Breast surgery is the most popular cosmetic surgery procedure. Discover five different breast augmentation techniques used by Doctor Vincent Masson, cosmetic surgeon in Paris.
Five breast augmentation techniques
>> Breast augmentation with breast implants :
The aim consists in reshaping the breast by placing a breast implant, most often in silicone gel, in a round or anatomical shape (pear shaped) either in front of the pectoral muscle (retroglandular or premuscular) or behind it (retromuscular), and using either the dual plane or the bi plane technique (the implant is both in front and behind the muscle). The scars are almost invisible and placed either at the level of the areola, the groove under the breast or under the arm in the armpit (axillary route). There is no age limit for the operation, which is performed more and more before 20 years of age but, on average, patients are between 20 and 40 years of age for primary implantations apart from ptosis correction (breast lift) after pregnancy.
>> Breast augmentation using a dual plane breast implant :
The implant is positioned both behind and in front of the muscle in this new technique recommended by Dr. Masson for a more natural result.
>> Breast augmentation by lipofilling or fat transfer :
Liposuction is carried out and the fat which is aspirated is purified by filtering or centrifugation and then reinjected into the breasts in order to reshape them. One or two sessions are necessary and the fat that is taken remains permanently. The method is natural. A debate around the risk of breast cancer linked to this lipofilling technique has long taken place but, after more than 20 years of study, we can today rule out the risk.
>> Composite breast augmentation (breast implant + lipofilling): :
The principle is to put in place a breast implant, hide its contours, and improve the shape of the breasts and cleavage by injecting more fat.
>> Ptosis correction with breast implants (or mastopexy) :
When there is excess skin (empty and sagging breast or breast ptosis), an implant alone or lipofilling will not be effective in lifting the breast. Only the volume will be increased. We are then obliged, in addition to the increase in volume, to lift the breast. Different techniques exist for this (round block, vertical technique, T-shaped breast plasty). The principle is to combine during the same procedure the installation of a breast implant and a breast lift (ptosis correction).
Dr. Masson’s office is the very first in Paris to be equipped with 4D Eve 4.0 scanner technology.
When you come for a breast augmentation consultation you will be able to use augmented reality to discover how your new breasts will look.
What size should you choose for breast augmentation?
Choosing the size of the implant is very difficult for breast augmentation. To tell the truth, this is the most delicate problem, everything else is just a question of organization including the appointment with the surgeon, blood test, mammography, anesthesia visit, the operative technique (areolar or under breast scar, dual plane etc.) and post-operative recovery. It is important to be patient because the first days are difficult, pain is present for 3 to 4 days and quite intense, you must wear your compression bra for 4 to 6 weeks and sport is impossible for the first few weeks after the operation. The scars take a year to fade and the shape and feel is only final after 3 to 6 months.
Many patients come to the clinic with a definite idea of the desired implant volume they want. I think this is a mistake because it is very difficult to compare yourself to before and after pictures or to friends. I have noticed that it is often these patients who are the most disappointed, in post-operative terms, with the size of their new breasts (often finding them too small).
In my opinion, you should not compare yourself to others. Between a 300 ml moderate profile implant (11.6 cm base and 4.2 cm projection) and a 300 ml or cc extra high profile implant (10.4 cm base and 5 cm projection) there is a big difference! The volume is identical, but the shape will be quite different. Nor should we reason strictly in terms of bra or cup size because there is a huge difference depending on the brand of lingerie and whether the bra is underwired or padded.
A very good benchmark is to consider that 200 cc or ml corresponds to a cup size in general.
When choosing implants, you must think in the first place of the thickness of the mammary gland and the muscle. The skin, breast tissue and muscle will cover the implant and therefore their thickness must be subtracted from the base of the chosen implant. Usually to measure the breast base, we place a measuring tape horizontally at the areola and measure the width of the desired breast. There must be the smallest possible gap between the two breasts (not always possible if the sternum is very large and the patient is very thin) and the breast must extend slightly to the side, towards the arm. We take the measurement and we remove the estimated thickness of the gland and the muscle which we divide by 2. We thus obtain the size of the breast base. The height of the implant then needs to be chosen or, at least if it is round, at what level it will be placed relative to the areola. Generally there is a lot of volume missing between the submammary groove and the areola and if the submammary groove is too high, it should be lowered. The lower the implant or the lower the groove, the less volume there will be above the areola and therefore the more natural the result. The distance between the groove and the areola is called segment 3 and the distance between the upper breast and the areola segment 2. We are looking to obtain a segment 3 longer than segment 2 to achieve a very natural result and ensure that the implants cannot be seen. The more you want an upwardly curved breast, the longer segment 2 will be.
After the base and the position of the implant, the projection has to be chosen. We talk about flat, medium, moderate, high and extra high profiles. The higher the profile, the more the projection, and so the more volume there is, the bigger the breast will be.
Do not confuse small breasts with a more natural appearance because large breasts can be completely natural and small implants can give a frightful and artificial appearance. In my opinion, the ideal is to always stay with a moderate profile (to gain one cup or one and a half cups for example, or to pass from a small B to a C cup). A high profile is best if you want to gain 2 cups (go from a B to a D or from an A to a C cup for example). The extra high profile gives breasts an unnatural look and the extra flat implants are useless in aesthetics in general because if a breast augmentation is considered necessary then there has to be a visible result, otherwise there is not much point. It is important to remember that the implants change after a few years, that this is not a lifelong operation. It is also important to remember that the shape and volume are not at all fixed or definitive, in fact, if you gain or lose weight, you gain or lose a lot of muscle, you breastfeed, or you lose skin elasticity, the shape of the breasts will change.
On average, but this is a personal opinion, I think that the best sizes of implants are between 180 cc and 390 cc, with an average of 300 cc.