Breast Augmentation

Breast Augmentation?: Changes in Size, Shape, and Appearance

Breast Appearance

Many women seek surgery, chemicals, lotions, mechanical devices, or special clothing to change the appearance of their breasts. Before reviewing the options that are currently available to women who are dissatisfied with their breast size, shape, or appearance, it is important to note that, like many other body parts, there exists a great deal of variation in the appearance of the female breast. Variation in size is due primarily to the amount of fatty tissue distributed around the milk glands. It is perfectly normal (and highly common) for one breast to be slightly larger than the other. As one author posits, "On real women, I've seen breasts as varied as faces: breasts shaped like tubes, breasts shaped like tears, breasts that flop down, breasts that point up…" Basically, as long as full function and sensation exists, the breasts can take any number of acceptable forms, shapes, sizes, or shades of skin tone. The following sections will present various options for dealing with breast size, including surgery, chemical options, mechanical methods and others.

Breast Surgery Options

Breast surgery typically can be divided into three general categories: reduction, reconstruction, and augmentation. Further these procedures may be categorized as elective or reconstructive depending on the circumstances for choosing the surgery.

Breast Reduction

Women with large, heavy breasts can be miserable. The excess weight can cause neck pain, back pain, skin irritation, bra strap indentations, numbness, or weakness. Surgical breast reduction is known as reduction mammoplasty. The procedure involves removal of excess skin, fat, and tissue. ?With this type of surgery, scarring can be extensive. Normal breast sensation, nipple-areola sensation, and milk production are preserved except in massively oversized breasts. Massively oversized breasts often require a more resectional type of procedure with grafting of the nipple-areola complex rather than a reduction procedure. The reduction type of procedure reduces breast appearance, volume, and contour, while preserving breast sensation and function. After breast reduction, women report tremendous improvement in their symptoms. Breast reduction is generally categorized as an elective procedure and may be covered by health insurance plans if the negative consequences are verifiable.

Breast Reconstruction?

Breast reconstruction may be done after a woman has had a breast removed, as may occur in some cases of breast cancer. The exact number of women who undergo reconstructive surgery is unknown, but the American Society of Plastic Surgeons (ASPS) estimates that 111,000 women will undergo reconstructive surgery to correct congenital or post-mastectomy deformities. The surgeon seeks to recreate a breast with the desired appearance, contour, and volume. The nipple-areolar component is also recreated. Normal breast sensation and normal breast function, such as nursing, are not repairable if the sensory nerves or milk glands and ducts have been removed or significantly injured. The appearance, contour, and volume of the breast can be recreated with implants or with a woman's own tissue. If an implant is used, the implant is sized to match the opposite breast. When possible, the implant is placed beneath a chest muscle. When using a woman's own tissue, sometimes a segment of the lower abdominal wall can be used. Other tissue options for reconstruction include the back muscle and skin or a segment of a buttock.

Breast Augmentation

Breast augmentation is performed to enhance the appearance, size, and contour of a woman's breasts. Women consider breast augmentation -- or augmentation mammoplasty -- for different reasons. Some women feel their breasts are too small in relation to their body contour (Elective). Some women desire augmentation after size loss associated with pregnancy or sickness--such as breast cancer (Reconstructive). Others desire to correct unevenness between the sizes of the breasts (Elective). ?According to 2008 estimates of the American Society of Plastic Surgeons (ASPS) approximately five percent (6 million) of the female adult population has undergone some form of breast augmentation or reconstructive surgery. Approximately 307,000 women underwent breast augmentation annually for cosmetic (elective) reasons. These numbers are only estimates because surgery may be performed by other medical professionals outside of the (ASPS). Surgical breast augmentation is performed with implants that can be placed either under a chest muscle (Subpectoral Implant) or over a chest muscle (Subglandular Implant). The incision can be placed in the armpit, the areola (or nipple), or the lower breast. ?A breast implant is a silicone shell filled with either a salt-water solution (saline) or with silicone gel. A woman determines her desired size by fitting trial implants. Currently, saline-filled implants are used on an unrestricted basis. Before April 2005, silicone gel-filled implants were available only to women participating in approved clinical studies. Silicone is a superior form of implant because it holds its shape but is also soft, giving much more realistic results. Breast augmentation has many potential risks but physicians have made progress in minimizing such risks and less invasive procedures such as periareolar, donut, or crescentic procedures, which are becoming more common. In a recent report by The European Journal of Plastic Surgery the most commonly reported complications were poor scar healing and areolar asymmetry. There will still be a period of time until these less invasive procedures become common practice but the reduction of more severe complications in follow up procedures is a positive step for elective breast augmentation. The most common risks of breast augmentation are: infection, hematoma (bleeding around the area of dissection), deflation, malposition of the implant, and firmness of the breasts (capsular contracture). Capsular contracture is known to be the single most common adverse effect of breast implants. Capsular contracture occurs when the post-surgery scars begin to heal; in some cases these scars will actually squeeze the implant, which may increase the implant firmness. This side effect does not pose a health risk but some individuals may find it to be so off-putting that they will have a surgical correction. Cancer detection is an important concern that has been associated with breast implants. Concern arises from the fact that implants are radio-opaque and compress the breast tissue, which may delay cancer detection both through mammography and self-exams. Yet these risks have proven to be minimal as the rates of cancer detection in women with implants tend to be identical or even better than those without implants. Improvements in mammography technology and increased individual self-checks have served to lessen this risk. It should be noted that while plastic surgery can often have dramatic benefits, it is also important to have realistic expectations to achieve a happy result.

