Often patients know exactly the breast augmentation look they want but have a hard time describing it. Below Dr. Albright (plastic surgery in San Antonio), educates patients to give them the vocabulary to choose the best look!
Let's talk about Breast SHAPE! In general, we look at a few main categories:
A. Breast position on the chest wall.
B. Breast volume (proportionate or disproportionate).
C. Breast Consistency (soft or firm).
D. Shape of the breast.
Upper pole projection (how far outward is the breast) usually seen from the side profile or oblique view. This is how much tissue looks to be defying gravity and filling up the upper pole. Usually after children, patients will complain about "lack of fullness" or having a "gap" at the top of their bra. In general as we age, we can expect less upper pole projection as the breast succumbs to gravity and undergoes natural transition from glandular to a more fat dominant breast.
Dr. Albright calls the shapes above:
1. Mid shape: A straight to slightly projected upper pole slope. Overall Impression: "does she or does she not have implants". Keep them guessing.
2. Mid-augmented shape: More projected upper pole but still less volume at the top than the bottom. Overall Impression: "I think she has implants".
3. Augmented shape: Maximum achievable projection of the upper pole and a closer match of upper and lower pole volume. Overall Impression: "Everyone knows she has implants".
In this section, we talk about Volume Distribution. In general, natural breast tissue sags overtime. As this happens, more of the breast tissue winds up at the bottom of the breast, creating the classic "teardrop shape" . Alternatively, if we maintain more volume at the top of the breast, it will seem less natural, especially as we age. This concept is the ratio of upper and lower pole breast volume!
Assuming the Nipples are in the right spot, then:
1. Mid shape: Lower pole dominant. Most of the volume of the breast/implant is below the nipple. Overall Impression: "Not sure she has implants".
2. Mid-augmented shape: More volume shifts to the top but it's still bottom dominant. Think 40:60 upper to lower pole volume. Overall Impression: "I think she has implants".
3. Augmented shape: Maximum achievable upper pole volume, usually trying to achieve a 50:50 upper to lower pole volume. Overall Impression: "Everyone knows she has implants"
Today, we will talk about Upper Pole 'Roundness' or the Upper Pole Transition. This is difficult to show in photos but is better seen when light is able to reflect off of the top of the breast/implant. For most natural breasts, as we age, the slope of the upper pole flattens, and there is not a very distinct transition separating the tissue above the breast from the breast itself. This is a smooth transition without a distinctly round upper pole.
Alternatively, if the transition from the area above the breast to the breast is NOT smooth, it can create a 'step off'. This is a sharp transition, and gives the appearance of the breast being more round in shape.
1. Mid shape: Very smooth transition, no clear step off. Overall Impression: "Not sure she has implants".
2. Mid-augmented shape: Some youthful roundness but without a sharp step off. Overall Impression: "I think she has implants".
3. Augmented shape: Sharp transition with round shape. Overall Impression: "Everyone knows she has implants".
The Fine Print: There are many variables that go into how we, as individuals, see and compare breast shapes. We must acknowledge that this topic is highly subjective and can be controversial. Breasts develop in all sorts of sizes/shapes and agreeing to a 'normative' breast may not be possible. However, most people have an idea of what they would consider an aesthetically appealing normative breast. This may NOT be based in reality! But we do it anyway. We mentally compare breasts to what we think we would expect to see relative to one's peers. Therefore, these will likely change with age and in different communities.
For more information, Dr. Albright's colleague, Dr. Kamran Azad has created a breast augmentation guide to help women choose the right implant for them. Stay tuned for more helpful information. If you like what you saw, please share with a friend or give us some feedback.
