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Breast Augmentation vs boob jobs

“Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson explains how an excellent breast augmentation should look undetectable, feel real and have a natural shape.” Jodi Thiessen reports.

Dr Darryl Hodgkinson makes a distinction between successful breast surgery and the obvious ‘boob job’ where it’s easy to tell a woman has had surgery.

Dr Hodgkinson points out that we are often confused as to what is really ‘natural’. “It’s very difficult to even find nude photos of natural women. I’ve gone back to before the era of breast implants and I’ve collected magazines from Tahiti and places where breast augmentation isn’t common. So when someone asks me for a natural look I ask ‘wait a minute, what is natural’?”

There are three broad areas that a breast augmentation should NOT be obvious in. “I think natural isn’t seeing the implant, the margins of it, or the top roundness, what I call the “Tori Spelling” look. An implant that is too large for a small frame is a dead giveaway and finally an implant that is too perky will tend to look like a boob job, a small amount of droop is natural. When the patient lays on her back the implant should roll to the side like natural breast tissue and not sit up like mountains.”

Examples Of ‘Boob Jobs’

“Boob Job” surgery is noticable in this case because the margins of the implant show and the placement of the implants is assymetrical.

“Boob job” surgery is noticeable in this case because the margins of the implant show and sit ontop of the chest wall without a gentle slope from the collar bone.

The general result of a “ boob job” does not appear natural.

This can be because the implant shows, the size is inappropriate, or the result is too perky.

Here are two examples of noticeable boob jobs.

NOTE: Dr Hodgkinson did not perform this surgery.

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 only a certain amount of perkiness.

“ The surgeon is presented with so many scenarios from patients – the size of their breasts, quality of their breast tissues, their chest wall dynamics, the amount of droop they have and so on,” says Dr Hodgkinson. “Then all their potential wishes and fantasies need to be addressed as well. So the surgeon has a lot of work to do not only in the physical evaluation of the patient but also in assessing and communicating with the patient about what she wants.”

Dr Hodgkinson lists some of the considerations when customising a breast augmentation to gain a natural looking result: incision placement, type and shape of the implant, fill of the implant, size of the implant and positioning of the implant.
Before having surgery, it is beneficial for the patient to show photographic examples of the breast they desire to their surgeon so that there is a clear, visual understanding of the desired result.

“ The internet has helped because patients can see before and after photographs of breast augmentati
ons. They like to see very standard shots; in posed photographs it’s hard to get a true indication of the shape and size of the breast,” says Dr Hodgkinson.

There are three choices about where to make the incision for a breast implant – underneath the arm, around the nipple or in the inframammary fold (where the breast meets the chest wall). There are advantages to each incision. “I find most patients know what they want and scars aren’t a big issue for them,” says Dr Hodgkinson. “They are more concerned with shape, positioning and size.”

The choice of whether the implant should be smooth, textured, low profile, high profile or anatomic in shape depends on the desires of the patient and also her body shape. “Having options of different shaped implants is important for patients since no one implant will give the best result every time,” explains Dr Hodgkinson. The type of implant fill can be cohesive silicone gel, which in general feels more like a natural breast and looks more like a natural breast. Or a saline fill which can be adjusted to give the same look and will in fact fall more naturally when laying down.

Although there is scope for the appropriate size of a breast implant, the patient’s body shape and chest wall measurements need to be taken into consideration.

“ When a breast augmentation is extremely large compared to the woman’s body, it looks like a ‘boob job’ because anyone can certainly see it,” notes Dr Hodgkinson.

The next question is where to put the implant. It can be placed either on top of the muscle or behind the muscle. “In general I put implants behind the muscle so the implants are partially covered,” says Dr Hodgkinson. “The muscle allows a nice smooth take-off from the chest wall. If put directly on top of the muscle they can look like rounded balls on the chest, which is definitely a giveaway!”

Gaining a natural-looking breast augmentation is possible; it’s a matter of eliminating the ‘give-aways’ such as seeing the margins of the implant, an implant that is too large and an implant that is too perky.

With these eliminated, it is easier to ensure the size, shape and position are correctly chosen to create a natural slope off the chest wall and a balanced shape and size with the body.

BEFORE AFTER breast augmentation
by Dr Hodgkinson
BEFORE AFTER breast augmentation by Dr Hodgkinson