Breast Implant Options in Modern Breast Augmentation Surgery: Dr Turner’s Approach

Last Updated May 2025

Breast augmentation is one of the most popular cosmetic surgical procedures performed in Sydney and worldwide. At his Manly and Double Bay clinics, Dr Scott J Turner, Specialist Plastic Surgeon, provides patients with comprehensive options for breast implants, carefully selecting based on individual anatomy, aesthetic goals, and lifestyle factors. This guide examines the six key considerations in breast implant selection that Dr Turner discusses with each patient during consultation.

1. Breast Implant Size

Size selection is one of the most critical decisions in breast augmentation and requires a personalized approach rather than a one-size-fits-all solution. The size of breast implants is measured in cubic centimeters (cc), not cup sizes, which provides a more accurate and consistent measurement system.

Dr Turner employs a comprehensive tissue-based planning method to determine the optimal implant size for each patient. This involves detailed measurements of the breast tissue, including width, height, and skin elasticity, to accurately determine which implant dimensions will best complement the patient’s natural anatomy.

To help patients make informed decisions about implant size, Dr Turner uses a variety of specialized tools:

• Tissue-based planning: Scientific measurements of chest dimensions to determine appropriate implant widths and volumes
• Mentor sizing kit: External sizers that patients can place in a bra to visualize different volumes
• Vectra 3D imaging: Advanced technology that creates three-dimensional simulations of potential surgical outcomes

This multi-faceted approach ensures that the selected implant provides proportionate enhancement while accounting for individual chest wall characteristics and helps patients visualize potential results before making their decision.

2. Breast Implant Shape

Dr Turner offers patients two primary implant shape options, each with unique benefits for different body types and aesthetic goals.

Round Implants

Round implants are the most frequently used worldwide and remain a popular choice for many of Dr Turner’s patients. These implants provide several advantages:

• Create fuller upper pole breast volume and cleavage
• Maintain their aesthetic appearance even if the implant rotates within the pocket
• Ideal for women with well-shaped breasts who desire additional volume
• Available in various projections to customize the final result

Despite concerns that round implants might create an artificial appearance, Dr Turner emphasises that a well-chosen round implant placed using the customized dual plane technique can achieve a very natural breast shape.

Anatomical (Teardrop) Implants

Anatomical implants mimic the natural slope of the breast with more volume at the bottom and a gentle taper at the top. Dr Turner recommends these implants for specific patient situations:

• Women with minimal natural breast tissue
• Cases of mild breast ptosis (drooping)
• Tuberous breast anomaly
• Patients who desire a more subtle enhancement with less upper pole fullness

These shaped implants consist of highly cohesive silicone gel to maintain their form and create a breast shape that closely resembles natural breast contours. However, they require precise positioning as rotation can result in an unnatural appearance.

Learn more about breast implant shapes

3. Breast Implant Texture

The texture of the implant surface plays an important role in how the implant interacts with surrounding tissue and affects long-term positioning.

Smooth Implants

Smooth implants feature a shiny, slippery outer shell that doesn’t attach to surrounding tissue, allowing some natural movement within the breast pocket. Dr Turner and many modern surgeons prefer smooth or nano-textured implants for most breast augmentation procedures. Smooth implants offer several benefits:

• More natural movement and feel
• Thinner shell that may provide a softer feel
• Reduced risk of certain complications associated with textured implants

Textured Implants

Textured implants have a rough surface designed to adhere to surrounding tissues. This texture was originally developed to reduce the risk of capsular contracture and to prevent implant rotation, particularly important for anatomical shaped implants. Textured implants come in several varieties based on the degree and type of texturing:

• Micro-textured implants: These have the finest texture with minimal surface irregularities, providing subtle tissue adherence while minimizing risks associated with more aggressive texturing.
• Macro-textured implants: These feature more pronounced texturing with larger and deeper surface irregularities for stronger tissue adherence.
• Polyurethane-coated implants: A distinct category where the implant is covered with polyurethane foam coating, allowing significant tissue ingrowth and typically offering excellent capsular contracture prevention.

