(Text & Illustrations by Roberto Lachica, M.D.)
Surgical enhancement of the female breast is very popular. There is no single standard that determines the ideal breast shape (or size). Preference of how a breast should look is often subjective. Most plastic surgeons agree that the “ideal breast” is similar in size to a C cup, sits above the bra line, and appears firm. This aesthetic ideal aligns with the breast shape and size that most women commonly request during their consultations. Surgical procedures are tailored to meet each patient’s unique aesthetic goals that considers their individual anatomy.
What are some of the typical concerns patients discuss during the consultation for cosmetic breast surgery?
Augmentation
“I want larger breasts and to look more feminine. I want to increase my bra size from an A (or B) to a C (or D). I want to fill out my clothes and my chest to look proportional to my hips.”
This patient is younger (20’s-40’s) and has good skin with little or no sagging. Volume augmentation is achieved with modern silicone gel implants that are inserted under the muscle through a small bra crease incision. These devices are soft, feel like breast tissue, and have a natural appearance. They are safe, durable, do not interfere with mammograms, and do not have to be replaced. A common implant size is approximately 350cc (240cc=1 cup).
Breast Lift (Mastopexy)
“My breasts are flat, sag, and have no shape. I need a bra to hold everything up.”
This patient is older (40’s -70’s) and has shape and volume changes after having children (more so after breast-feeding), or because of age and gravity. Other patients have lost substantial weight after exercise, diet, surgery, and more recently medications such as Ozempic. A breast lift repositions the breast tissue and tightens the skin to create a higher, firmer, and rounder appearance. The procedure involves making incisions on the breast, which, when performed by a skilled surgeon, heal with great results. In cases of larger, heavier breasts, excess tissue is removed (reduction), making the surgery more complex. Shape and scars after mastopexy are highly dependent on the surgeon’s skill and experience.
Combined Breast Procedures
“My breast sag AND I would like to increase my bra size.”
This patient requires both breast lift and augmentation. In select patients who require minimal lifting or a small implant, mastopexy can be safely combined with a small breast implant. For patients who need more significant change, a 2-stage procedure (mastopexy then augment) is a safer approach and produces a longer-lasting shape.
Combined Breast and Body Procedures (Mommy Makeover)
“My breasts sag, and I have a pooch in my lower tummy area.”
Breast reshaping procedures can be combined (or staged) with body procedures such as tummy tuck and liposuction.
A knowledgeable, experienced, and skilled plastic surgeon can understand the patient’s goals, communicate if and how surgery can achieve those goals, and disclose any limitations or risks. Additionally, a skilled plastic surgeon will have an extensive portfolio of photos that accurately showcases the results to potential patients during the initial consultation.
Roberto D. Lachica, M.D. is a board-certified aesthetic plastic surgeon who practices at The Langsdon Clinic. The Langsdon Clinic is located at 7499 Poplar Pike in Germantown, Tennessee. To schedule a consultation for face or body plastic surgery, call (901) 755-6465 or visit www.langsdonclinic.com.