Dual-plane Technique

The dual-plane technique combines elements of both submuscular and subglandular placement, thereby benefiting from the muscle’s coverage at the top of the implant while allowing the lower portion of the implant to sit beneath breast tissue. This approach can deliver a more natural breast shape and reduce the risk of certain complications while offering a stable position and adequate tissue coverage.

Implants, Incisions, and Considerations

In standard breast augmentation, the surgeon makes incisions (most commonly in the inframammary fold, around the areola, or occasionally in the armpit), creates a pocket for the implant, and then inserts the implant. Modern implants can be filled with silicone or saline, and they vary in shape, size, and projection. The choice of implant is based on individual patient anatomy, preference, and our recommendations.

What Is Preservation Breast Augmentation?

Preservation breast augmentation (also sometimes referred to as “tissue-preserving breast augmentation” or “preservation technique augmentation”) is a refined surgical method that emphasises maintaining the integrity of the patient’s natural breast structure. The overarching principle is to minimise disruption to blood vessels, nerves, glands, and connective tissues. By preserving these components as much as possible, the risk of compromising the breast’s long-term health or sensation is potentially reduced.

The concept of preservation in breast surgery builds upon evolving approaches in cosmetic and reconstructive procedures. Similar philosophies have been adopted in breast reduction and mastopexy (breast lift) procedures, wherein surgeons strive to keep the breast’s blood supply intact in order to promote faster healing, fewer complications, and more robust results. Extending this principle to augmentation means that every step of the surgery is designed to reduce invasive manoeuvres that might otherwise damage key structures.

How Does Preservation Breast Augmentation Differ from Traditional Methods?

While traditional augmentation focuses on creating a pocket for the implant under or above the muscle, preservation breast augmentation involves creating the pocket over the muscle often in a subfascial plane. Here are the key differences:

Minimised Tissue Disruption

In preservation breast augmentation, the surgeon may employ a more precise dissection technique to separate layers of tissue without cutting through critical support structures such as the Cooper’s ligaments (these ligaments help maintain breast shape and contribute to firmness). Preserving these ligaments aids in supporting the implant over time, potentially leading to more stable results. The muscle is also preserved which can aid a quicker recovery. The plane is usually subfascial meaning that it is under the thin layer of tissue just above the muscle.

Optimised Blood Flow

By carefully conserving blood vessels and limiting the dissection, preservation breast augmentation can help reduce the risk of complications such as tissue necrosis, delayed healing, or infection. Good blood flow is fundamental to healthy healing and reducing postoperative issues.

Enhanced Sensation Preservation

During more traditional augmentations, there is a risk of disrupting nerves that contribute to nipple and breast sensation. Preservation breast augmentation with more limited dissection may help reduce the risk of sensory changes.

The Potential Advantages of Preservation Breast Augmentation

The growing popularity of preservation breast augmentation can be attributed to the potential benefits associated with this conservative approach. These advantages may include:

Reduced Trauma to Breast Tissue

By protecting existing tissues, surgeons minimise the physical trauma inflicted during the procedure. Reduced trauma can translate into less bruising, swelling, and postoperative discomfort.

Possibly Lower Complication Rates

Maintaining robust blood supply and structural integrity can decrease the likelihood of complications such as infection, tissue necrosis, or significant bleeding. A strong blood flow and well-preserved tissue layers are associated with healthier postoperative outcomes.

Shortened Recovery Period

Although recovery experiences can vary considerably between patients, a procedure that is less disruptive to tissues may facilitate quicker healing and recovery. Some patients report being able to return to work or normal activities sooner than they might with more traditional methods.

Preservation of Sensation

Because the nerves are handled carefully during preservation breast augmentation, the risk of reduced breast or nipple sensation may be lowered compared to more invasive procedures.

Who Is an Ideal Candidate for Preservation Breast Augmentation?

