Davis

More than 310,000 breast augmentations were done in 2018, the most recent year for which data is available. That’s enough to make it the most widely performed cosmetic surgery in the United States by a pretty wide margin. (Liposuction is the runner-up, at nearly 260,000 procedures, according to the American Society of Plastic Surgery.)

Still, for all that appeal—not to mention, mainstream acceptance—women tend to arrive for their consultations under-informed and surprised by the nuances of the procedure. So, over the next couple of posts, I’ll be taking a closer look some key aspects that, hopefully, will aid the decision-making process for anyone considering breast augmentation. We’ll start here with the different types of breast implants.

Why silicone

Basically, there are two kinds of breast implants: silicone and saline. Each has its own set of benefits and drawbacks. I’ll start with silicone because it’s the most popular. According to one recent estimate, silicone breast implants were used in 70% of the breast augmentations performed in the US.

While their potential for ruptures is well-known at this point—the risk is relatively minimal, though it’s recommended that MRIs are done roughly every couple of years for the life of the implant in an effort to detect leaks at their onset—silicone implants have become increasingly popular in recent years as the prevailing preference has gradually shifted from dramatic outcomes (think Baywatch in the nineties) to subtle, natural-looking enhancements. Of the two types, silicone implants are the softest and feel most like natural breast tissue. They’re also available in both round and teardrop shapes.

Highly-cohesive silicone implants are different from the standard kind in that the silicone gel has a thicker consistency, which makes them firmer to the touch. But they’ve also proven to hold up better and be less susceptible to rupturing.

Why saline

Saline implants are filled with sterile saltwater, which means, if they should ever rupture, the implants’ contents will be absorbed by the body without any ill effects.

Beyond the safety aspect, saline implants are favored by women who prioritize upper pole fullness and projection with their new breasts. In other words, they prefer a dramatic result to a subtle enhancement. Keep in mind, saline implants are heavier than silicone, which may cause the breasts to become bottom-heavy over time.

And because they’re not prefilled, unlike silicone implants, a smaller incision may be warranted. There is, however, some additional risk with this particular type of incision. With silicone implants, the incision is larger, but it’s hidden in the breast crease, which is considered optimal not only for aesthetic purposes but also because it affords the surgeon prime access to the breast pocket.

Finally, if cost is a consideration, saline implants are generally the less expensive option.

In my next post, I’ll go a bit deeper into implant shapes and outline some of the thinking that’s involved in positioning the implants.

Breast augmentation has remained the most popular type of cosmetic plastic surgery in the United States because the procedure has evolved. The shift in preferences from dramatic-looking breasts to subtler enhancements coincided with the emergence of a range of new implant shapes, diameters, and projections, which allowed—for the first time—for a truly tailored, customized look and feel.

With those nuances comes a host of decisions. In an effort to prepare you for your breast augmentation consultation with a board-certified plastic surgeon, I’m exploring a few key aspects of the procedure. In my last post, I unpacked the benefits and drawbacks of the different kinds of implants. Here, I’ll get into the roles that implant shape and positioning play.

Subtle enhancement or dramatic makeover?

There are two basic breast implant shapes, round and teardrop, also known as anatomical and contoured, though, within each, there are many degrees of difference in terms of both size and profile. The reason for choosing one shape over another will hinge largely on your aesthetic goals, but it’ll also be influenced by the implants’ placement and your preferred incision location.

Your anatomy—body type, sternum width, chest-wall contour, and existing breast tissue—will also play a big part in the decision-making process.

Round implants, which resemble a compressed ball, tend to be favored for their fullness, lift, and resulting cleavage. Because they’re circular and uniform, there’s minimal variation in fullness or projection between the top and bottom of the implant. In other words, round implants will project, or stick out, further from the body than teardrop implants, for a more dramatic silhouette.

