Breast Augmentation

Dr Sparks’ standard implant position — a stable shape with good soft-tissue cover.

In the dual-plane technique, the implant sits partly beneath the chest (pectoralis) muscle in its upper portion and partly beneath the breast tissue in its lower portion. This combines the advantages of both planes: the muscle provides good soft-tissue coverage over the upper pole — for a smooth upper contour and a lower risk of visible rippling — while the lower position allows the breast to take a teardrop shape and the implant to sit correctly behind the nipple.

The degree of dual-plane release is adjusted to the individual breast, which is what allows the technique to be tailored rather than applied uniformly. It is Dr Sparks’ standard approach for most augmentations.

Internal support to help the result hold its position over time.

One of the long-term challenges of breast augmentation is that the weight of an implant, over years, tends to stretch the tissues and allow the breast to descend or the implant to settle low. To address this, Dr Sparks incorporates an internal bra — internal support that reinforces the lower pole and the implant pocket.

The internal bra acts as a reinforcing hammock within the breast, helping to hold the implant in its planned position and resist the downward stretch that would otherwise compromise the shape over time. It is part of planning for durability, not only how it looks good at the outset.

Routine fat grafting to the inner breast for natural cleavage.

An implant alone often struggles to create natural fullness in the medial pole — the inner breast and cleavage — and an implant placed too far medially in pursuit of cleavage produces an unnatural, over-close appearance and visible edges. Dr Sparks’ solution is to routinely graft the patient’s own fat to the medial pole as part of the augmentation.

This composite approach — implant plus fat grafting — uses the implant for volume and the fat to shape the cleavage and soften the transition between the implant and the patient’s own tissue. The fat adds soft-tissue coverage where it is most needed, for a softer inner contour and cleavage.

Type, profile, and dimensions matched to the patient — not to a number.

Implant selection is a clinical decision made with the patient. Dr Sparks selects an implant whose dimensions — base width, projection, and profile — suit the patient’s chest and tissue, not to a predetermined cup size. An implant that is too wide or too projecting for the anatomy is a common cause of an unnatural result and of long-term tissue stretch.

Discreet, well-concealed incision options.

The augmentation is performed through an incision in the inframammary fold — the natural crease beneath the breast — where the scar is well concealed and the approach gives precise control of the implant pocket. Incision options are discussed at consultation and selected with scar concealment and surgical precision in mind.

Combining augmentation with mastopexy where the breast has descended.

Where the breast has descended and the nipple sits low, an implant alone will not correct the position — it will simply enlarge a descended breast. In these patients, augmentation is combined with a breast lift (mastopexy), so that the breast is both lifted and given volume. Whether a lift is needed is assessed honestly at consultation.

Swelling, muscle discomfort, supportive bra, and restricted activity.

• A supportive surgical bra is worn continuously to support the implants and the fat-grafted areas.
• Some discomfort related to the chest muscle is expected with the dual-plane position, particularly in the first week.
• Lifting and reaching overhead are restricted; light walking is encouraged.
• Most patients return to non-strenuous work within one to two weeks.

Progressive return to activity and settling of the implants.

• Everyday activity is gradually resumed; strenuous exercise, chest exercise, and heavy lifting are deferred until around six weeks.
• The implants gradually settle into a more natural position as swelling resolves and the tissues relax.
• Scar management begins once the incisions have healed.

Final shape and scar maturation.

• The breast shape continues to settle over three to six months; the medial-pole fat graft establishes its final volume by around three months.
• Scars mature over 12 to 18 months — initially firm and pink, fading and flattening progressively.
• Long-term review is recommended, and ongoing monitoring of the implants over the years is advised.

In the dual-plane technique, the implant sits partly beneath the chest muscle in its upper portion and partly beneath the breast tissue in its lower portion. This gives good muscle coverage over the upper pole — for a smooth upper contour and less visible rippling — while allowing the breast to take its shape in the lower pole. The degree of release is tailored to each breast, which is why it is Dr Sparks’ standard approach for most augmentations.

An internal bra is internal support placed within the breast to reinforce the lower pole and the implant pocket. Over years, the weight of an implant tends to stretch the tissues and allow the breast to descend. The internal bra acts as a reinforcing hammock that helps hold the implant in its planned position and resist that downward stretch — so the result is planned to be durable, not only good at the outset.

An implant alone often struggles to create natural fullness in the medial pole — the inner breast and cleavage — and pushing an implant too far inward to chase cleavage produces an unnatural, over-close look with visible edges. Dr Sparks routinely grafts the patient’s own fat to the medial pole instead. This composite approach uses the implant for volume and the fat to shape the cleavage and soften the transition between implant and tissue, for a more natural inner contour.

No. Breast implants are medical devices, not lifetime devices. Over a lifetime, the great majority of patients with implants will require further surgery at some point — to address capsular contracture, implant rupture, change in the breast over time, or elective change. Augmentation should be undertaken with this long-term commitment clearly understood, and Dr Sparks discusses it fully before any decision is made.

BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) is a rare cancer of the immune system that has been associated with breast implants, particularly certain textured implants. It is rare and, when detected and treated appropriately, generally has a good outcome. It is one of the specific risks discussed fully and frankly as part of the consent process, so your decision about augmentation is genuinely informed.

Breast implant illness is the term patients use for a range of systemic symptoms they attribute to their implants. It is not a formally defined medical diagnosis, but the symptoms described are real, and Dr Sparks takes them seriously. They are part of the open discussion before augmentation, so that the decision is made with a full understanding of the recognised and the reported risks of implants.

Augmentation may affect the ability to breastfeed, though many patients are able to breastfeed after augmentation; this cannot be guaranteed. Implants can also affect how mammograms are performed and interpreted, so it is important to tell your screening provider that you have implants. Both are discussed at consultation.

A considered, proportionate approach is the central goal of Dr Sparks’ approach — and it depends on more than the implant. The dual-plane position gives good soft-tissue coverage, the internal bra supports the shape over time, medial-pole fat grafting shapes the cleavage, and the implant is matched to your anatomy, not to a predetermined number. Together these are planned to produce a breast that is fuller and well-proportioned.

It depends on whether the breast has descended. If the nipple sits low and the breast has dropped, an implant alone will simply enlarge a descended breast — a lift is needed to reposition it. If the breast position is good, an implant alone is appropriate. Dr Sparks assesses this honestly at consultation and will tell you directly if a lift is required for a good result.