Breast Implants: Looking Real, Part 3: Position

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In my private practice, the most frequent procedure I perform is breast augmentation; I perform well over one hundred procedures of breast enhancement in Denver every year! Women who consult with me about breast enhancement in my Denver practice, which specializes in breast augmentation, uniformly express the concern that they do not want results that look “fake.” This blog is the third in a series in which I talk about what goes into avoiding the “fake look.”

In my previous blogs, I have written about the importance of size and shape in achieving a natural appearance with breast implants. In this blog, I will write about the importance of breast implant position to getting attractive results from breast augmentation.

Most women undergoing breast augmentation will benefit from placing the implant underneath the chest muscle (subpectoral), rather than on top of the muscle (prepectoral) and beneath the breast tissue. This technique produces softer breast contours (see Blog: Breast Implants: Looking Real, Part 2: Shape), and the subpectoral implant position results in significantly fewer capsule contractures, the hardening of the breast from scarring or tightness of the space for the implant.

The implant position must be centered behind the nipple. If the implant is too far to the center, the nipple will appear to point too far to the side. If the implant is placed too high on the chest, the nipple appears to point downward; if the implant is placed too low behind the breast, the nipple will point too high.

Here, symmetry becomes very important: the nipples must point the same way on each side.

Further, if the implants are placed too high on the chest, there will be excessive fullness and roundness to the top of the chest, like an exaggerated push-up bra, creating a fake appearance to the breast enhancement.

A common misconception is that implants will lift or support drooping breasts. This is not the case. If a woman is seeing drooping, a breast lift may be desirable, perhaps adding implants for size and enhanced shape. On the other hand, we commonly place breast implants to correct the deflation of the breast or loss of volume after pregnancy.