Breast surgery.
Proportion, considered.

Augmentation changes breast volume and projection using an implant. Periareolar incisions follow the areola border; inframammary incisions follow the fold beneath the breast; transaxillary incisions sit in an underarm crease. Each leaves a scar in its respective location. Incision selection is separate from the choice of implant or pocket.

Saline and silicone implants both use a silicone outer shell. Saline implants contain sterile salt water; silicone implants contain cohesive gel. Form-stable, or “gummy bear,” describes a firmer gel design. An implant is not a lifetime device, and rupture, capsular contracture and other complications can require further surgery.

Shape may be round or anatomical. Profile describes projection in relation to base width, while size is expressed as volume in cubic centimeters. Smooth and textured surfaces interact differently with surrounding tissue and carry different considerations. Vectra 3D sizing can support a discussion of proportions; it does not predict an exact result.

Exchange removes an existing implant and replaces it. Reasons may include a desired size change, rupture, malposition or a capsule problem. Pocket correction, capsule treatment or a lift may be part of the plan when changing the implant alone would not address the concern.

Rupture is a break in the implant shell. Saline leakage often leads to a noticeable loss of volume, while silicone rupture can occur without an obvious shape change. Examination and appropriate imaging help guide evaluation and next steps.

A lift removes excess skin and reshapes tissue to change breast and nipple position. Incision patterns include periareolar, vertical or “lollipop,” and inverted-T or “anchor.” The amount of skin excess and reshaping determines the pattern; scars are permanent. A lift may be combined with augmentation when more volume is also desired.

Reduction removes breast tissue, fat and excess skin to reduce heaviness while reshaping and lifting the breasts. Patients may seek relief from back or shoulder discomfort, skin irritation or limits on activity. The plan considers symptoms, proportion, scars, nipple position and future breastfeeding goals.

The transaxillary route places implants through an underarm incision, using endoscopic guidance to view the internal anatomy. It avoids an implant incision on the breast but leaves an underarm scar. Skin quality, nipple position, implant choice and the need for a lift affect whether it is appropriate.