Breast Augmentation Louisville

According to the American Society of Plastic surgery, over 300,000 women undergo breast augmentation each year, making it one of the most popular cosmetic procedures available. One may choose to have cosmetic surgery performed for a variety of reasons including small breasts, asymmetry, and loss of volume due to pregnancy or weight loss. The options for breast implants are constantly changing with the placement varying from in front or behind the chest muscle depending on the individual patient’s anatomy and desired result. Implants can be placed in several different methods such as below the breast, around the nipple, or under the arm. I strive to achieve a natural augmented look on every patient. Oversized implants are discouraged due to high risk of complications like development of scar tissue around the implant, also known as capsular contracture, and/or implant rupture.

Breast implants

The opinions for implants are constantly changing. Although saline and silicone implants are used, there are a variety in each category. There are advantages and disadvantages to each. There have been significant advancements in regards to silicone implants in the recent years. The previously used fragile silicone implants prone to rupture have since been replaced with more durable and natural looking ones. New generation silicone implants are “form-stable”. They are less prone to rupture and have an improved ability to retain their shape. There are now options regarding the surface texture and shape of implants. There are a variety of implants available.

The use of saline implants can allow for a smaller incision site, are less expensive when compared to silicone, and have the ability to modify the sizes as needed to achieve the favorable result. Saline implants allow for me to provide the most symmetric outcome possible due to the ability to adjust the sizes during the procedure rather than using the pre-filled silicone implants. This is particularly important in women with asymmetric breasts prior to augmentation. Silicone implants may provide a more natural look and feel especially for women with little breast tissue to begin with.

Much like every other aspect in life, all good things come with a slight risk of a poor outcome but I do everything in my nature to ensure my patients’ safety and well-being. Silicone implants should not be used in women under 22 years of age as stated by the Food and Drug Administration (FDA). Both implants have very low risk of rupture or infection after being placed. Silicone implants have been proven to be safe and un-associated with autoimmune diseases or lymphoma as previously documented in prior studies. Despite all the new advancements, I believe yearly follow up is required for any women receiving breast implants or other procedures.

Breast enhancement does not simply imply augmentation. A drooping (ptotic) will appear worse if only an implant is placed, without a lifting procedure. Ptosis is common and can increase with age, weight fluctuation, and pregnancy. There are a variety of methods to lift the breast to create a more youthful appearance, this is known as a mastopexy. Each of the procedures differ in complexity, incisions needed, and long-term outcomes. Traditionally, mastopexy has been centered around an approach around the areola (periareolar or “donut” mastopexy) or more aggressive approaches such as the “wise-pattern” mastopexy. My preferred method is the “SPAIR” mastopexy which can be more complex but provides a more successful long term outcome. This procedure results in a better shape, less scarring, and a more accelerated healing process. A breast lift may be combined with augmentation to increase both size and a more youthful breast position.

Goals

Breast enhancement can be very complex when considering the various components including the different materials, shapes, and sizes of implants. Also part of my consideration includes the symmetry of each breast whether an implant is being placed or not. Overall, the goal is a natural appearing breast that achieves the desired fullness and position. Stability of these results over time is critical to avoid the possibility of long-term complications. If an un-natural or overly augmented look is desired, other surgeons may be more appropriate. We take breast enhancement very seriously and treatment is individualized to achieve the optimal results for each patient.

Breast Implant Volume Required to Increase Bra Size

Nina-Marie NM King; What Is the Standard Volume to Increase a Cup Size for Breast Augmentation Surgery? A Novel Three-Dimensional Computed Tomographic Approach. Plast Reconstr Surg. 2017 May;139(5):1084-1089

Background
Women commonly inquire about the size of an implant needed to increase bra cup size. Historic approximations indicated that each 100cc increment increases one cup size. Subsequent studies have shown a wide variation. Different bra manufacturers are not always consistent regarding cup sizes. This study is designed to analyze the volume needed to increase one cup size, utilizing a variety of bra manufacturers.

Methods
Size 34 B-E bras were evaluated from 3 different bra manufacturers. The actual volume of each cup size was evaluated by a variety of methods, including volume displacement, measurements and CT reconstruction. 79 patients were evaluated who had undergone breast augmentation. These patients had been studied using the a 3-dimensional imaging device (Vectra). All women received silicone, form-stable implants.

Results
Actual bra volumes were variable among different manufacturers for the same cup size. Looking at bra cup volume by itself, the average volume required to increase one cup size ranged from 108-151cc’s across the different manufacturers. The implant volume required to increase one cup size varied between patients from 75-295cc, with a mean of 138cc.

Conclusion
Bra manufacturers are inconsistent regarding cup sizes. Some manufacturers have different cup sizes for the same actual volume. Therefore, it is very difficult to predict the volume needed to consistently increase one cup size. Nevertheless, an average volume of 130cc’s was required for smaller band sizes, and 150cc’s for larger band sizes.

Take-home message

Patients and surgeons know well that bra sizes vary among manufacturers. My experience is that professional sizing at particular stores is vital. It is also very helpful to be consistent when choosing bra brands. More accurate data now shows that an increase of around 150cc’s will equate to increase in one cup size. This is still just an estimation, as there are a variety of breast implant consistencies (saline vs. traditional silicone vs. form-stable silicone) and projection (low vs. moderate vs. high) for the same implant volume.