I think there are a lot of subtleties about breast augmentation that the public is not aware of. Breasts by their very nature are never exactly the same before or after plastic surgery. It is common for patients to have asymmetric breast volume and shape. It is common to have different degrees of droop. Many women have one breast that is slightly higher on the chest wall than its counterpart. In these patients the fold of the breast and the nipple are slightly higher. Often the underlying muscles are very different as well; the dominant hand pectoral muscle is often thicker.
What I do in breast augmentation is attempt to find the best balance of all these opposing forces. Saline breast implants offer some flexibility because I can change the volume. I will often adjust the size of saline implants intra operatively to find the best overall balance of shape versus volume. When you change the volume of a saline you change its shape. If the dominant pectoral muscle is thicker than the non dominant I may back off the volume slightly. If a patient is droopy I may keep the volume to give lift and projection even if the upper pole is fuller. In some situations I will use a lager breast implant on one side. The larger implant will have a greater diameter, but may keep a better shape rather than just over filling the same size implant which would make it pointier. In cases of extreme asymmetry I may use a high profile implant on one side and moderate or low on the other.
If one breast is higher than the other I may have to drop the fold of the higher breast down so that the upper portion of the implants will be symmetric. This is a balance and trade off as well. Often the higher breast will have a higher nipple. Dropping the fold can make the higher nipple even higher—again a trade off for the goal of overall symmetry.
Silicone gel breast implants look and feel more natural. The smooth round implants which I prefer are technically not tear drops but when upright they take on a teardrop shape. To me they are the preferred implant in very slender patients with little breast tissue to cover over the implant. In patients with droop a saline implant may be preferable. While technically less natural saline implants are fuller in the upper portion and give more breast elevation in the patient with droop.
Each patient, each case is different and augmentation is about finding the best balance. Contact my office today to schedule a consultation to meet with me. Together we can determine the best implant size and type that will meet your needs.