Teardrop implants, on the other hand, mimic the shape of natural breasts. They’re thinner at the top than they are at the bottom, and they gradually slope down from the top to the middle. It’s favored by women who want their breasts to look a little fuller or perkier. In fact, it’s an ideal choice for those who want to correct mild sagging. The implant itself can provide sufficient lift. For those with more significant sagging, a breast lift may need to be combined with the augmentation.

Positioning brings it all together

Both shapes come in a variety of sizes and profiles, which is the term that refers to how far the breast projects from the chest wall. A high-profile implant has the smallest base width and produces the most pronounced silhouette. While a moderate-profile implant has a wider base width and a more modest projection.

Heading into your consultation, it’s good to have a general visual of what you want your breasts to look like, but there’s no need to settle on a size or even a shape until you’re able to review specific examples with your plastic surgeon. I also take a series of measurements that help guide that decision and ensure that the implant is precisely placed in proper relation to the shoulders and nipples. Think of it as equal parts art and science.

The décolletage has traditionally been a point of frustration for many. It’s nearly as susceptible as the face and hands are to sun damage and the earliest signs of natural aging (think crepe-y wrinkles and mildly sagging skin), yet it’s been distinctly more difficult to treat. But that’s changed in recent years, thanks to a slew of innovations. Here’s an overview of some of the most effective ways to remedy décolletage wrinkling and restore a more youthful appearance.

Injectables

Dermal fillers can improve and enhance an ever-expanding spectrum of features. They’re still most commonly used for the face, but with an experienced plastic surgeon and the right filler—Sculptra, a versatile L-lactic acid filler, and hyaluronic acid fillers are generally the go-tos—the same effect can be achieved with the décolletage (read: wrinkle-free skin).

Depending on the filler that’s used, you can expect the results to last between six months and two years. And, of any of the methods highlighted here, injectables provide the most immediate results—and with zero downtime, no less.

Lasers

Similarly, carbon dioxide lasers, which superficially vaporize skin, and other non-ablative lasers are most popular for treating facial wrinkles, but they’re also being used more and more to treat décolletage wrinkles, scarring, and hyperpigmentation that can result from sun damage.

Most patients achieve their desired results within two to six sessions, which can be paired with skin-tightening treatments to minimize the recovery time.

Micro-fat grafting

This is a two-part procedure, where a small amount of excess fat is removed from another part of the body (the abdomen, thighs, or arms, most commonly). It’s then cleaned and injected into several points across the décolletage. Though not expressly a skin-tightening treatment, the injections will have a plumping effect, which will naturally tighten the surrounding skin, resulting in a smooth, youthful-looking décolletage.

The grafts are considered to be longer-lasting than dermal fillers. And, because it’s your own tissue that’s used, there’s no risk of an allergic reaction.

Chemical peels

A formula comprised of several acidic chemical components removes the outermost layer of the skin, revealing the smooth layer beneath. Chemical peels are considered to be one of the most effective ways to treat mild wrinkling and sun damage on the face. The same formulas are typically employed for the collarbone and décolletage.

Most patients achieve their desired results after three or four peels, which are administered several weeks apart.

As different as this summer will feel this year, it’ll remain the same in lots of ways, too. We’ll still enjoy soaking in the sun’s warmth for a passing moment and the cool stillness that arrives at dusk. We’ll still savor the unique sensations of grass and sand between our toes and the scent of something, anything, grilling nearby.

And we’ll still hate the way our butts look in shorts and especially bathing suits.

No such poll exists, but if it did, I’m sure it would indicate that the butt is one of the features that many of us want to change most about ourselves. It wasn’t a surprise when, a few years ago, butt enhancement surgery became one of the fastest-growing cosmetic surgery procedures in the United States.

At its height, there was a buttock procedure being performed every 30 minutes, on average, in this country, according to the American Society of Plastic Surgeons. That included both butt implants and butt augmentation, or the Brazilian butt lift. While implants were largely responsible for that initial surge, doctors have been steering their patients more toward the Brazilian butt lift over the last couple of years because it’s considered to be a much safer procedure, the recovery’s a lot easier, and the results tend to be far more positive.

