Breast augmentation and breast implants are terms often used as if they mean the same thing, but they refer to two distinct components of cosmetic breast enhancement. The fundamental difference lies in their nature: one is the surgical procedure performed, and the other is the medical device used to achieve the desired outcome. Understanding this distinction is the first step for anyone considering this form of body contouring.
Clarifying the Terminology: Procedure vs. Device
Breast augmentation is the surgical process designed to increase the size, enhance the shape, or restore the volume of the breasts. It is the overall action performed by the surgeon to modify the breast contour, often used to correct asymmetry or restore fullness lost due to weight fluctuation or pregnancy. The procedure can be accomplished through various methods, most commonly involving the placement of implants, but sometimes through fat transfer, which utilizes the patient’s own tissue.
Breast implants, in contrast, are the specific medical devices used to create the volume increase in an implant-based augmentation. They are the prosthetic tools, typically consisting of a silicone shell filled with either a liquid or gel substance.
Understanding the Types of Implants
Implants are primarily categorized by the material used for their filling, which influences their feel and required monitoring. Saline implants contain a sterile salt water solution, which is filled into the silicone shell after placement inside the body. If a rupture occurs, the implant deflates, and the harmless solution is naturally absorbed by the body. This allows for a smaller surgical incision because the shell is inserted empty.
Silicone gel implants are pre-filled with a cohesive silicone gel designed to mimic the feel of natural breast tissue. These implants require a slightly larger incision for insertion because they are placed in their final, filled form. A specialized category, often called “gummy bear” or form-stable implants, uses a thicker, highly cohesive silicone gel that maintains its shape even if the shell is compromised. Patients with silicone implants need regular imaging, such as an ultrasound or MRI, to monitor for a “silent rupture,” as the gel may remain contained within the implant pocket.
Implants are also differentiated by their outer surface and overall shape. The surface can be smooth, which offers the softest feel and allows the implant to move more freely within the breast pocket. Alternatively, a textured surface encourages scar tissue to adhere to the implant, helping to keep it in a fixed position and reducing rotation.
In terms of shape, round implants are symmetrical, offering a fuller look, particularly in the upper portion of the breast. Because of their uniform shape, rotation does not affect the breast’s appearance. Teardrop-shaped, or anatomical, implants have a contoured design with more projection at the bottom, aiming to replicate the natural slope of a breast. If a teardrop implant rotates, however, it can lead to an unnatural appearance that requires surgical correction.
Surgical Technique and Placement Options
The execution of breast augmentation involves not only the selection of the implant but also the choice of placement plane and incision site. The two primary placement options determine the implant’s relationship to the chest wall musculature.
Subglandular placement positions the implant directly behind the breast tissue but in front of the pectoral muscle. This choice typically results in a quicker recovery period because the muscle is not manipulated.
Submuscular placement places the implant partially or entirely beneath the pectoralis major muscle. This technique offers greater coverage for the implant, which is often preferred for patients with minimal natural breast tissue to help conceal the implant edges and minimize visible rippling. While it may involve a longer recovery time and more initial discomfort due to muscle disruption, it is associated with a lower incidence of capsular contracture and can provide a more gradual, natural slope to the upper breast.
The surgeon also selects an incision site, which is the entry point for the implant and is chosen to minimize the visibility of the resulting scar. The inframammary incision, placed in the natural crease beneath the breast, is the most common approach, offering the surgeon excellent access for precise pocket creation and implant placement.
The periareolar incision follows the border between the areola and the breast skin, allowing the scar to blend with the color difference. A transaxillary incision is made in the armpit, which leaves no scar on the breast itself, though it requires specialized instruments to create the implant pocket.
Pre-Surgical Consultation and Planning
The consultation phase is a comprehensive process where the patient and surgeon align on goals and determine the appropriate surgical plan. During this meeting, the surgeon conducts a physical examination, taking precise measurements of the existing breast size, shape, and skin quality. This assessment helps determine the anatomical constraints and the best implant dimensions to achieve a proportionate outcome.
The patient’s aesthetic expectations are discussed, and visualization tools, such as external sizers or 3D imaging, are often used to demonstrate the potential post-operative volume and projection. This step is important for setting realistic outcomes and selecting an implant volume, measured in cubic centimeters, that complements the patient’s overall body frame. A review of the medical history, including any current medications, smoking status, and family history of breast cancer, is completed to ensure the patient is a suitable candidate for the procedure.