Introduction Anyone knows the legend of the Holy Grail and the mythology around it. How legends say that this was the cup where the blood of Jesus was collected, and it was said to possess amazing healing powers. Unfortunately, this is just a legend, a story for children and for the dreamers. Like the Holy Grail is that cream, lotion, or massage technique that you saw online or on TV that is promised to make your boobs bigger. Some say it will take 3 to 7 days and some more “serious” ones say it will take about a month, but that either way the result is supposed to be amazing. You can imagine if something like this would exist then plastic surgeons all over the world will be without a job, and most women will be at least a C cup. Just like if the Holy Grail will exist, everyone will live forever. In reality, there are only two procedures known to work and effectively enhance your breasts. Both these procedures are medical interventions that require a trained and certified plastic surgeon to perform them. These are fat transfer and breast implants. Fat transfer for breast augmentation This is a relatively new procedure used to enhance your breasts. It was initially used only to remedy previous mistakes with implants in revision surgery or to correct breast asymmetry. As the name suggests, this procedure involves the transfer of fat from one part of your body to your breasts. Much of the volume seen in breasts is made of fat, therefore the idea of taking that fat from somewhere else. It is a two-step procedure: first, during liposuction fat is harvested from a problematic area of your body such as the tummy, hips, buttocks; then in a separate step this fat is injected into your breasts. The main benefit of this procedure is the fact that it sculps your body as a whole. You lose fat from a place you didn’t want, and you use it to enlarge your breasts. Furthermore, fat is a natural component of your own body, therefore the risk of complications such as rejection or developing other allergies is minimum. This is the most natural option to enhance your breasts if you want to do it but are afraid of implants and a much-complicated surgery. Fat grafting offers a rather permanent enhancement to your breasts that looks and feels natural. Even if your breasts will not be able to gain two or more cups in bra size but a smaller enlargement, they will look natural. Another benefit is the fact that this procedure is almost scar free: the cannula is inserted through a really small incision that heals quickly, and it is not seen. Breast augmentation with implants This is probably the most known and performed procedure that offers breast enhancement. It is surgery, but it supposes just one procedure. It is considered to be very simple and common by most surgeons that specialize in this kind of operation. This can be performed using a variety of techniques that I will discuss further. Essentially, the plastic surgeon will make an incision then create a pocket above or below your chest muscle, insert the implant in the pocket, put it in an exact position and then suture the wound and bandage it. Being a common procedure, it is usually done in an outpatient facility, and most patients are not supposed to stay there overnight. General anesthesia is required, so you will spend some hours in the facility to be monitored until its effect passes. Pain and swelling will be present, for some more and for others less. Recovery takes about a week, depending on your body’s response to surgery in general. You will be able to return to work, but you will not be allowed to do any strenuous activity for up to four weeks. Considering a surgery might be difficult, but the main advantage of this breast enhancement procedure is the fact that it has been done for a very long time. Implants, saline or silicone, are now considered safe, and as technology and medicine progress, new implants are being developed and researched. Apart from long use with an exact knowledge of advantages and possible risks or complications, implants also offer a reliable method of breast enlargement. Implants are medical devices that are transformed or absorbed by your body, as in the case of fat cells. They have a size and a shape, and they keep it. Implants offer the possibility of choosing a larger size for your new breasts. Fat grafting can only enlarge your breasts by one cup at the most. Implants can do more in terms of size, and they have various shapes and textures. While implants are not made to last a lifetime, they still don’t have an expiration date, so they can last as long as 20 years. Fat cells will absorb in time, so you might need another injection. There are various techniques that plastic surgeons use to perform this specific operation. These techniques refer to two main aspects of the procedure: incision and implant placement. Both these two facets are important for the desired and planned outcome of the augmentation. There are 4 parts of your body where a surgeon can choose to make the incision in accordance with the aspects of the surgery he performs: Inframammary This supposes a small incision in the breast crease between the breast itself and your chest. Being done in a space that is all the time hidden to the eyes, this kind of incision allows a wider space to cut, thus leaving the choice of a bigger implant. It is probably the most used technique, preferred by both patients and doctors. This incision permits the surgeon the best view and access to the breast pocket so they can position the implant correctly. This also has the advantage that if you plan on breastfeeding in the future, there are no risks associated with it because no nipple nerves or milk ducts will be sectioned. Trans-axillary A trans-axillary incision is made in the armpit. Due to its placement and difficult access to the surgical site, doctors will use a special camera to be able to position the implant. Furthermore, this kind of incision is usually used for saline implants since they usually come deflated and need less space. The main advantage of this incision is the fact that the breasts will not carry any scars. The armpit is also not an exposed part of your body, usually hidden from prying eyes, so you will be able to wear any top or swimsuit you want. This technique will also not interfere with any future plans of breastfeeding. Periareolar This incision is made on the outer side of the areola, where the pigmentation naturally changes color. This gives the advantage of little to no visibility of the scar. It is suited for a smaller implant or a saline one. Transumbilical This kind of incision is made around the belly button. Through it, the implants are inserted and moved up to the pocket. It is a rather difficult technique since it involves a lot of work from the surgeon with the help of special equipment. The main advantage is the fact that the breasts will be intact with no scars on them. There will only be one incision, and also not in an easily exposed area. Regarding the placement of the implant, there are two main positions of it, and another one that combines the two. Subglandular In this case, the implant is placed immediately under the glandular tissue and above the chest muscle. This method is usually preferred by women who have enough natural glandular tissue to cover the implant. The main benefit of this technique is the fact that recovery is quick and the pain you will feel is less. No muscle will be pulled or displaced in any way, so there will be less to recover from. It poses a great advantage for women who exercise regularly because the moves made by the muscle behind the implant might deform or distort it. Submuscular The submuscular placement means that the implant is placed under the glandular tissue and the muscle altogether. The surgery will be more difficult since the muscle will need to be pulled up, but it has multiple advantages. The muscle will be an extra layer of protection for your implant and will also take some of the strain that will be put on your tissue. It offers a better image in case you need a mammogram. If you need a lift, this is the method that will be used to place the implant. Dual plane placement This technique uses elements from both the subglandular and submuscular placement. It places the implant behind the muscle in the upper part or sometimes even the middle part of the breast, but the lower part will only be covered by glandular tissue. This is the best technique used in the case of ptosis (saggy or droopy breasts), but also for those who want a natural lower volume of the breast. Conclusion No matter what kind of augmentation or technique you will have, you must be sure that this the perfect choice for you. Study all available and competent materials you can find before going into your doctor’s office. This way you will be able to ask informed questions and evaluate if this is the surgeon you want or not. Be rational and flexible in your decisions and accept the fact that an experienced plastic surgeon can determine what method or technique is best for you according to the envisioned results you have for your body.