Not every person seeking breast augmentation will be an ideal candidate for a preservation approach, but for many, this technique may be a compelling option. An initial consultation with an experienced plastic surgeon like Mr Nassab is critical to determine suitability. Generally, candidates might be:

Someone with some natural breast tissue

Patients with some existing breast tissue will be better candidates than those with little or no breast tissue. This allows us to go in the plane above the muscle and hopefully reduce the risks of rippling. In very slim patients there is little cover of the implants and so there may be a higher risk of rippling.

Someone seeking a more quicker recovery

Preservation breast augmentation may allow patients to have a quicker recovery with less postoperative pain.

Good General Health

Patients need to be in good overall health, without major systemic medical conditions that might impede healing.

Having Realistic Expectations

While preservation breast augmentation can deliver transformative results, it is important to remember that the final outcome depends on a variety of factors. Patients should maintain realistic expectations regarding achievable size and shape, based on their unique anatomy. Some patients with sagging or ptotic breasts may need additional procedures such as uplifts.

Selecting the Right Implant

Some implants may be better suited for this technique. These are implants that are silicone and filled more resulting in lower rippling risk. The Mentor Memory Gel Xtra, Motiva, or Mia implants are examples of these types of implants.

This patient underwent subfascial breast augmentation using a 325cc high profile round textured implant.

Frequently Asked Questions

Is preservation breast augmentation more expensive than traditional breast augmentation?

Costs can vary based on the surgeon’s expertise, geographic location, choice of implant, and hospital or clinic fees. While the surgical technique may differ, the difference in cost is not always significant. During your consultation, we will provide a breakdown of fees, allowing you to make an informed decision. The techniques such as Preserve or Mia are generally more expensive due to the cost of the implants and instruments required to perform the procedure.

How long does a preservation breast augmentation procedure take?

The duration can range from 60 to 90 minutes, depending on the complexity of the case, the surgical approach. If additional procedures, such as a breast lift, are required then the procedure will be longer.

Is there a difference in scarring compared to standard breast augmentation?

Incisions for preservation breast augmentation often follow the same patterns used in conventional procedures. The use of devices to insert the implants may result in slightly shorter scars compared to some traditional scars. The scars in the armpit tend to be smaller than those underneath the breast.

What if I decide to have children or breastfeed in the future?

Preservation breast augmentation may conserve glandular tissue and ductal structures allowing breast feeding in the future.

Can I combine preservation breast augmentation with other procedures?

Yes. Many patients choose to address multiple aesthetic concerns at once, such as a breast lift or liposuction. Combining procedures can be an efficient way to minimise overall recovery time, but discuss potential combinations with your surgeon for a personalised plan.

Is preservation breast augmentation suitable for a revision procedure?

Patients undergoing revision will already have a pocket from previous surgery and so this technique is not likely to have any benefits.

The Future of Preservation Breast Augmentation

As breast surgery techniques continue to evolve, preservation methods are likely to become more mainstream. We have already seen that there has been a move towards preservation rhinoplasty and preservation deep plane facelift techniques. Ongoing research into new surgical tools and advanced implant materials may enhance the efficacy of tissue-preserving approaches. We have seen the Mia technique using minimal access incision in the armpit to perform the procedure and the Motiva Preserve technique using a special device for insertion of the implants.

Preservation breast augmentation represents a paradigm shift in cosmetic breast surgery. By focusing on safeguarding the breast’s structural, vascular, and nerve integrity, this technique offers:

• Reduced tissue trauma and potentially quicker recovery

• Preservation of blood flow and nerve pathways, which may preserve breast sensation

While the principles of preservation breast augmentation are compelling, the decision to undergo any form of breast enhancement should be made in consultation with a qualified plastic surgeon like Mr Reza Nassab. During your appointment, we will evaluate whether you are a good candidate for the procedure, help you select the most appropriate implant type and size, and walk you through each step of the process to ensure you are well-informed and confident in your decision.

