Breast Augmentation

Breast Augmentation vs. Boob Jobs: What’s the difference?

Breast Enlargement, Breast Enhancement, Breast ImplantsWhat makes an excellent breast augmentation different from the classic “boob job”?  Breasts that don’t look augmented, but rather completely natural, the ultimate goal for any breast surgeon.

An excellent breast augmentation can look natural, feel real and have a natural shape.  For cosmetic plastic surgeons, there is a distinction between successful breast surgery and the obvious “boob job” where it’s easy to tell a woman has had surgery. Part of an excellent breast augmentation is the fact the breasts look as if they could actually occur in nature. There should not be a question in the viewer’s mind as to whether or not these are real or are surgically created.


A good breast augmentation has a natural fullness and gentle sloping off the chest wall.  There should be natural cleavage, without webbing between the breasts and a certain amount of perkiness.

There are 5 basic considerations that make for a desirable breast augmentation:

  •  which incision to use
  •  what type of implant to use
  •  placement of the implant
  •  texture of the implant
  •  size of the implant

Before having surgery, you should go over photographic examples of the breasts you want with your surgeon so that you both have a clear, visual understanding of the desired result.  The plastic surgeons job is to make the breasts look like the photographs.

The are 4 choices regarding where to make the incision for a breast implant: underneath the arm, around the areola, or in the inframammary fold (where the  breast meets the chest wall).  The fourth is the umbilical incision, but is not as preferred as the others (only suitable for saline implants).  There are advantages to each incision.

I generally allow the patient to direct me as to which incision she wishes to have. We know that each incision has a certain amount of scarring but our goal is to have the scar so minimal it’s inconspicuous. Sometimes there are ethnic factors (in terms of skin type and colour) that might  encourage one incision over another.  But I have to say that of all the breast augmentations I have performed on nurses, doctors or my own employees, none have ever asked me to do either the areola or armpit approach.  I find it highly significant that women who have been  surrounded by the plastic surgery industry, and have seen the most results, have never asked for an incision other than beneath the breast fold.

The type of implant used can be either silicone gel or saline. I prefer to use  silicone gel implants than saline implants. The silicone gel implants, in general, feel more like a breast and look more like a breast.  However we can certainly adjust the saline implants and in most cases are able to give women a natural looking breast.

The next question is where to put the implant.  It can be placed either on top of or  behind the chest muscle.  I place implants behind the muscle so the implants are  partially covered. The muscle allows a nice smooth take-off from the chest wall.  If put directly on top of the muscle they can look like a half-grape fruit or rounded ball on the chest.

The fourth criterion in an excellent breast augmentation is the choice of specific implant.  Should it be smooth, textured, lower profile, high-profile or anatomic?  It’s important that each implant is individualised to achieve the size and shape the patient desires- that individualisation should dictate the decision. It’s my feeling that if the surgeon is wedded to only one type of implant then all the breast augmentations will look the same.  This is not cookie-cutter breast surgery.  Cookie-cutter breast augmentations are, in my opinion, “boob jobs.”

Finally although there is a size range from which to choose, the breast implant must be appropriately sized for the individual. When a breast augmentation is extremely large compared to the woman’s body, in my mind, it falls into the category of a “boob job” because anyone can spot it.  If you take a little woman and you gave her size double-D breasts, most people would agree that this is inappropriate. For a larger woman however, that size may be reasonable.  Most of my patients want to be in the C to D range but certainly some women want to be a large D and some women only desire to be a B-cup size.

“Boob jobs” are often hard, round balls on a woman’s chest.  Beautiful breast augmentations have a natural shape and size, allowing natural movement, the implanted breasts slope gently off the chest and feels soft to the touch- that should be the goal of every plastic surgeon.

Question: What features in a breast augmentation do you think makes it look like a “boob job”? You can leave a comment below .


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