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Summary: Achieving beautiful results from breast augmentation requires much more than simply following standard operating procedure. Taking extra care throughout the technical surgical steps has a major impact on ensuring an optimum outcome. Since aesthetics play such a large role in how patients and surgeons measure the success of breast enhancement, it’s important to take every precaution during surgery to avoid the most common aesthetic complications.


Addressing Cosmetic Concerns

While serious complications are rare following breast augmentation, any aspect of surgery that has the potential to affect the physical beauty of the breast should be considered a priority. Women shouldn’t require breast revision surgery to correct a problem that could have been avoided in the first place simply by taking a better approach during the initial surgery. Yet, all too often, this is exactly what happens; each of these cosmetic concerns is better addressed during the procedure rather than after.

  • Asymmetry: Every woman has some degree of natural asymmetry to her breasts. In fact, one of the primary reasons to consider breast enhancement is to resolve any visible unevenness. To achieve symmetrical end results, breast surgeons must ensure that implant pocket size and position are positioned similarly on the chest wall. This keeps the inframammary folds even with each other and maintains a similar distance between nipple and inframammary fold on each side.
  • Bottoming Out: Overdissection of the inframammary fold can cause bottoming out, the condition where the breast appears to descend down the chest wall. The risk of bottoming out can be minimized by choosing implants that are not too large for the patient’s existing breast size and supportive tissue while maintaining appropriately conservative pocket dissection.
  • Double Bubble: A double bubble deformity is diagnosed when the implant remains superior while the natural breast tissue migrates inferiorly. This can occur when implants are placed too high above the inframammary fold with the surgeon’s expectation that they will drop over time, or when the inframammary fold is overly compromised during surgery. Proper implant alignment combined with limited undermining of the inframammary fold can lessen the risks of this complication.
  • Synmastia: Synmastia, sometimes also called symmastia, is the appearance of “uni-boob,” where the cleavage between the breasts is compromised or eliminated. This is more likely to develop in instances where the medial aspect of the breast pocket was stretched too far or overdissected; synmastia is most often seen in response to overly aggressive attempts to increase the appearance of cleavage, especially when larger implants are used in very thin patients.

Ensuring Beautiful Results

Although no surgical efforts can completely guarantee a perfect outcome, it’s clear that taking the time to choose a skilled, experienced board certified plastic surgeon is likely to reduce many of the common aesthetic complications associated with breast implants. A cosmetic surgery is still a surgery, and should only be performed by those surgeons who have the right combination of training, expertise and eye for artistry.

It’s also important to keep in mind that, should any of these complications occur after surgery despite taking all reasonable precautions, a second surgery from a breast surgeon with proficiency specifically in breast revision surgery can typically improve the final outcome of a previous breast augmentation. However, the better approach is for all surgeons to take the time to practice more effective techniques and make sensible technical and visual choices during the surgery itself, negating the need for revision at all.

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