What’s the difference between the two procedures?

For implant surgery, implants are placed beneath the gluteal muscle through an incision in the buttock cheeks. It’s typically a two- to three-hour procedure. Afterward, patients are encouraged not to sit directly on their implants for three weeks because the pressure could cause them to shift out of position. And the recovery period generally lasts about two weeks.

The Brazilian butt lift is done in two parts. First, fat is liposuction-ed out of the patient’s abdomen, hips, or thighs. It’s then cleaned and separated and injected into the patient’s butt. It’s about a one-hour procedure. And patients are usually back to work and their normal lifestyle 24 hours later.

Why is the Brazilian butt lift trending?

Since the grafted fat is being taken from another area of the body, the Brazilian butt lift is kind of a two-for-one procedure: Contour an area of concern and gain a shapelier butt in the process. Plus, since the grafted fat is your own tissue, there’s no risk of an allergic reaction or rejection.

The procedure also allows for more flexibility. Depending on the amount of available fat, you can upgrade to a Kim Kardashian-esque butt or simply add a touch more curve to your natural shape. Implants, on the other hand, are molded to specific sizes and volumes.

If you’ve always thought of butt enhancement surgery as something a small group of women somewhere are having done, it’s much more widespread than that. And that’s because they’ve discovered a wealth of confidence in finally addressing a feature they longed to change and never thought they could.

You probably know about Botox. You may even be aware of the fact that there are other botulinum toxins—even though just about everyone, aside from board-certified plastic surgeons, refers to them as Botox, the same way you may refer to all tissues as Kleenex. But have you ever stopped to wonder what the difference is between Botox and the others? Lindsay Kirkman has, and she wrote about it recently for RealSelf.

In fact, she went further than that. She had Botox injected into one half of her forehead and Jeuveau, the newest of the four botulinum toxins approved by the FDA, injected into the other. Interestingly, of the three not named Botox, Jeuveau is the first to be formulated with the same 900 kDa molecular weight as Botox. The similar chemical composition should mean that Jeuveau’s results would most closely resemble those of Botox.

Kirkman cites one study that showed that Jeuveau could even begin working sooner and last longer than Botox. That said, how long a botulinum toxin treatment lasts depends more on the person than the toxin because how we metabolize it varies from person to person.

As for Kirkman, she had 18 units of Jeuveau injected into the left side of her forehead and the crow’s feet (the wrinkles etched into the corner of the eye) on the left side of her face and the same amount of Botox injected into the right side of her forehead and the crow’s feet on the right side of her face. 

“Ultimately, the pain level on both the Jeuveau side and the Botox side was exactly the same—as in very minimal,” she writes. “I felt a slight pinch every time the needle went in, but the tingly feeling went away within seconds.”

A couple of days later, the Jeuveau had “clearly” taken effect, Kirkman writes, while she hadn’t yet noticed a response from the Botox. That changed on Day Six. “The Jeuveau side feels even more locked in place, but for the first time, the Botox side has also started to produce that feeling of muscle immobilization,” she writes. “I can also tell that my brow lift has started to kick in—again, even more so on the Jeuveau side, where I’m seeing more of an arch start to form.”

Two months out, she writes, “Now when my face is at rest or when I am smiling, the lines on my forehead and between my brows still look equally smoothed out on both sides.

“However, in order to go beyond my own general observations in the mirror, I also asked my husband and a few friends to weigh in. All parties pointed out that as I naturally engaged in conversation—particularly when I looked surprised or curious—there were more obvious lines starting to reappear near the temples on the side of my face injected with Botox,” Kirkman says. “The difference is subtle enough, though, that I don’t think it’s anything anyone else would notice without specifically paying attention.”

If nothing else, it’s always good to know you have options. Comparable options.