Most Common Techniques in Breast Aesthetic Surgery

Why and How Is Breast Aesthetic Surgery Performed?

Breast aesthetic procedures are performed not only for cosmetic enhancement but also to correct asymmetry or restore volume lost after childbirth, breastfeeding, or weight loss. The goal is not only to increase size but also to achieve an aesthetically pleasing breast shape, proper projection, and natural symmetry.

A detailed preoperative evaluation is crucial. Factors such as breast volume, skin elasticity, chest wall shape, and the patient’s expectations help guide the surgical plan.

Most Common Breast Aesthetic Techniques

In breast augmentation, techniques can be categorized into three key decisions: implant placement, incision location, and implant type. Each choice plays a role in the final outcome.

Implant Placement Options

The plane in which the implant is placed affects both the final look and recovery experience.

Some of the most commonly used placements include:

• Submuscular (under the pectoral muscle): Offers a natural slope and helps reduce visibility or rippling. Preferred in patients with thin tissue and allows for easier mammography interpretation.
• Subglandular (over the muscle): Provides more prominent cleavage with a quicker recovery. Best suited for patients with sufficient natural breast tissue.
• Dual plane (partially under the muscle, partially under breast tissue): A hybrid technique that combines the benefits of both placements. Offers a natural contour with better upper pole coverage.

Incision Locations and Approaches

The route through which the implant is inserted influences both surgical control and scar visibility. The most common incision options are:

• Inframammary (under the breast fold): The most widely used method. Provides excellent access and visibility for implant placement. The scar is hidden in the natural crease.
• Periareolar (around the areola): Allows precise placement, with the scar blending into the pigmented area. May be less suitable for patients planning to breastfeed.
• Transaxillary (through the armpit): No visible scar on the breast. However, it is technically more challenging and may require endoscopic assistance.

Each incision has its own advantages and should be selected based on patient anatomy and surgeon experience.

Types of Implants Used

Implants differ in shape and surface texture, both of which impact the final result. The choice depends on the desired appearance and the patient’s body type.

By shape:

• Round implants: Ideal for patients who want more upper pole fullness and cleavage.
• Anatomical (teardrop) implants: Mimic the natural shape of the breast, with more volume in the lower half. Offer a more subtle and natural look.

By surface texture:

• Textured implants: May reduce the risk of capsular contracture.
• Smooth implants: Offer more natural movement but may carry a slightly higher risk of capsule formation.

How Is the Right Technique Chosen?

The optimal technique is always tailored to the patient. The surgeon’s job is to match the patient’s goals with anatomical feasibility.

For example:

• In patients with thin skin and low body fat, submuscular placement is often best.
• For mild sagging post-pregnancy, dual plane positioning may provide the most support.
• For those desiring prominent cleavage, round implants may be preferred.

A detailed preoperative consultation including measurements, photo analysis, and sometimes 3D simulation helps inform the decision-making process.