How can you tell if a woman has had breast implants?
Published November 10, 2009, by:
Fadi Nukta, MD
The number of breast augmentations performed in the United States is astonishing. According to the American Society of Plastic Surgeons (ASPS), more than 307,000 breast augmentations were performed in 2008 (still a huge number, despite a drop from 249,000 in 2007, due to the economy). This means that many celebrities that we are exposed to on TV and the Internet have had the procedure. This is slowly changing how we look at and evaluate breasts. With more breast augmentations being performed, the augmented look is not being considered as fake as it was years ago. In a study from Yale University published in the Journal of Plastic and Reconstructive Surgery, women were asked to evaluate how natural and ideal pictures of different breasts looked. As a surprise to the investigators, the women surveyed ranked some signs of augmented breasts as more natural and beautiful than nonaugmented breasts. One of the most common questions I get asked by friends, family and patients is: How can you tell if a woman had breast implants?
In order to be able to determine if a woman had work done, it is important to know that implants are two kinds, depending on the filling material — saline or silicone. They can be placed under the breast or deeper under the pectoralis major muscle. Each kind and method comes with its own advantages and problems.
Saline implants are filled with saltwater, so they feel very different from the breast tissue. They also can have wrinkles, which make the edges of the breast look like an underfilled water mattress. This is most obvious on the side and top of the breast. They become very obvious if a woman bends down. Silicone implants feel much more natural, but still not exactly like a normal breast. Plastic surgeons make implants less obvious by placing them under the muscles, which works much better in hiding the implant. However, in thin and athletic patients, contracture of the muscle can lead to the movement of the implant. Watch “Dancing with the Stars” for several good examples of breast implants in athletic women. Another important sign is the presence of scar tissue that pushes the breast in one direction or another, called “capsular contracture.” This usually makes the breasts have a stuck-on appearance on the chest wall. This stuck-on appearance can also be caused by large implants placed in petite patients.
In my opinion, the most important sign for determining the presence of an implant is something called “upper pole fullness.” In a natural breast, the profile of the breast slides in a straight line from the collar bone down to the nipple. In the presence of an implant, this line is changed to an outward curve. For plastic surgeons, this is considered a sign of implant. However, for many patients (through the influence of watching celebrities), this is now an acceptable look.
Finally, less obvious signs are the incisions, which can be placed under the areola and nipple, under the breast, in the axilla and around the belly button.
In summary, to be able to tell if someone had implants. Look at the top of the breast, is it really bulging out, are there any wrinkles on the edge and does the breast move side to side or up and down with moving muscle?
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