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Sacramento & Granite Bay (916) 929-1833

Breast Augmentation Choices for a Bigger Bust, A Break Down


Posted July 14, 2022 in Breast Augmentation

Many women believe the most significant decision to make for breast augmentation is implant size, but there are several ways this breast surgery is customized to your anatomy and cosmetic goals. Dr. Scott Green is a board-certified plastic surgeon who has helped many women achieve a larger bust with breast augmentation. He will outline your breast implant choices during your consultation at our Sacramento or Granite Bay offices.

Increasing breast size includes options for implant size, fill, placement and incision site. Surprisingly, implant size may be one of the easier choices. The goal is breasts that balance your figure, not overpower it. Dr. Green can give you implant sizers to wear in your bra, which will help you choose the implant size you want and visualize your results.

Saline Versus Silicone Implant Fill

Both saline and silicone breast implants have an outer silicone shell.

Silicone breast implants are filled with a dense material (silicone) that mimics the natural feel of human tissue and fat. These implants are known for providing a more natural breast appearance and are FDA-approved for people 22 and older. Silicone breast implants are less likely to rupture or show wrinkling under the skin. They also have a low rupture rate in the first 10 years, but imaging tests are needed after five years and then every three to check for ruptures.

Saline breast implants are silicone shells filled with a sterile saline (or saltwater) solution. These implants are filled after being surgically placed in the body, requiring smaller incisions and providing more choices for the incision site and resulting scars. Saline implants are FDA-approved for those 18 and older and rarely rupture. If they do rupture, the breasts look deflated as the body absorbs the saline solution. Subglandular placement with saline breast implants may show wrinkles or ripples under the skin.

Subglandular Versus Submuscular Implant Placement

Implant placement depends on your unique anatomy, health, implant size, chosen fill and cosmetic goals.

Subglandular, or over-the-muscle placement positions the breast implant between the breast tissue and chest muscle. The shell sits below the breast glands, which improves the chances of successful breastfeeding in the future. Breast implants over the muscle cause less pain during recovery and move less with physical activity. However, this placement may not offer a natural breast appearance and can make mammograms less accurate. Subglandular breast implants may have a higher rate of capsular contracture when the scar tissue around the breast implants tightens and squeezes the shell.

Submuscular, or under-the-muscle, implant placement positions the breast implant partially under the chest muscle, providing a more natural look and improving mammogram readings. This implant placement option has a lower rate of capsular contracture, but patients can expect more discomfort after the procedure and a longer healing period.

The right implant placement for your breast augmentation depends on how much breast tissue is present and the strength and size of the chest muscles.

Incision Site for Breast Implants

The type of implant you choose may dictate the incision site for your breast augmentation procedure. There are three options for incisions:

  • Periareolar: An incision is made around the bottom half of the areola (pigmented skin around the nipple) to conceal the resulting scar. The periareolar incision is often used when breast lift is combined with breast augmentation.
  • Inframammary: An incision is made in the breast crease for best access to place the implant. The inframammary incision is typically best for silicone breast implants and is the most commonly used technique in the United States.
  • Transaxillary: An incision is made in the armpit and a tunnel to the area for implant placement. Transaxillary incisions are only used for saline breast implants and are more likely to cause asymmetrical results. An empty saline implant is rolled up, pulled through the tunnel and filled with saline solution.

If you’re interested in breast augmentation, contact our board-certified plastic surgeon to discuss your options. Schedule a consultation with Dr. Green in Sacramento or Granite Bay by calling (916) 929-1833 or filling out our online contact form.