Planning for
breast enlargement

Careful planning is of benefit for any project, and most certainly will pay its dividends in breast augmentation.

The effort of the surgery is to provide each woman with a carefully tailored enhancement, and that relies on putting together several variables, relating to the safety of the operation, the woman's preferences for shape and size, considerations regarding implant manufacturers, and the longevity of the result.


The available implant shapes include round and teardrop or anatomical implants. Within these categories, the implant shape may be flatter (low-profile), or a more prominent (moderate profile, high profile, very high profile).

The differences in implant shape are the results of effort to create a balanced augmentation in a variety of breast types, in terms of volume and elasticity.

These elements need to be discussed at the time of the consultation, examining the potential benefits and limitations of each choice.

Filler & Texture

The types of implants available in the UK today are filled either with cohesive gel of silicone or saline. In terms of the safety, as far as a scientific evidence so far, it doesn't seem possible to make a distinction between the two.

In terms of the texture, that cohesive gel of silicone is slightly firmer, more similar in texture to a young breast tissue. Saline filled implants are typically slightly softer, and more prone to rippling, in particular when the overlying breast tissue is thin.

All the implants available in the UK have a silicone shell, with several layers to allow for strength and aiming for different interactions with the surrounding tissues. In addition, it is possible to use implants that have a thin layer of polyurethane foam on top of the silicone shell. The purpose of the polyurethane foam is to reduce the rate of capsular contracture.


It is important to understand that cup size is a relative measurement which cannot give a clear indication of breast implants’ size.

On occasion, the choice of breast augmentation cup size may be assisted by 3D imaging, as well as being determined using sizers.

A useful guide to the effect of breast implants on breast size after augmentation can also be achieved using a measurement of rice placed in a stocking and fitted into a bra.

3-D imaging can also help with appreciation of the shape changes of the breasts in terms of different sizes, different profiles and shapes.

Access Incisions for Breast Enlargement

Access incisions

The type of breast implant chosen also affects the options for surgical incision and the resulting placement of breast augmentation scar.

An axilla (armpit) incision can only be used for round implants but the most commmonly used access incision is inframammary, where the scar is hidden beneath the breast in the natural fold.

Areaola incisions require a minimum nipple diameter and so are not suitable for all women or all implant sizes and types.

Implant placement

There are several options for positioning the implant behind the breast, and they are discussed at the time of the consultation, in relation to individual characteristics of the patient, the degree augmentation anticipated and personal preferences.


The most common alternatives include the subglandular position for the implant, where the pocket is created behind the breast tissue but front of the pectoral muscles.

This approach gives more mobility to the breasts, but offers less support, and depending on how much breast tissue covers the implants there may be more palpability of the implant through the skin.


Subfascial placement of the implants is when the pocket is developed behind the breast and the pectoral fascia but in front of the pectoral muscle fibres, in order to add some support to the implant with aren't going fully subpectoral.


The other common option is subpectoral position, where the pocket is created behind the pectoral muscle over the chest wall.

The advantages decreased palpability of the implant, and more support, but the implants will have less lateral mobility, and may have some more movement with contractions of the muscles.

Access Incisions for Breast Enlargement

Tubular breast shape

The tubular breast shape describes a breast with a narrow base, disproportionately large areola (nipple), and the bulk of the breast tissue behind the nipple giving rise to a root tuber effect.

The breast tissue often overhangs the narrow base of the breast even when small and breast augmentation surgery for tubular breasts usually aims to address these three issues: the narrow base, the hanging breast tissue, and the large areola.

A two-stage augmentation may be necessary in some cases in order to create a more proportional appearance to tubular breasts and each patient will work with the surgeon to develop a customised plan including choices over breast augmentation size, implant type, incision site(s), and the degree of areola reduction.

Fat transfer may assist the breast augmentation with implants in creating an elegant contour for tubular breasts.

Get in touch. Talk to our helpful team or book a consultation with Mr Lucian Ion. Call 0207 486 7757