Is the result good?

This is one question that everyone would ask after a cosmetic surgery. Whether it is the nose or the eyes or any part of the body, the patient would be curious about how his/her body has changed.

Today, I would like to share about “what is a good breast augmentation?” and “what is the standard of a good surgery?” All results can be objective at the earliest between 2 to 6 months.

1. Location of the implant

Breast augmentation involves making a pocket and putting a foreign substance, implant, into that pocket. This is rather a simple procedure. The surgical method is not too complex. It may be one of the simplest surgeries.

But the problem arises after the implant is put in. The implant does not stay in that particular location. As times passes, the implant tends to move to another spot. We can estimate such movement. Capsular contracture is one of the main reasons that lead to this movement.

If the implant is out of its location, the breasts may look asymmetric, look like the upper volume is lost, and the breasts may look too far apart or too close to one another.



This happens when the capsule formed, pushes the implant to one side.
We can know the exact location of the implant by observing where the nipple is pointing towards. When you look at the breast gland, the nipple should be located in the middle. If the implant is located at the upper part of the breast, then the nipple would be pointing downwards. If the implant moves to lower part, then the nipple would point upwards.

If the implant moves more inside, then the nipple would point outwards. As such, one can know if the implant is in the appropriate position or not, by looking at where the nipple is pointing.



Just talking about it is easy, but one needs to consider many factors of the breast before the augmentation surgery because of all the complications that may follow. There are many cases where the patients have unaligned breasts before the surgery.

Therefore, we need to look at each breast separately; right one by itself and left one by itself. But the patients take a look at their breasts together at a glance and state which breast or nipple is higher than the other. Also, your eyes are positioned higher than the breasts, therefore when you see the mirror, it is difficult to judge the position of the implant objectively. It is better to take a photo in order to make more objective judgement but the position and the direction of the camera lens has to be horizontal with the position of the nipples.

2. Feeling of the breasts

There is no objective way to determine this. Everyone feels different towards whether the breasts feel soft or hard when they touch them. How soft should the breast be for you to feel that it is good? How hard should the breast feel in order to know that it has capsular contracture? What is the accepted level of feeling that there is a foreign substance?

There is no answer to all these questions. This is the difficulty of judging how the breasts feel after the breast augmentation. Below is the relatively simple standard that I have made.

1) When you push the breast to 12, 3, 6, or 9 o’clock position, it should not feel that the breast is stuck down or be resistant to the push

2) The implant should move together with the breast skin (If there is a capsular contracture, the implant would not move but the skin will. If the pocket is too large, then the implant would move far greater than the breast skin)

3. Infection and inflammation

I have shared much about infection in the past. There are 4 symptoms of infection : oppressive pain, swelling, red reaction and fever.

“Pain” itself cannot mean that there is and infection. There needs to be some symptom of infection in order for you to know accurately.

When you push a certain spot on the body and if that hurts, we call this oppressive pain. But we need to know for sure if that particular spot is hurting or not. When we put in the implant into the body, there is a high possibility that germs build up around the implant.

There are findings that these germs are the source of capsular contracture and when they become active, they could lead to severe case of infection damaging the tissue cells around. This can be notices with in the first 2 or 3 weeks of the breast augmentation. After this period, capsule is formed around the breast that stops the oxygen and nutrition reaching the germs, making them obsolete. The wound or puss from the infection is already formed at this stage.

The infection is at the peak level within the first few weeks of the breast augmentation.

4. Breast symmetry

There are many reasons on why breasts on each side look different.
First is the asymmetric position of the two nipples. This is important because there are many patients with one nipple higher than the other. In most cases, the left nipple is higher than the right nipple because we have different organs located at different sides of the upper body. There is a heart on the left side, and the lungs on each side look different as well. Most people have left rib that is higher than the right. The skin acts as a cover therefore the skin on the left side is tighter than the right.

For the same reasons, the inframammary folds are asymmetric as well. You can find this 90% of the time.

Second is the bone asymmetry. The bones composed in the chest are, sternum in the middle, ribs on the sides, and spine on the back. There are very rare amount of people with sternum exactly in the middle. Most people have sternum a little to the right or left. This limits the area of the implant pocket that can be made on each side. The side with a larger chest would have more space for the pocket, vice versa. This is why we also need to limit the size of the implant.



Also, there are many with curved spines. It may be because of the computers, but there are many patients with bend neck and spines. Curved spines mean that the breasts cannot be symmetric. This cannot be treated in cosmetic surgery.

Third is the volume asymmetry. Most patients have left breast that sticks out more than the right. The left chest is larger therefore the bottom area of the left chest is higher than the right. In most cases, we use small volume implant on the left to match the size of the right.

In order to fine out the symmetric result of the breasts after the augmentation, we need to know that original status of the body before the breast augmentation. If you have smaller chest and lower inframammary fold on the left, you may have a dilemma. Using a larger size implant would pull down the inframammary fold more downwards. You need to talk about such things with the surgeons beforehand. Of all the problems that you can have after the breast augmentation, breast asymmetry is the most difficult one to treat. Your original breast and chest are all asymmetric.

Today, we looked at what a ‘good surgery’ is. I hope the contents have helped you out.
Thanks a lot and have a great day.