Last month the American Society for Aesthetic Plastic Surgery (ASAPS) surveyed their member surgeons to get an idea about current trends in breast augmentation. Most of the answers they received are not at all surprising, with one big exception.
The preference for natural looking results continues for the vast majority of plastic surgeons and their patients. For example, the average implant size used by most of the surgeons who responded to the survey is 300 – 400 cc. For most patients, this size will result in full C cup breasts. More than 60% of surgeons place the implants under the chest muscle rather than on top of the muscle, again aiming for a natural slope to the chest wall.
An overwhelming majority of ASAPS plastic surgeons prefer round implants as opposed to “anatomical,” or teardrop shaped implants. No reason was given for the preference, but the plastic surgeons I’ve worked with say that implants occasionally rotate inside the breast capsule. Obviously, anatomical implants would look funny upside down. Not only that, most plastic surgeons feel that round implants look very natural when the right size and position is selected, and particularly when placed under the chest muscle.
The ASAPS survey found that 64% of surgeons prefer an incision near the crease underneath the breast. Although there are other options, notably around the areola, an incision under the breast can give the surgeon optimal access.
The big surprise, at least to me, is how many plastic surgeons and their patients continue to choose saline-filled implants. The ASAPS survey showed that 60% of their members are still using saline implants, with a huge majority of those selecting saline implants for first time patients. Furthermore, when silicone gel was chosen over saline filling, the reason most often cited was “patient preference.”
So, it would appear that many plastic surgeons still select saline-filled implants quite often. The question is, “Why?” Not only has the filling been shown to be safe and unlikely to leak, it both looks and feels more like real breast tissue as well.
Could it be that even though silicone gel implants were re-approved by the FDA in 2006, there’s still a lack of faith in the devices? Perhaps patients, and even some surgeons, haven’t done extensive research on the options? Maybe the choice of saline is simply a result of habit?
Whatever the case may be, the president of the ASAPS noted that good results depend more on “patent-appropriate” surgical techniques more than on the type of implant chosen.
True, but I’m still puzzled.