17 - Breast augmentation

Abstract

■Breast augmentation is one of the most commonly performed aesthetic procedures in the United States and abroad.■Preoperative assessment should determine the appropriate approach, including choice of implant, breast pocket (submuscular, subfascial, subglandular, subpectoral with dual plane), incision location (inframammary, periareolar, transaxillary, transumbilical), and the need to lower the inframammary fold (IMF).■Implant selection has expanded over the past few years to include many variables including implant fill (saline or silicone), implant shell surface (smooth or textured), implant form (round or shaped), implant dimensions (width, size, projections), and implant cohesiveness (fourth- or fifth-generation implants), with associated differences in form stability and implant softness.■IMF positioning is critical to establishing optimal implant placement in the pocket.■Surgical approach, implant choice, and operative technique can impact the incidence of complications, including implant malposition and capsular contracture.■In preparing for a breast augmentation, one must understand each patient's goals and expectations and see if they can be achieved.