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Pre-operative Evaluation

In suitable patients, breast enlargement may be possible with fat injection. However, due to the necessity of repetitive sessions and feasibility in small to medium volume replacements, fat grafting has not gained wide popularity as silicone implants. For this reason, breast augmentation with silicon implants will be emphasized more thoroughly. Fat grafting is seperate topic in this site that may also be checked.

The silicone prosthesis is placed through the possible smallest incision from the areas may be hidden well. There are 3 main regions:

  • Armpit,

  • Areola (the pigmented circular area),

  • Under breast fold.

Each region has its own advantages and disadvantages. The most appropriate site for the patient will be determined in the preoperative period.

The implant may be placed in one of these surgical planes:

  • Under muscle,

  • Under muscle fascia

  • Under breast

  • Partially under muscle (Dual plane).

If there is not enough breast tissue to cover and hide the implant to be placed, "Dual plane" or "partial muscular plane" is the first option. This technique combines the advantages of under-muscle and under-breast planes. The lower pole of the breast is filled with breast tissue and prosthesis, while the upper pole is filled with muscle and prosthesis.

It offers less postoperative pain compared to the sub-muscular plan, and provides risk of lower capsular contracture rates and less implant visibility at the lower pole.

On the other hand, in the presence of sufficient tissue to cover the implant, "Sub-Fascial" or "Under Pectoralis Fascia" is the preferred plane. Even less pain compared to Dual Plane with better projection are the main advantages. Lower capsule formation rates compared to "Sub-Glandular" or "Under Breast" plane has been doumented also.

What is an Anatomical implant (or a Tear Drop implant) ? The difference is in shape... Anatomical devices are elliptical and asymmetrical in contrast to circular and symmetrical  round implants.

The advantage of this is that it is possible to achieve a more natural appearance easily in people whose body structure is dsitinguished (For example, tall and narrow body types or, conversely, short and wide bodies). However, rely on your surgeon's advice for implant choice as this may be a technically demanding decision.

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It is pointless to insist on implant type or anatomical plane to be placed unless your aesthetic surgeon tells you ...

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