Q: Dr. Eppley, I am interested in a natural breast augmentation that will last and hopefully not need to be redone repeatedly. Also, I can not support stem cell enriched augmentation if the source of such cells is from aborted babies. Is this the only source? What is being done such as in other countries? I am also wondering about the possible risk of cancer cells growing from such a procedure. The only info I could find about that seemed to be related to women who had the procedure following a lumpectomy or mastectomy.
Do you recommend the fat transfer procedures? I am not comfortable with the silicone or saline options because of the risks.
I am very small busted and have breast fed many children and now have nearly nothing left.I was small to begin with and now that my last baby is weaned, it is quite different than lactating. Thank you for the information.
A: What you are seeking in natural breast augmentation is the holy grail…natural, permanent, and does not involve an implant. By today’s techniques, you are seeking something that does not yet exist. Natural breast augmentation today uses one’s own fat that is processed and then injected and may have some viable stem cells in it. Besides having to have enough to fat to harvest and use, one has to accept the unpredictability of how much fat will survive and whether it survive smoothly without irregularites. There is also the risk that the procedure may have to be repeated depending upon how much fat survives during the first procedure. What is not known about fat transfer is if it increases the risk of breast cancer although this is believed to not be a concern.
While fat injection breast augmentation is done today and is becoming more mainstream, it is still restricted to a very few women who have the right physical qualifications for it. It is far from a breast augmentation technique that is perfected. For a reliable breast augmentation result that produces an immediate and predictable result, implants a much more reliable technique despite the limitations of being a medical device.
Dr. Barry Eppley
Q: Dr. Eppley, I am going to get breast implants and need some help in selecting size. I am currently a 34B with one breast about a quarter of cup larger than the other. They are perky but just not full. I am uncertain on whether to get saline or silicone implants and am looking for the most natural result possible.
A: When it comes to getting a natural breast augmentation result, it does not matter whether a saline or silicone implant is used. That has nothing to do with making a difference between looking augmented or not. Rather it is a function of implant size and implant location (above or below the muscle) as well as what your breast tissues look like now. As a general rule, it is almost always better to go below the muscle so that there is a natural slope in the upper pole of the breast. If you keep the implant base width at the same size or less than that of your natural breast base width, you will almost always look fairly natural. The size of breast implants is directly related to their base diameter. The larger the base diameter, the larger the implant. A simple tape measurement of your breast base diameter would help considerably in making a good implant size selection for you.
Dr. Barry Eppley
Q: I am interested in getting breast implants but only want to go up maybe one cup size. I don’t want anything drastic just a little change. I want the result to be completely natural looking and not fake. How can I be sure that will happen?
A: The concept of natural breasts can mean different things to different women. In general, however, what most women are referring to is a breast that is not disproportionate to their body and chest size and one that does not have a completely round shape. (too much upper pole fullness)
The most assured way to avoid an unnatural breast augmentation result is to have properly sized breast implants. In short, don’t get too big of an implant for your chest or the amount of breast skin that you have. The single best way to avoid that problem is to keep the diameter of the implant at or less than your own breast base diameter. Implants that are wider than your breast base will always look unnatural or too big. This may also mean to avoid a high profile implant which can have a tendency to look rounder after surgery, particularly if you have small breasts with tight skin to start.
Natural breasts are also those that don’t have palpable (able to feel) implant rippling. This is more of a concern with saline implants who have a greater tendency to develop implant rippling, which may also be able to be seen as well.
In summary, natural breast augmentation is best done by choosing a silicone gel implant that is slightly narrower than your breast base width. For many women this means that implants sizes will run between 250cc to 350cc.
Dr. Barry Eppley
Q: What can I have done to make my breasts look fuller but still feel as natural as possible?
A: Breast implants are the only reliable method for increasing the size of one’s breasts currently. Many women have breast implants that look quite natural while others have a breast look after augmentation that some perceive as unnatural or fake. What is the difference between the two?
There are many element that contribute to the appearance of a breast augmentation. How loose or tight is the overlying breast skin and the size of the implant are the major contributing anatomic factors. A large implant with an initial tight breast skin will create a more rounded look with a full upper pole. A smaller implant with loose pre-existing breast skin will end up as more of a tear-drop shape.
The feel of a breast implant, however, is slightly different. Regardless of implant size, either saline or silicone gel implants can feel quite natural. Outside of the body, most people would agree that silicone implants feel more like natural breast tissue. But inside the body that difference is not as obvious. Saline breast implants can feel unnatural if rippling is present on the bottom or sides of the breast or if the implant is significantly overfilled so that it feels too hard.
In general, most breast augmentation patients are quite pleased with the feel of their implants. Unhappiness with implants that are too hard or too soft is a rare reason for revisional surgery.
Dr. Barry Eppley