Final Thoughts

Breast augmentation has come a long way since the early days of rudimentary implants. Preservation breast augmentation, with its focus on maintaining the integrity of the native breast tissue, nerves, and blood supply, exemplifies the ongoing innovation in aesthetic plastic surgery. This evolution continues to benefit patients who are seeking a more natural-looking and feeling augmentation, while potentially enjoying reduced complications and enhanced long-term results.

Nevertheless, no surgery is entirely risk-free. It is vital that any prospective patient weighs the benefits of preservation breast augmentation against potential complications, the healing process, and their personal budget. If you have been contemplating breast augmentation but feel uncertain about the traditional approach, preservation breast augmentation may be just what you are looking for. Its distinct principles of minimal tissue disruption make it an appealing option for individuals who desire a high-quality, aesthetically pleasing result that has rapid recovery. While it might not be suitable for everyone, it is important to discuss options with Mr Nassab.

If you think this procedure could be right for you, it is best to book a consultation with Mr Nassab who will help you explore the intricacies of this technique, ensuring that you have all the information necessary to make a confident, informed choice regarding your body, your appearance, and your well-being.

Breast implant rippling is a relatively common concern among individuals who have undergone breast augmentation surgery. This condition refers to the visible or palpable folds and wrinkles that can appear on the surface of the breast, giving the skin an uneven texture. While rippling is not necessarily harmful to health, it can significantly affect the aesthetic results of breast augmentation, causing distress and dissatisfaction for some patients. There are a number of factors that result in more visible rippling.

What Causes Breast Implant Rippling?

Understanding the causes of breast implant rippling is essential for prevention and treatment. There are some factors that can be difficult to correct due your anatomy or implant technology. Several factors contribute to the development of this condition, including:

1. Implant Fill Material

Saline implants are notably more prone to rippling compared to silicone gel implants. Saline implants contain a saltwater solution, which has lower viscosity than silicone gel. This means the saline solution moves more freely within the implant shell, allowing folds and wrinkles to form more easily. Conversely, silicone implants have a thicker, more cohesive gel that better maintains the implant’s shape, significantly reducing the likelihood of rippling. In the UK, saline implants are rarely used but you can still get rippling with silicone implants. The fill of the implant is an important factor in rippling. Most implants are not filled fully so they have some softness to them. This means that they can develop folds or ripples which is normal. If an implant is filled fully they tend to be more solid and not feel as natural. There are some types of implants that are filled slightly more such as the Mentor Memory Gel Xtra or some Motiva implants. These may have less rippling but may still develop this.

2. Implant Placement

The position of the implant within the breast greatly influences rippling. Subglandular placement (above the muscle but beneath the breast tissue) provides less natural tissue coverage, increasing the visibility of ripples, particularly in patients with thin breast tissue. On the other hand, submuscular placement (beneath the pectoralis major muscle) offers better coverage, substantially reducing the risk of rippling. Some very slim patients will always develop some degree of rippling even when the implant is placed under the muscle.

3. Patient Anatomy

The patient’s body characteristics significantly impact the occurrence of rippling. Individuals with thin or minimal natural breast tissue, low body fat, or very slim body frames are more susceptible to noticeable rippling due to insufficient soft tissue coverage to conceal implant edges or folds. The skin also thins with time and this can result in more visible rippling. Patients with more tissue are less likely to develop rippling as there is more tissue to cover the breast implants.

5. Implant Size

Selecting implants that are disproportionately large relative to the patient’s natural breast tissue and body frame can cause stretching and thinning of the breast tissue and skin. This stretching can lead to visible rippling, as the tissue coverage becomes insufficient to conceal the implant adequately.

Is Implant Rippling Normal?

Rippling can be considered normal, especially in certain positions or lighting conditions. For example, some patients might notice slight rippling when bending forward or lying down. However, more pronounced rippling that is visible at rest or through clothing can occur with weight changes and due to the factors discussed already.

