In the first of a two-part series, Sydney plastic surgeon Dr Kourosh Tavakoli explains the key elements of a natural-looking breast augmentation.

The number of breast enlargement operations is on the increase, and the demand for natural-looking results is even more apparent. As a plastic surgeon specialising in breast augmentation and lifting procedures, I have been privileged to treat a large number of patients every year in my Sydney clinics. Therefore, I have drawn from this wide experience to develop the formula for successful and attractive breast augmentation.

Telltale signs

There are three main telltale signs of unnatural-looking breast augmentation to be avoided:

1. Breast implant margin:

This should be soft and imperceptible, as obvious implant edge visibility, especially in the midline, will resemble the look of Tori Spelling or Posh Spice’s implants.

2. Breast implant size:

An implant that is too large for a small frame is usually an obvious giveaway that a patient has had a breast augmentation. The best example of this is Pamela Anderson-style breasts. Women wanting to go from an A cup to a full D cup need to understand this point.

3. Perkiness:

An augmented breast that is too perky will tend to look fake, as a small amount of droop is natural. When a patient lies on her back, the breast implants should roll to the side like natural breast tissue and not sit up in rigid peaks.

Before undergoing surgery, it is beneficial for the patient to review photographic examples of the breasts they would like and to convey their wants to the surgeon so there is a clear, visual understanding of the desired result.

Clinical parameters and key considerations

There are six main clinical parameters for breast implants on initial consultation:

• Patient’s body build and height
• Natural breast size, shape and symmetry
• Nipple position in relation to the breast
• The quality of breast skin
• Chest wall shape and dimension
• Patient’s desire for new cup size and shape

After establishing the crucial parameters in the clinical examination, the process of tailor-making the right breast augmentation begins.

I believe there are six key considerations for a surgeon when customising a breast augmentation to gain a naturallooking result:

1. Incision placement

There are three choices about where to make the skin incisions for breast enlargement. They can be in the breast fold (inframammary), around the nipple (periareolar) or underneath the arm (transaxillary). These incisions can all produce scarring. Although patients may voice some initial concerns about the location of their scars, they are ultimately far more concerned with the final shape and size of their breasts.

2. Breast implant shape

The choice of implant varies from round to teardrop shapes. The round implant comes in both low and highprofile varieties. The shape variation is in the width and projection of the implant for any given size. The spectrum of breast implants available to the surgeon can therefore provide great versatility in achieving a more natural look.

Use of the teardrop (anatomical) shape depends on the patient’s desired outcome, as well as her breast shape. In general, there are two groups of women who benefit from teardrop-shaped breast implants. It can be the ideal choice for women who have droopy or tuberous breasts. Mild elevation of the nipple in relation to the breast mound can be achieved without the need for extra scars on the actual
breast (unlike breast lift scars). In these cases, the implants will be inserted in a subglandular or subfascial pocket (under the breast tissue). In severe cases of droopiness, breast lift must be performed to restore aesthetic shape.

Secondly, some patients specifically want less fullness in the upper quadrant. Teardrop breast implants certainly offer less fullness in these particular situations. It should be noted, however, that this request tends to be very personal, as most women are seeking breast augmentations in order to obtain upper pole fullness.

It should be noted that teardrop or anatomical implants do have tendency, estimated at about 5 percent, to rotate. Unfortunately, this problem can only be corrected by secondary surgery.

3. Breast implant fill

I use both the cohesive silicone-gel and saline-filled breast implants. The new generation silicone-gel breast implant is very safe and generally feels and looks more like a natural breast. The gel is always my first preference.

The gel usually comes in low and high cohesiveness (soft or firm), and patients should ask their plastic surgeon for different samples at the time of the consultation so that they can make the most informed choice possible.

Welcome to the next generation of cosmetic treatments. Subtle changes that equal major impact, courtesy of groundbreaking technology and these doctors.

The best breasts

For many women, our breasts symbolise our most feminine physical characteristic. But for various reasons — lack of development, postpregnancy changes resulting from breastfeeding, radical weight loss, ageing — you may be considering breast augmentation.

A successful breast augmentation shouldn’t necessarily look obviously different… in fact, the success hinges on the doctor’s surgical technique and attention to detail. Renowned Sydney plastic surgeon Dr Kourash Tavakoli has developed a specialised breast practice and his reputation is based on understanding the essentials of natural breast augmentation.

Dr Tavakoli uses his extensive experience to treat not only poorly developed or shaped breasts, but also sagging breasts, common in women after breastfeeding and/or weight loss.

The Australian-trained plastic surgeon also promises minimal scarring and ensures his patients feel comfortable with what is an intimate procedure. Further reason why Dr Tavakoli has one of this country’s busiest breast implant practices.