Summary: For many years, breast augmentation surgery has been among the most commonly performed cosmetic procedures in the United States. One reason for its consistent popularity is the array of mental and physical benefits breast augmentation offers patients, from a psychological and professional edge to enhanced self-confidence. The most common age for breast enhancement is between 40 and 54, but women of any age can enjoy beautiful breast augmentation results as long as the right approach is taken. The patient’s breast size and profile, both of which are impacted by age, will determine the best course forward.
Physical Changes Due to Age
Pregnancy, breastfeeding, aging, gravity, weight loss, and heredity are all elements that can adversely affect breast tissue quality. Glandular tissue shows signs of ptosis (drooping) as the supportive ligaments lose strength and become less structurally effective. The loss of fatty tissue due to hormonal changes as well as changes in collagen production and breakdown of collagen fibers also affect breast stature and firmness. Physically, these changes necessitate a customized approach toward breast augmentation for each individual woman that every plastic surgeon should be familiar with.
There are two standard types of breast implants: silicone gel and saline. The origins of silicone breast implants began in 1962 and five generations of evolution have resulted in the current cohesive gel implants, as well as the latest form-stable “gummy bear” implants. In contrast to saline implants, silicone gel implants require a larger incision, but will usually provide a more natural look and feel.
Saline implants are distinguished by the smaller incision they require, since they are filled only after they have been surgically inserted. Since younger patients are typically more concerned with scarring, saline implants may be an attractive option. Saline implants can be used for patients as young as age 18, while silicone implants are approved by the FDA for cosmetic use in patients age 22 and older.
Adjusting Implant Profiles for Age
A patient and surgeon must work together to choose an implant type and profile that meets the patient’s goals. One simple baseline to begin with is that the profile of the implant, for the size to be used, should match the width of the natural breast.
- Low profile implants are often ideal for older patients, as the lack of existing soft tissue may cause larger implants to look less natural. Middle-aged women might consider a moderate or moderate plus profile implant, as these strike a balance between projection and a natural look. Some surgeons feel there is little difference between moderate and moderate plus implants, so a reasonable case could be made for either one depending on the patient’s priorities.
- For younger women or those who prefer a more dramatic look, moderate plus and high profile implants are often the ideal choice, particularly when cleavage is the patient’s top goal. High profile implants more closely mimic the look and feel of a full, youthful breast, so these often create the best results in younger patients.
The Right Implant
The right implant is the one the surgeon and patient together feel most comfortable moving forward with. Patients who favor projection over a subtle look will want a larger-profile implant, while women who want a more natural enhancement or those who are older are more likely candidates for moderate or moderate plus implant profiles instead.