The ABCs of Cosmetic Surgery: Breast Augmentation Terms to KnowJanuary 23, 2019 | ABCS
If you’ve been considering breast augmentation, it’s likely you’ve already spent some time scouring the internet for information. It’s also likely that you’ve come across a few terms you’re not familiar with, which can make understanding the procedure challenging.
To help those feeling overwhelmed with information or curious about the breast augmentation lexicon, we’ve created a breast augmentation glossary that covers some of the most common terms you’ll come across.
This glossary is not intended to provide medical advice or diagnostic information. If you are experiencing any concerning issues, please seek medical care from your cosmetic surgeon, general practitioner, or emergency services.
- Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin lymphoma that occurs when abnormal T-cells develop, typically in the lymph nodes. ALCL is extremely rare. BIA-ALCL, or breast implant associated ALCL, is an ever rarer form of ALCL that develops in the scar tissue surrounding breast implants. So far, all documented cases of BIA-ALCL have been linked to textured breast implants. You can learn more about BIA-ALCL and our safety recommendations here.
Anatomical Breast Implant
- An anatomical breast implant is a form-stable silicone implant shaped to resemble the natural curvature of the breast, i.e. a teardrop. See “Teardrop Breast Implant”
- Augmentation mastopexy is a procedure designed to both lift drooping breast tissues and add fullness through the placement of a breast implant. Typically referred to as a breast lift with implants or breast augmentation with lift, this surgery is most often recommended to those who are experiencing breast sagging from childbearing, weight loss, or aging and also wish to restore lost fullness, particularly to the upper breast.
- “Bottoming out” is a post-breast augmentation complication that occurs when the breast implants falls to a lower position on the chest, below the natural crease of the breast (inframammary fold). This condition can occur if your breast tissue is week and/or your breast implants are too large or the breast crease was lowered too far during surgery. Bottoming out is more common when breast implants are placed over the muscle.
- “Breadloafing” is a layperson’s term for symmastia, a rare post-breast augmentation complication wherein the breast implants settle too close together, leaving little-to-no room between the breasts. Symmastia most-often results from over-dissection of the breast tissue, allowing the breast implants to “fall” toward the center of the chest. See “Symmastia.”
- Breast augmentation is a surgical procedure that enlarges the breasts through the placement of saline or silicone breast implants.
- When any medical implant is placed in the human body, your body responds by forming a capsule of scar tissue around the device. This process is a normal part of healing that occurs when your body isolates a foreign object—and it can help keep your breast implants in place as you recover.
- Capsular contracture occurs when the capsule of scar tissue that naturally forms around breast implants (or any medical implant) hardens and begins to constrict the implants. Depending on the severity of capsular contracture, you can experience breast pain, overly firm and tender breasts, a tight and round appearance, and/or misshapen nipples.
- Typically performed to help treat surgical complications after breast augmentation, such as capsular contracture, a capsulectomy involves surgically removing the capsule of scar tissue that naturally forms around breast implants. Either a portion (partial capsulectomy) or the entirety of the capsule may be removed, depending on the preference of the surgeon and patient, severity of complication, and any associated risks. Unlike an en bloc capsulectomy, this procedure is performed without removing the breast implant.
Cohesive Breast Implants
- Cohesive breast implants are a form-stable, silicone gel breast implant often referred to as “gummy bear implants.” The cohesivity of a breast implant is determined by how many chemical cross-links (connections) between silicone molecules their are; the more cross-links, the more firm and stable the breast implant will be. Highly cohesive breast implants, for instance, contain a very firm gel that retains its shape while still feeling similar to natural breast tissue. See “Form-Stable Breast Implants” and “Gummy Bear Implant.”
- Cooper’s ligaments are connective tissues in the breasts that help provide structure and support. These ligaments run from your clavicle to the interior portion of the pectoralis major muscle and branch through and around your breast tissue.
- “Dog ears” are small areas of excess skin that occur at the end of an incision, similar in appearance to a dog ear. While rare in procedures that don’t involve skin tightening incisions, they can happen with breast augmentation. Dog ears can be removed with scar revision.
Drop and Fluff
- “Drop and fluff” describes the normal process of breast implant settling after breast augmentation. Immediately after surgery, it’s normal for breast implants to sit high and firm on the chest as your body reacts to surgery with muscle tightening and swelling. As you begin to heal, your muscles relax and skin starts to stretch to accommodate your breast implants, allowing them to “drop” into a more natural position on the chest and “fluff” as they fill the lower breast cavity. This process can take up to six months or more, depending on your anatomy, type of breast implant placed, and surgical technique.
Dual Plane Breast Augmentation
- Dual plane breast augmentation is a technique where breast implants are placed under the pectoral muscle at the upper and mid-portion of the breast while the lower part of the breast implant is left uncovered by the muscle. This technique requires creating a pocket for the breast implant both under the muscle and in the breast tissue. This technique is often recommended for women who have a mild amount of breast drooping or wish for a very natural look with more fullness in the lower breast. Some surgeons also use this method for women who have tuberous breasts.
