Breast augmentation has long been one of the most popular cosmetic procedures worldwide, sought by those looking to enhance breast shape, size, and overall appearance. An approach known as preservation breast augmentation has been gaining traction although it is has been around for some time. This method focuses on maintaining as much native breast tissue and anatomy as possible during the augmentation process, thus preserving blood flow, supporting tissues, and natural contours. By doing so, patients can potentially benefit from fewer complications, a smoother recovery period, and more aesthetically pleasing results that complement their natural breast structure.

We will delve into the concept of preservation breast augmentation, discuss how it differs from traditional methods, explore potential benefits and risks, and answer the most frequently asked questions surrounding this procedure. You will be equipped with a more thorough understanding of preservation breast augmentation and how it might align with your aesthetic goals.

Breast Augmentation

It is important to have a basic understanding of the traditional breast augmentation approach. Typically, a breast augmentation involves creating a pocket for an implant within the breast. This pocket can be made either beneath the chest muscle (submuscular placement), beneath the breast tissue (subglandular placement), or partly beneath the muscle and partly beneath the breast tissue (a dual-plane approach).

Traditional Breast Augmentation Techniques

Submuscular (Under the Muscle)

With submuscular placement, the implant is positioned partially or completely under the pectoralis major muscle. This approach can offer a more gradual slope to the upper breast and is thought to reduce the risk of certain complications, such as capsular contracture. However, it may be associated with a slightly longer recovery time and a greater degree of postoperative discomfort.

Subglandular (Over the Muscle)

In a subglandular procedure, the implant is placed beneath the breast tissue but above the pectoralis major muscle. This can lead to a more defined upper-pole fullness, quicker recovery, and less discomfort. However, it may potentially increase the risk of visible rippling or capsular contracture if proper technique is not followed or if there is insufficient soft tissue coverage.

Dual-plane Technique

The dual-plane technique combines elements of both submuscular and subglandular placement, thereby benefiting from the muscle’s coverage at the top of the implant while allowing the lower portion of the implant to sit beneath breast tissue. This approach can deliver a more natural breast shape and reduce the risk of certain complications while offering a stable position and adequate tissue coverage.

Implants, Incisions, and Considerations

In standard breast augmentation, the surgeon makes incisions (most commonly in the inframammary fold, around the areola, or occasionally in the armpit), creates a pocket for the implant, and then inserts the implant. Modern implants can be filled with silicone or saline, and they vary in shape, size, and projection. The choice of implant is based on individual patient anatomy, preference, and our recommendations.

What Is Preservation Breast Augmentation?

Preservation breast augmentation (also sometimes referred to as “tissue-preserving breast augmentation” or “preservation technique augmentation”) is a refined surgical method that emphasises maintaining the integrity of the patient’s natural breast structure. The overarching principle is to minimise disruption to blood vessels, nerves, glands, and connective tissues. By preserving these components as much as possible, the risk of compromising the breast’s long-term health or sensation is potentially reduced.

The concept of preservation in breast surgery builds upon evolving approaches in cosmetic and reconstructive procedures. Similar philosophies have been adopted in breast reduction and mastopexy (breast lift) procedures, wherein surgeons strive to keep the breast’s blood supply intact in order to promote faster healing, fewer complications, and more robust results. Extending this principle to augmentation means that every step of the surgery is designed to reduce invasive manoeuvres that might otherwise damage key structures.

How Does Preservation Breast Augmentation Differ from Traditional Methods?

While traditional augmentation focuses on creating a pocket for the implant under or above the muscle, preservation breast augmentation involves creating the pocket over the muscle often in a subfascial plane. Here are the key differences:

Minimised Tissue Disruption

In preservation breast augmentation, the surgeon may employ a more precise dissection technique to separate layers of tissue without cutting through critical support structures such as the Cooper’s ligaments (these ligaments help maintain breast shape and contribute to firmness). Preserving these ligaments aids in supporting the implant over time, potentially leading to more stable results. The muscle is also preserved which can aid a quicker recovery. The plane is usually subfascial meaning that it is under the thin layer of tissue just above the muscle.

Optimised Blood Flow

By carefully conserving blood vessels and limiting the dissection, preservation breast augmentation can help reduce the risk of complications such as tissue necrosis, delayed healing, or infection. Good blood flow is fundamental to healthy healing and reducing postoperative issues.

Enhanced Sensation Preservation

During more traditional augmentations, there is a risk of disrupting nerves that contribute to nipple and breast sensation. Preservation breast augmentation with more limited dissection may help reduce the risk of sensory changes.

The Potential Advantages of Preservation Breast Augmentation

The growing popularity of preservation breast augmentation can be attributed to the potential benefits associated with this conservative approach. These advantages may include:

Reduced Trauma to Breast Tissue

By protecting existing tissues, surgeons minimise the physical trauma inflicted during the procedure. Reduced trauma can translate into less bruising, swelling, and postoperative discomfort.

Possibly Lower Complication Rates

Maintaining robust blood supply and structural integrity can decrease the likelihood of complications such as infection, tissue necrosis, or significant bleeding. A strong blood flow and well-preserved tissue layers are associated with healthier postoperative outcomes.

Shortened Recovery Period

Although recovery experiences can vary considerably between patients, a procedure that is less disruptive to tissues may facilitate quicker healing and recovery. Some patients report being able to return to work or normal activities sooner than they might with more traditional methods.

