23 April 2017
Breast augmentation is very often performed with round prostheses. The insertion route (through the armpits, nipple or sub-mammary fold) varies according to the surgeons' habits and beliefs, the patient's requests or her history.
I think that the procedure should be performed as often as possible using anatomical prostheses by the sub-mammary route (invisible scar under the breast). Anatomical prostheses give a much more natural appearance than rounds and the waist can be adapted to the patient's measurements, making them a preferred intervention in the therapeutic arsenal to improve the overall silhouette.
In my opinion, round prostheses should no longer be offered by the axillary route (scar in the armpit) for several reasons, but in particular because prostheses tend, over time, to move up and out under the contractions of the muscle under which they are positioned.
Here is an illustration of this problem which is quite frequently encountered in my current practice.
The patient was operated on by a renowned surgeon who frequently performed breast augmentation with axillary round prostheses. After moving her prostheses to the armpit, she was reoperated by another surgeon, using the same technique. The patient, dissatisfied with the result, asked me for a solution to improve the shape of her breasts.
The round prostheses were removed with a scar under the breast and anatomical prostheses were inserted.
Round prostheses give an unnatural shape to the breast. The fact of inserting them by the armpits under the muscle forces the surgeon to leave a way of passage from the prostheses to the armpit. The prostheses go up with time and are too high compared to a chest that tends to fall over time.
It is therefore necessary not only to lower the prostheses but also to use anatomical prostheses that will give more curve to the lower part of the breast. This solution restores the breast to its natural shape and thus the breast ptosis (the falling breast) can be reduced or even completely abolished.
We can see very clearly that the right prosthesis is too high. The position and shape of the prosthesis increases the falling appearance of the chest.