Breast Augmentation Procedures

One of the most common questions about breast augmentation we get asked is, what happens to the cleavage?
Most women wish their cleavage can become narrower after breast augmentation. While most women have what would be considered ‘normal’ breast cleavage, some of our patients present with an above average space between their breasts.
Remember, everybody is different. No two women have exactly matching breasts, and cleavage is one such way they differentiate.

In a situation, where the cleavage is excessively wide, the hope is that breast augmentation will help to correct this problem. Unfortunately, it rarely does.

Wide Breast Cleavage

As you can see in the above picture, the “after” result may make cast doubt as to whether the surgery was performed correctly. In looking at the “before” picture, you will notice that this patient had natural breasts which were wide apart, therefore. her implants were placed further apart to match up with her breasts. Her result is as good as it can be based on her pre-existing anatomy. Take a look at the image below highlighting her cleavage lines. This helps to better understand how the cleavage remains relatively unchanged.

Wide Breast Cleavage Explanation

If your breasts naturally sit far apart, your surgeon will need to place the implants far apart during the breast augmentation process too. The reason being, your implants should sit underneath your breast tissue. In other words, your natural breast tissue should sit on top of your implants, not next to your implants.
f the implants were placed closer together then your natural breast tissue would be left sitting off to the side. If the natural breast tissue is not properly aligned with your implants, it will look incredibly odd and unnatural.

Picture a round implant. The nipple should be sitting on top of the implant’s apex. If it is misaligned, it will sit off-centre with the surface of the implant not facing forward but curved around and be looking off to one side. This is what would then happen to your breasts, they would sit with your nipples looking outward.

In the example below, a patient underwent a breast augmentation with sub-muscular implants. Although her implants are perfectly aligned with her breasts and nipples, she was unhappy with the excessive cleavage. In order to correct this, I repositioned her implants above the pectoral muscles (her pectoral muscles were also naturally wide apart and prevented her implants from sitting closer together). As a result, she now has a better cleavage. The price she paid, however, is that her nipples are now off-centre and looking to the sides.

Extreme Bodies: Cartoon Hourglass

Not everyone wants what can be considered a normal look though. For some, an exaggerated body shape lies at the heart of their desire.
For years, the hourglass figure has been the ideal body type for women everywhere. The silhouette of a tiny waist, supporting the larger hip and breast curvature is a symbol of sex appeal and womanhood. This is a trait which has been commonly seen in cartoon characters, used to emphasise aspects of their character.

But, while most women hope to someday achieve this form through the realistic measures of exercise or dieting, Penny Brown has found a faster, untraditional, and seemingly risky solution to this dilemma.

This young 25-year-old has sacrificed her life into moulding her body after pin-up vixen Jessica Rabbit from the film, Who Killed Roger Rabbit. Two breast enhancements and years of 23-hour tight lace training has finally transformed her into a feminine caricature.

Penny was always curvy but her weight was evenly distributed throughout her body. Thus, it didn’t really emphasize the dramatic hourglass shape she longed for. So, she started corset training her waist.

A Victorian Beauty Practice

Corset training is an old technique that involves wearing a steel boned, heavy duty corset for a couple of hours a day so that your waist can slowly sink and shrink in size. Corset training can be quite controversial; it’s proven to shift and squeeze internal organs permanently. Women in the Victorian era wore corsets every day, which also contributed to the constant fainting and lack of appetite that they often displayed. Wearing a corset can be quite painful and restrictive; Penny states that she usually has problems driving or sitting down for long periods of time while wearing her corset.
For meals, she uses a blender so that they are ingested in liquid format since the corset doesn’t allow much room for bloating. Within the first four months, Penny claims she had dropped 15 inches from her waist measurements, moving from a 38 to a 26.

However shrinking down her waist only deals with half of her image, the other half is concerned with the excessively bigger breasts. Her breast enhancements ranged from an O to an H cup and the internet celebrity claims she’s still always looking into more augmentation.

Happily Ever After?

Penny claims she is completely happy with her body and is no longer feeling insecure about herself. Her husband completely supports her every step of the way and her internet fan base either loves her or hates her. In interviews, she states that the corset feels like an armour to her, a type of safety blanket. Penny is not concerned with the health risks associated with her extreme lifestyle, particularly regarding the corset training and she plans on continuing her upkeep.

For women like Penny that thrive on extreme proportions to gain body confidence, is there ever a limit? More importantly, what are the health risks and dangers that can result from this process and just where do you draw the thin line which can separate fashion and health?

What is Normal?

400cc is the average size of breast implants in many clinics. While at some clinics the average breast implants size is smaller, in Texas, we suspect, the average would be significantly larger but we don’t have any recent studies to support this hypothesis 😉

But what is a 400cc breast implant and what cup size will it give you? This is a frequent question we face. The simple answer to this is – it depends!

Breast cup size is measured relative to the chest size. For a woman who is short and has a narrow chest, a 400cc breast implant will create very large cup size D or perhaps even DD. The very same implant on a woman who is tall and has a broader chest is likely to produce a full B or a small C cup.
So the letter is not really important when choosing your breast implants. What really matters is what looks good on you. For that reason, we have many shapes and sizes of breast implants at our clinic, including the 400cc implants.

Choosing Your Own Path

When our patients undergo a breast augmentation consultation, they are allowed to look at and feel any implant we have in our clinic. They are allowed to try them on to see what looks good on them.
Ultimately, what you want is to look in a mirror and feel great about yourself, not worry whether or not a 400cc implant is too big, or whether a C or a D cup is what you want. Choosing the best breast implant can be nerve-racking. This is why we dedicate so much time and effort into getting this stage of the process correct.

A large part of this comes down to understanding exactly what options are available to you. In addition to choosing the overall look you wish to achieve, there are actually other factors you need to consider.

Making a Firm Decision

Cohesive gel breast implants is another name commonly used for silicone breast implants. Cohesive gel means the silicone is in the form of a gel and the gel is very sticky, more solid than liquid. In the same way that a gummy bear is more cohesive than Jello, modern silicone breast implants are more cohesive than the older generation of implants.

The downside of this change is that the implant feels a little harder. The upside is that the gel stays together and does not leak into your body if a silicone implant ruptures.

Another advantage of the increased cohesiveness in these newer silicone breast implants is that they ripple less than the older versions. The Allergan company has a new INSPIRA line of silicone breast implants which are more cohesive and more filled.
Mentor has COHESIVE 1, 2, and 3 referring to increasing degree of cohesiveness. COHESIVE 3 is the most cohesive and this is the true ‘gummy bear’ breast implant. However, this is found only in anatomic (teardrop shaped) breast implants. The Allergan company’s version of the gummy bear shaped implants is called STYLE 410.

How to Move Forward

Having been available in Canada since 2000, cohesive gel implants require a slightly larger incision for insertion compared to saline implants. This is because they are more solid and more difficult to squeeze through a small incision. Because of this, insertion is usually performed through an incision in the fold under the breast or occasionally through an incision around the areola. Armpit incision is possible but only up to a certain size. The largest cohesive gel implant we recommend placing through an armpit incision would be 450cc.

Cohesive gel implants are more expensive than basic saline implants and this explains the difference in the surgical fee of gel vs saline breast augmentation.

If you are curious about cohesive gel implants and breast augmentation, your next step should be to schedule an appointment with Top Doctor Martin Jugenburg at our downtown Toronto location. During your consultation, Dr. Jugenburg will go over all of the details involved with breast augmentation surgery with you and also show you actual cohesive gel implants. You will be able hold them and see how they feel, as well as try on different implant sizes and shape to see which one you like best.