Preservation of Sensation

Because the nerves are handled carefully during preservation breast augmentation, the risk of reduced breast or nipple sensation may be lowered compared to more invasive procedures.

Who Is an Ideal Candidate for Preservation Breast Augmentation?

Not every person seeking breast augmentation will be an ideal candidate for a preservation approach, but for many, this technique may be a compelling option. An initial consultation with an experienced plastic surgeon like Mr Nassab is critical to determine suitability. Generally, candidates might be:

Someone with some natural breast tissue

Patients with some existing breast tissue will be better candidates than those with little or no breast tissue. This allows us to go in the plane above the muscle and hopefully reduce the risks of rippling. In very slim patients there is little cover of the implants and so there may be a higher risk of rippling.

Someone seeking a more quicker recovery

Preservation breast augmentation may allow patients to have a quicker recovery with less postoperative pain.

Good General Health

Patients need to be in good overall health, without major systemic medical conditions that might impede healing.

Having Realistic Expectations

While preservation breast augmentation can deliver transformative results, it is important to remember that the final outcome depends on a variety of factors. Patients should maintain realistic expectations regarding achievable size and shape, based on their unique anatomy. Some patients with sagging or ptotic breasts may need additional procedures such as uplifts.

Selecting the Right Implant

Some implants may be better suited for this technique. These are implants that are silicone and filled more resulting in lower rippling risk. The Mentor Memory Gel Xtra, Motiva, or Mia implants are examples of these types of implants.

This patient underwent subfascial breast augmentation using a 325cc high profile round textured implant.

Frequently Asked Questions

Is preservation breast augmentation more expensive than traditional breast augmentation?

Costs can vary based on the surgeon’s expertise, geographic location, choice of implant, and hospital or clinic fees. While the surgical technique may differ, the difference in cost is not always significant. During your consultation, we will provide a breakdown of fees, allowing you to make an informed decision. The techniques such as Preserve or Mia are generally more expensive due to the cost of the implants and instruments required to perform the procedure.

How long does a preservation breast augmentation procedure take?

The duration can range from 60 to 90 minutes, depending on the complexity of the case, the surgical approach. If additional procedures, such as a breast lift, are required then the procedure will be longer.

Is there a difference in scarring compared to standard breast augmentation?

Incisions for preservation breast augmentation often follow the same patterns used in conventional procedures. The use of devices to insert the implants may result in slightly shorter scars compared to some traditional scars. The scars in the armpit tend to be smaller than those underneath the breast.

What if I decide to have children or breastfeed in the future?

Preservation breast augmentation may conserve glandular tissue and ductal structures allowing breast feeding in the future.

Can I combine preservation breast augmentation with other procedures?

Yes. Many patients choose to address multiple aesthetic concerns at once, such as a breast lift or liposuction. Combining procedures can be an efficient way to minimise overall recovery time, but discuss potential combinations with your surgeon for a personalised plan.

Is preservation breast augmentation suitable for a revision procedure?

Patients undergoing revision will already have a pocket from previous surgery and so this technique is not likely to have any benefits.

The Future of Preservation Breast Augmentation

As breast surgery techniques continue to evolve, preservation methods are likely to become more mainstream. We have already seen that there has been a move towards preservation rhinoplasty and preservation deep plane facelift techniques. Ongoing research into new surgical tools and advanced implant materials may enhance the efficacy of tissue-preserving approaches. We have seen the Mia technique using minimal access incision in the armpit to perform the procedure and the Motiva Preserve technique using a special device for insertion of the implants.

Preservation breast augmentation represents a paradigm shift in cosmetic breast surgery. By focusing on safeguarding the breast’s structural, vascular, and nerve integrity, this technique offers:

• Reduced tissue trauma and potentially quicker recovery

• Preservation of blood flow and nerve pathways, which may preserve breast sensation

While the principles of preservation breast augmentation are compelling, the decision to undergo any form of breast enhancement should be made in consultation with a qualified plastic surgeon like Mr Reza Nassab. During your appointment, we will evaluate whether you are a good candidate for the procedure, help you select the most appropriate implant type and size, and walk you through each step of the process to ensure you are well-informed and confident in your decision.

Final Thoughts

Breast augmentation has come a long way since the early days of rudimentary implants. Preservation breast augmentation, with its focus on maintaining the integrity of the native breast tissue, nerves, and blood supply, exemplifies the ongoing innovation in aesthetic plastic surgery. This evolution continues to benefit patients who are seeking a more natural-looking and feeling augmentation, while potentially enjoying reduced complications and enhanced long-term results.

Nevertheless, no surgery is entirely risk-free. It is vital that any prospective patient weighs the benefits of preservation breast augmentation against potential complications, the healing process, and their personal budget. If you have been contemplating breast augmentation but feel uncertain about the traditional approach, preservation breast augmentation may be just what you are looking for. Its distinct principles of minimal tissue disruption make it an appealing option for individuals who desire a high-quality, aesthetically pleasing result that has rapid recovery. While it might not be suitable for everyone, it is important to discuss options with Mr Nassab.

If you think this procedure could be right for you, it is best to book a consultation with Mr Nassab who will help you explore the intricacies of this technique, ensuring that you have all the information necessary to make a confident, informed choice regarding your body, your appearance, and your well-being.