En Bloc Capsulectomy
- En bloc capsulectomy describes a technique for breast implant removal that involves removing both the implant and the entire capsule of scar tissue that naturally forms around the breast implant simultaneously. This method is often favored when a rupture or other complication has occurred or implants are over a certain age, as the capsule may have fragments of silicone, bacteria, or inflammatory cells that can lead to issues if exposed to the body. Because the entire capsule and implant are removed together, the inside of the capsule is not exposed. En bloc capsulectomy is not always necessary when having implants removed or replaced, though some doctors favor this technique to ensure patient safety and consistency in results.
Form-Stable Breast Implants
- Form-stable breast implants, often referred to as “gummy bear implants,” are filled with a highly cohesive silicone gel that retains its shape over time. Form-stable implants have more cross-links between silicone molecules that traditional silicone gel breast implants, giving them their firmness and gummy-like texture. See “Cohesive Breast Implants” and “Gummy Bear Implant.”
Gummy Bear Implant
- The latest generation of highly cohesive silicone breast implants are colloquially referred to as “gummy bear breast implants” for their firm yet flexible texture. Though firmer than traditional silicone implants, gummy bear implants are known for their natural look and feel while retaining their shape as the implants age. Gummy bear implants are now available in both anatomical and round shapes and in a variety of levels of firmness and cohesivity. See “Form-Stable Breast Implants” and “Cohesive Breast Implants.”
- A hematoma is a swelling of clotted blood outside of the blood vessels within the tissues. Hematomas are typically caused by injury or excessive pressure to the wall of a blood vessel, which allows the blood to seep out and collect in the surrounding tissues. It doesn’t take much trauma to cause a hematoma; consider the pocket of blood often seen under a nail after minor injury to a finger or toe. The first signs of a hematoma include discomfort, swelling, redness, and bruising. Mild hematomas are common after any surgery and typically not a sign for alarm in breast augmentation patients unless a severe hematoma, excessive pain, or irregular bruising are present.
- Implant malposition is when breast implants shift within the breast pocket, moving to an unnatural position that impacts your results. Implants can fall too low, leaving too much fullness below the nipple; sit too high, creating excess fullness in the upper pole of the breast; migrate laterally to the sides, where breasts are spaced too far apart; or move too close to the center, creating the appearance of a singular breast. Implant malposition can be fixed with a secondary surgery that involves adjusting the breast pocket and, often, replacing breast implants.
- Implant rippling is when the edges of a breast implant are visible through the skin. When it occurs, rippling is typically visible at the outer perimeter of the breast implants, most often along the outer edge, toward the armpit. Women with little natural breast tissue or who are very thin have a higher risk of implant rippling, which occurs when there is poor tissue coverage of the implant. Visible implant rippling can also happen if a scar capsule is too loose, saline implants weren’t filled sufficiently during surgery, or an unsuitably sized implant was placed. Rippling can happen with either saline or silicone breast implants, though it is most common with round saline implants. Many surgeons opt to “overfill” saline breast implants to reduce the risk of rippling, though overinflation may also cause wrinkling in the implant if not done appropriately.
- For breast augmentation, the inframammary incision is made in the natural crease under the breast, the inframammary fold. This incision is a relatively small, horizontal incision that typically runs between 2 – 5 cm in length, and it can be used for both saline and silicone breast implants. Because the resulting scar is inconspicuous, obscured by the breast crease, and easily hidden by a bra or swimsuit, the inframammary incision is one of the most popular among patients.
- The Keller Funnel is a device used to make the process of placing breast implants more efficient and reduce the risk of infection after surgery. The device looks and functions similar to a pastry icing piping bag. Using no-touch delivery, the breast implant is first placed in the sterilized, hydrated bag at its widest end. The narrow end is is then inserted into the incision and the breast implant is gently propelled into the surgical pocket.
- Mammary hypoplasia, or “tuberous breasts,” is a condition caused by breast malformation, resulting in an asymmetrical, constricted appearance. This condition occurs when the breast does not fully form during puberty, often appearing as a constricted or collapsed areolar area, a high breast fold, and breast tissue that tilts downward. Tuberous breasts often appear pointed, square, or oval in shape, and it may affect one breast more so than the other. Breast augmentation can be performed to improve the appearance of mammary hypoplasia, though it will first require releasing the constricted tissue before placing breast implants. See “Tuberous Breasts.”
- The nipple-areolar complex is located near the center of the breast mound and includes the nipple and surrounding pigmented skin (areola).
- The periareolar incision is made along the outside edge of the nipple-areolar complex and is most often in used in breast lifting procedures as it can allow for removal of excess skin, particularly when combined with a vertical or anchor shape incision to lift the lower portion of the breast.
