The 4 Ss When Considering Breast Augmentation

It’s hard to believe that breast implants have been in use for over 50 years, but less surprising is the fact that breast augmentation still remains the nation’s most popular cosmetic surgical procedure.

While the number of surgeries continues to grow, so does the advancement in technique and breast implant technology posing a challenge for patients considering breast enhancement.

To ease the confusion, I’d like to cover the 4 S’s for breast augmentation:

Silicone vs. Saline Implants

There have been several exciting advancements recently in the development of breast implants, as it relates to size, profile, texture and the overall composition of the implant itself.

Gone are the days of the first generation silicone implants that made headlines in decades prior. Today, we are excited to offer patients numerous implant options that have been tested for both safety and efficacy.

For a majority of patients (72% in 2013), silicone implants are the desired choice over saline. The benefits of silicone, including the newest cohesive gel or “gummy bear” implants, are a lighter, softer more natural feel. There is also a lower deflation rate and less rippling however, patients can expect to pay more for a silicone breast augmentation.

For a certain population who desire a slightly smaller incision or less costly option, saline implants are often a great alternative to silicone. Ultimately, the patient is the final decision maker so it is important she is comfortable with her implant selection.

Surgical Incision

Although breast augmentation surgery is more widely accepted in today’s society, a large majority of patients prefer to keep their surgery private and therefore have concerns about the size and location of their incisions.

Through advancements in breast surgery techniques and products such as the Keller Funnel, we’ve been able to significantly reduce the appearance of scars. Although there are different standard incision approaches in breast augmentation surgery, most plastic surgeons prefer inframmamry (under the breast fold), peri-areolar (around the areolar) or transaxillary (under the armpit).

The surgeon should discuss which incision approach is best-suited for the patient’s body type, implant selection and daily lifestyle.


Determing size is no doubt the largest cause of anxiety for patients seeking breast augmentation.

There always seems to be the general concern of “I don’t want to be too big but I want to look like I’ve had something done.” Another statement I often hear from my patients is “My friend has 350cc implants and hers look great so I want the same.” It is important to educate patients on their body’s anatomy and how breast implant size options are determined.

At the consultation, the surgeon should take measurements to understand what size implant is most appropriate for the patient’s anatomy and offer a method in which she can visualize her results. From the use of imaging technology to trying on different implant sizers, patients should be active participants in the size selection process.


The final S when considering breast augmentation (and the most important) is selecting a plastic surgeon to perform the procedure.

The surgeon should be certified American Board of Medical Specialties (ABMS) in the field of plastic surgery as well as an ASPS member.

In addition to having proper certifications, it is important for patients to have access to before & after photos either online or in the office so they can review the surgeon’s results.

While many patients find online reviews helpful, often they take a greater interest in the feedback from friends or family members who have previously undergone cosmetic surgery.

Whether patients find their surgeon online or through a referral, they should feel a connection with the doctor as well as the entire practice staff but most importantly, patients must be confident of the surgeon’s ability to deliver their desired results.

Source: ASPS

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2201 Murphy Avenue, Suite 301,
Nashville, TN 37203

At Nashville Plastic Surgery, we have a deep understanding of the important role that physical image plays in life, yet we never lose sight of emotional well being. Our approach to plastic and reconstructive surgery integrates these fundamental principles to promote overall health.