If you go online and search for “types of breast augmentation,” most of the results refer to different types of breast implants. Choosing implants is undoubtedly one of the most important decisions involved with breast augmentation, but there are many other options to discuss with your plastic surgeon before the procedure.
Besides the types and sizes of breast implants available, other options include incision locations and where the surgeon places the implants. You may also opt for breast augmentation without implants, using fat taken from another area of the body to provide a modest increase in the size of your breasts—a breast augmentation technique called fat transfer or grafting.
Surgeons insert implants through small incisions that may be made in one of 3 locations:
- At the base of the breast (inframammary fold)
- On the lower edge of the areola (periareolar)
- In the armpit area (transaxillary)
The inframammary location is the most popular option because it provides the surgeon direct access to creating an implant pocket and minimizes the risk of complications. Some patients worry about having a scar on the breast, but it’s hidden in the crease and typically fades significantly after about a year.
During breast augmentation surgery, the surgeon creates a pocket for the implant. The locations may be:
- Above the chest muscle, behind the existing breast tissue (subglandular)
- Under the chest muscle (submuscular)
- Partially under the muscle (dual plane)
The best location depends on the patient’s anatomy, cosmetic goals, size and type of implant, and lifestyle. For example, I usually recommend submuscular placement for patients with little existing breast tissue to minimize the risk of visible rippling or feeling the implant. On the other hand, a woman who enjoys upper body workouts can benefit from a subglandular placement, which doesn’t involve disrupting the chest muscle.
These before-and-after photos feature some of my actual patients with different implant locations:
Breast Implant Types
You can choose between saline and silicone gel implants and the size of the implants. (We wrote an earlier blog post about how to choose the right implant size.) Whether you opt for a saline or silicone implant is based on your preference. Most patients believe silicone gel implants provide a more natural look and feel than saline implants. Within the category of silicone implants are different levels of cohesiveness.
The most cohesive silicone gel implants are sometimes called gummy bear implants because the gel maintains its shape, similar to gummy bear candies.
What Is ‘Natural’ Breast Augmentation?
Some women who want to enhance their breast size are reluctant about getting breast implants. Fat transfer breast augmentation is an option. During the procedure, the surgeon uses liposuction to harvest fat from another area of the body, such as the abdomen or buttocks. The fatty tissue is then purified and injected into the breasts.
Breast augmentation with fat transfer is a possible approach for patients who want to increase the size of their breasts by only about 1 cup size. It’s also less predictable than using implants because not all of the transferred fat survives after being grafted to the breasts.