I broadly classify the surgeries I do on the breast into 2 categories - reduction procedures and augmentation procedures. Both also produce a breast "lift" at the same time, with the amount of lift produced differing depending on the type of procedure done.
For breast augmentation surgeries, I again separate them into 2 groups - my patients who want implants and those that prefer using their own fat.
For augmentation using implants, I use mainly cohesive gel silicone implants that are USFDA approved. The latest generation of these implants are extremely soft and no longer necessitate a routine change at the 10-year mark. For the majority of my patients, these implants are placed in a dual-plane manner, with part of the implant under the pectoralis muscle and part of it under the breast tissue. This allows for the most natural shape with the muscle acting as a clamp to prevent future sag or migration of the implant.
For augmentation using their own fat, or fat grafting to the breasts, it requires the harvest of fat tissue using liposuction techniques, usually from the thighs, tummy and love handles. A fairly large amount of fat is required as often only 50% of the fat transferred to the breasts are retained, with the rest being absorbed by the body in the 1 month after the surgery. Fat grafting to the breasts produces a very soft and natural result but there is a limitation in the size increase; I tell my patients not to expect any more than a 1 cup size increase at the end after the 50% fat loss period with each fat grafting procedure.
Sometimes, I perform a hybrid of the 2 for specific patients, where I use both implants as well as fat grafting to augment the breasts. This is usually for patients who have very little breast tissue to start off with and want very large implants.
I hope that answers some of the queries about breast augmentation.