Breast Lifts

In some women, the skin is not strong or resilient enough to support the weight of the breast, causing the breasts to sag. With this condition, called ptosis, there is too much skin, compared to breast tissue. To give the breast a lift, the excess skin must be removed. This surgery involves some degree of permanent scarring, but products to help minimize the appearance of scars are available.

Chemical Options: Bloussant

Bloussant is advertised as the "all-natural form of breast enhancement that gradually augments the size and shape of the breasts using a formula that promotes a healthy transformation." With Bloussant breast enhancement, the consumer is said to be able to add inches to the bust in a less expensive alternative to costly surgery. Bloussant offers a non-surgical option to attaining fuller, firmer breasts with a combination of different supplements and ingredients. This formula is supposed to, ideally, deliver larger breasts in just a few weeks. However, every woman should beware of taking supplements that are designed to alter the body, especially because many (including Bloussant) have not been approved by the FDA. Also, the product costs about $200 to $250 dollars, a gamble for those on a budget.

Herbal and?Chemical options which are sometimes marketed as a safe alternative to surgery. The herbs in these breast enhancers vary, but many of them contain various mixes of Fenugreek Extract, Saw Palmetto, Fennel Seed, and Wild Yam. They are proposed to work because they contain phyto-estrogens (a plant form of estrogen) that simulate the hormones found in young girls' breasts and cause growth of the mammary gland tissue. ?While this argument sounds convincing, one must realize that the estrogen found in plants is much less potent than the estrogen that is normally found in women's bodies. It would take incredible amounts of phyto-estrogens to mimic the effects of human estrogen. The herbal products can claim success in part due to the placebo effect, in which 1 in 3 people given a placebo (a neutral substance) will experience the expected effect. ?Not only should a person question the efficacy of the herbal preparations, but they should be concerned about the safety of the herbs found in these products as well. Herbs are not regulated by the FDA, and may have serious side effects. If considering the use of herbal breast enhancers, talk with your physician and conduct your own research to assess potential risks and side effects.

Mechanical Options: BRAVA

The BRAVA vacuum breast enhancement system is composed of two plastic domes secured to the breasts by means of a sports bra. The program consists of wearing the bra for 10 hours a day, for 10 weeks in a row. According to the tests, this should allow the wearer's breasts to emerge a half to a full cup size larger. BRAVA has been approved by the FDA, and costs about $2500 dollars. This high-tech sports bra comes equipped with a microprocessor that regulates and records the system's action and performance.

The BRAVA system, like other elective procedures, has potential benefits and risks that must be taken into careful consideration before use. The benefits of the BRAVA system include gradual and lasting growth of breast tissue without surgery or the use of medications. BRAVA is approved for use by the FDA and meets all federal regulatory requirements. The BRAVA system is based off the medical principle of tension-induced tissue growth, which activates the production of new breast tissue by your own body. The BRAVA system does have drawbacks that must be acknowledged. The system is relatively expensive, around $2500. Once purchased, the individual must wear the system for 10 hours everyday for 10 weeks in order to achieve the stated results of a half to one-cup size increase in their bust. Therefor it is up to the individual to decide if the cost and inconvenience of the product can be out weighed by the potential benefits.

Non-surgical, Non-Medical Options

Many women seeking changes in their breast size cannot afford drastic surgeries, pricey medications, or special mechanical devices. Even for those who can afford the previously mentioned options, the potential risks, along with personal values may factor in to choosing non-surgical, non-medical options.  Luckily, there have been a number of safe, inexpensive products released for women who wish to change the appearance of their breasts.

The WaterBra

The Water Bra is a regular brassiere with two fluid filled sacs inside the cups. The sacs are specially designed to resist breakage and will seal off if punctured to avoid embarrassing leakage. This bra is supposed to be very good at simulating actual breast shape, movement and feel. Also, the fluid is positioned in such a way as to promote increased cleavage and lift. A variety of manufacturers offer the bra, including Lily of France and Victoria's Secret. The bras range from about $30 to $50.

Gel Inserts

Gel inserts can be purchased in a number of lingerie and women's stores for about $25. These inserts are helpful because they can be inserted in any bra as desired to increase lift, volume, and appearance of cleavage. The inserts are a safe, inexpensive, non-permanent way to increase breast size.

Breast Reduction Exercises offers some specialized exercise tips to help reduce undesirably large breasts. These chest exercises are a safer alternative to the expensive reduction surgery, which may be quite painful and scar extensively.

Final Remarks

?The breast dissatisfaction many females experience may be due to the fact that they feel that their breasts do not fit a specific cultural ideal. Currently in America, the entertainment industry and popular images in magazines and movies tell us that our culture values large, symmetrically shaped breasts and a good deal of cleavage. It is unclear whether or not the media has caused significant changes in the desire for "perfect" breasts, but the fact remains that the social trends concerning breast augmentation can be seen quite negatively. For example, the average age of women requesting breast augmentation has dropped since the late 1980's. If you are experiencing dissatisfaction about your breast size, shape, color, or appearance, and are considering some of the options above, try to remember that there is no such thing as "perfect" breasts. The drastic measures women take to fit into an ideal image of beauty may be dangerous or expensive, and might not even produce the desired result. Therefore, it is important to be cautious which products we support and which ones we ignore.



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Crooks, R. & Baur, K. (2002). Our Sexuality (8th Ed). California: Wadsworth.

Last Updated 28 May 2012.