- Breast implant rupture is a complication that can occur for a variety of reasons at any point after breast augmentation surgery, though it most often happens as the outer shell of the breast implant weakens with age. Damage from surgical instruments, over or underfilling breast implants, capsular contracture, trauma, and even excessive compression are some contributing factors. When saline breast implants rupture, the breast implant will noticeably deflate over the course of a few days as the saline solution leaks and is safely absorbed by the body. If a silicone breast implant ruptures, the cohesive gel material does not leak like saline—typically, the silicone gel will remain within the capsule of scar tissue and only be detectable by MRI. Breast revision surgery is required to remove the damaged breast implant and, often, the surrounding capsule.
Saline Breast Implants
- Saline breast implants are composed of a silicone outer shell that is filled with sterile saline solution once it has been placed during surgery. Saline breast implants are available to women 18+.
- A seroma is an accumulation of fluid that collects under the surface of the skin and often develops after a surgical procedure, near the incision site or where tissue has been removed. For breast augmentation patients, seromas may develop within the first few weeks or months after your procedure, typically around the breast implant.
Shaped Breast Implants
- Shaped breast implants are a form-stable silicone implant shaped to resemble the natural curvature of a breast, i.e. a teardrop shape. These implants retain their shape rather than moving with the body as round breast implants do. See “Teardrop Breast Implant” or “Anatomical Breast Implant.”
Silicone Breast Implant
- Silicone breast implants are composed of a silicone outer shell filled with silicone gel of varying cohesiveness. Unlike saline implants, silicone breast implants come pre-filled. They are approved for patients over age 22.
Smooth Breast Implants
- Smooth breast implants are designed with a soft, smooth outer shell that allows them to move more naturally with the breast pocket.
Subglandular Implant Placement (Overs)
- Subglandular implant placement—also known as over the muscle placement—is when the implant pocket is created and implant placed under the glandular tissue of the breast, above the pectoral muscle. Subglandular placement typically involves a shorter recovery time and may results in a more uplifted look, though it does have a greater risk of implant visibility through the skin and a less natural look on some body types.
Subpectoral /Submuscular Implant Placement (Unders)
- Subpectoral implant placement—or under the muscle placement—is a technique where the implant pocket is created and the implant placed under the glandular tissue and pectoral muscle. Submuscular placement recovery is slightly longer, though many patients prefer the natural look and added support.
- Symmastia is a rare post-breast augmentation complication wherein the breast implants settle too close together, leaving little-to-no room between the breasts. Symmastia most-often results from over-dissection of the breast tissue, allowing the breast implants to “fall” toward the center of the chest. See “breadloafing.”
Teardrop Breast Implant
- Teardrop breast implants are a form-stable silicone implant shaped to resemble the natural curvature of the breast, i.e. a teardrop. These implants retain their shape rather than moving with the body like round breast implants. See “Shaped Breast Implant” or “Anatomical Breast Implant.”
Textured Breast Implants
- Textured breast implants go through a texturizing process that creates a “rough” or grained surface to the outer shell of the implant to help scar tissue conform more closely to the implant to reduce movement. While there are both saline and silicone textured implants, the textured surface is most common with anatomically shaped implants to reduce the risk of malposition or flipping. Textured implants have recently fallen out of favor due to their correlation with the development of BIA-ALCL.
- The transaxillary incision is made in the armpit where resulting scars are practically invisible. Breast implants are placed through this incision using an endoscopic surgical camera. This incision technique is often recommended to patients who are prone to keloid scarring or very concerned with resulting scars on the breast. The transaxillary incision is one of the least common, as it is a complex technique that requires specific experience and skill to properly perform. Saline or silicone implants can be placed through the armpit incision.
Transumbilical Breast Augmentation
- Transumbilical breast augmentation (TUBA) is a technique where breast implants are placed through a small C- or J-shaped incision in the natural creases of the belly button. Through the incision, an endoscope (thin, flexible tube with a camera) is guided under the skin up to the chest, creating a channel and expanding the breast pocket. An empty saline breast implant is then fed through the channel, placed over or under the pectoral muscle, and filled with saline to the desired size. While this method can only be used for saline implants, patients who choose TUBA do so for the lack of visible scars on the breast, reduced risk of loss of sensation or infection, and quicker recovery. TUBA is a less common form of breast augmentation as it requires added surgeon training and experience.
- A condition caused by breast malformation, tuberous breasts have an asymmetrical, constricted appearance. This condition occurs when the breast does not fully form during puberty, often appearing as a constricted or collapsed areolar area, high breast fold, and breast tissue that tilts downward. Tuberous breasts often appear pointed, square, or oval in shape, and it may affect one breast more so than the other. Breast augmentation can be performed to improve the appearance of tuberous breasts, though it will first require releasing the constricted tissue before placing breast implants. See “Mammary Hypoplasia.”