Reducing the Risk of Rippling

There are several approaches that can help reduce the risk of developing implant rippling:

1. Opt for Silicone Implants

Choosing silicone gel implants over saline significantly reduces the risk of rippling due to the gel’s cohesive nature. Silicone implants maintain their shape better, providing a smoother, more natural appearance. The higher cohesive gel implants such as Memory Gel Xtra or Motiva implants may have lower rippling risk when compared less cohesive gel implants.

2. Submuscular Implant Placement

Placing implants beneath the chest muscle provides additional tissue coverage, masking potential rippling effectively. This approach is particularly beneficial for patients with thin breast tissue or a slim physique.

3. Appropriate Implant Sizing

Selecting the right implant size that aligns proportionately with the patient’s natural breast dimensions and body structure is crucial. This reduces tissue strain and helps prevent rippling from occurring.

4. Enhancing Tissue Coverage

In patients with thin breast tissue, additional procedures such as fat grafting (lipomodelling) or using acellular dermal matrices or mesh can increase soft tissue coverage. These methods can help diminish the visibility of rippling.

Why Am I Experiencing Rippling?

If you are experiencing noticeable implant rippling, several factors might be at play:

• Implant Type: If saline implants were selected, their fluid nature might contribute significantly to the issue.
• Placement Position: Implants placed above the muscle (subglandular) in individuals with minimal tissue coverage are more prone to rippling.
• Body Composition: Individuals with thin breast tissue or low body fat will inherently have a higher risk of rippling.
• Implant Size Issues: Implants that are too large for your natural anatomy can cause tissue stretching, resulting in rippling.
• Weight Change: If you have recently lost weight then this is likely to contribute to the risk of more noticeable rippling.
• Skin Changes: As we age the skin thins and this also happens after implants have been in for a long time. The thinning of the skin or laxity can result in rippling.

Treating Implant Rippling

If rippling has become a concern, several treatments can address and significantly improve the condition:

1. Fat Grafting

Fat grafting, also known as lipomodelling, involves harvesting fat from other parts of your body and injecting it into the breast. This procedure increases the thickness of breast tissue covering the implant, effectively camouflaging ripples and improving overall breast contour and appearance.

2. Implant Exchange

Swapping saline implants for cohesive silicone gel implants can significantly reduce rippling. Silicone implants maintain their shape better and offer a smoother, more natural look and feel. We often find that patients will change to the more filled implants when having exchange of breast implants surgery.

3. Changing Implant Position

Repositioning the implants from above to below the muscle (submuscular placement) provides additional soft tissue coverage. This approach effectively masks rippling, especially in patients with thin breast tissue.

4. Using Acellular Dermal Matrix (ADM)

Acellular dermal matrix is a natural material used to reinforce the breast tissue around the implant. During a revision surgery, ADM provides an extra layer of support, smoothing out the implant’s surface and significantly improving the cosmetic outcome.

5. Superior Coverage Technique

This surgical approach involves using part of the chest muscle (pectoralis major) to provide better coverage over the implant’s upper portion, reducing rippling visibility. Research has shown this technique effectively reduces the prevalence and visibility of rippling. This is essentially changing the plane of the implant from over to under the muscle.

6. Skin Tightening

Some patients may have skin laxity which occurs with ageing, pregnancy, breast feeding and having had implants. There is often improvement in the rippling when the skin is tightened using a breast lift which can also include a change of implants at the same time.

Conclusion

Breast implant rippling, while generally considered normal and harmless, can significantly impact the aesthetic satisfaction of breast augmentation patients. Understanding its causes and risk factors helps in both prevention and treatment. Modern surgical techniques and implant options have considerably reduced the incidence and severity of rippling. If you experience rippling, book a consultation with Mr Nassab to discuss options and suitable corrective measures tailored specifically to your needs. With appropriate intervention, significant improvements in breast appearance and patient confidence can be achieved.