Due to concerns about rare complications associated with highly textured implants, Dr Turner, like many surgeons, has shifted toward using nano or micro textured implants in most cases, carefully selecting the appropriate texture based on individual patient factors and anatomical requirements.

4. Breast Implant Projection

Projection refers to how far the implant extends forward from the chest wall and significantly influences the final breast profile.

Types of Projections

Dr Turner offers various projection options to help achieve each patient’s desired breast appearance. These typically include:

• Low Profile: Provides minimal projection, creating a more subtle enhancement that’s flatter in appearance
• Moderate Profile: Offers natural-looking projection suitable for a balanced appearance
• High Profile: Creates maximum projection for a more prominent, rounded appearance
• Ultra-High Profile: Delivers the greatest forward projection for a given base width

The selection of implant projection is determined by detailed measurements of the patient’s chest wall and breast tissue, along with their aesthetic goals regarding cleavage and fullness.

5. Breast Implant Placement

The position of the implant relative to the chest muscles significantly impacts both the appearance and feel of the augmented breast.

Placement Approaches

Dr Turner offers several placement techniques, each with specific benefits for different patient situations:

Subglandular Placement: The implant is positioned behind the breast tissue but above the pectoral muscle. This approach works best for women with adequate natural breast tissue coverage and typically allows for a quicker, less painful recovery.

Submuscular Placement: The implant is placed under the pectoral muscle, providing additional tissue to minimise breast implant visibility or rippling in the cleavage area. This may be recommended for very thin patients or those with minimal breast tissue.

Dual Plane Technique: This advanced placement method positions the upper portion of the implant under the pectoral muscle while allowing the lower half to sit under the breast tissue. Dr Turner notes this technique as “one of the latest developments in breast augmentation surgery” that offers greater customization. It’s particularly beneficial for:

• Improving mild breast ptosis (drooping)
• Providing better muscle coverage to prevent visible rippling
• Creating a natural slope while maintaining fullness in the lower pole

Dr Turner tailors the placement approach based on the patient’s anatomy, tissue characteristics, and desired outcome.

Learn more about breast implant placement

6. Breast Implant Access Incision

The surgical incision provides access for creating the implant pocket and influences the visibility of resulting scars.

Incision Options

Dr Turner discusses three primary incision options with patients, each with unique considerations:

Inframammary Fold: An incision placed in the natural crease beneath the breast. Dr Turner often prefers this approach because it:

• Provides optimal exposure to underlying tissues
• Allows for precise pocket creation and implant placement
• Is associated with the lowest complication and revision rates
• Results in a scar that’s typically well-concealed within the natural breast fold

Periareolar: An incision around the edge of the areola, which often heals inconspicuously due to the natural color transition at this site. This approach may be suitable for certain patients but offers less direct access to the implant pocket.

Transaxillary: An incision within the armpit that avoids any scarring on the breast itself. While appealing to some patients, this approach provides less direct visualization during surgery and may be associated with higher rates of implant malposition.

Dr Turner carefully evaluates each patient’s anatomy and preferences before recommending the most appropriate incision approach, balancing aesthetic outcomes with surgical precision and long-term results.

Conclusion

Selecting the optimal breast implant involves careful consideration of multiple factors, including the patient’s anatomy, tissue characteristics, and aesthetic goals. Dr Turner’s approach emphasizes individualized assessment and educational consultation to help patients make informed decisions about their breast augmentation.

By systematically evaluating implant size, shape, texture, projection, placement, and incision options, Dr Turner creates customized surgical plans designed to achieve natural-looking, proportionate results that complement each patient’s unique body. This comprehensive approach to implant selection, combined with surgical expertise and attention to detail, helps ensure optimal aesthetic outcomes and patient satisfaction.

Dr. Scott J Turner is a Board Certified Cosmetic Plastic Surgeon serving Sydney with clinics in Manly and Double Bay.