Podcasts

Q1: So, the obvious first question: what exactly is the “ballerina breast augmentation?”

A1: Wow, right to the point I see.  No build up or excitement or teaser?  Ok, ballerina breast augmentation refers to small volume breast augmentation simply stated.

Q2: I thought you might say that. Does it go by any other terminology or name?

A2: Yes, it also can be called “yoga breast augmentation” or “fit look breast augmentation”

Q3: What is the objective or goal in Ballerina breast augmentation?

A3: Well, the goal is to enhance the breast in a way that compliments a slender, athletic physique, mirroring the aesthetic of ballet dancers. It focuses on creating a more natural, subtle, and proportional enhancement of the breast.

Q4: Can you tell us how you achieve this objective? Are there different techniques, different implants?

A4: These outcomes are facilitated by the use of smaller, lower profile implants. This allows me to improve breast fullness and enhance shape without creating a dramatic change while at the same time refining elegant appearance.

Q5: How long have these terms like ballerina breast augmentation or yoga breast augmentation been around?

A5: That is a difficult one to answer.  They are definitely recent terms born out of social media and terms coined within the last 4 years or so.  The concept of small breast augmentation, however, has been around for decades.  The concept of smaller, more natural-looking breast augmentation has gained traction in recent years. This trend reflects a shift towards a more athletic toned physique for women. 

Q6: So, is the concept of larger breast augmentation a thing of the past?

A6: Definitely not.  There are still very many women who want larger, fuller, and fake or “fakeish” looking breasts.  IT is just that this concept of ballerina breast augmentation has gained the most traction recently.

Q7: This is done with breast implants, correct?  Are there alternatives to achieving these small, subtle, proportional elegant outcomes?

A7: Excellent question. Yes, this surgery is done with breast implants, however fat grafting or fat transfer can in theory be an alternative to breast implants to achieve subtle enhancements but there are three main issues with this. Firstly, you need a certain amount of fat to be collected in order to fat graft.  In fact, you need a fairly significant amount to be collected so that after processing the fat there is a reasonable amount available to transfer into the breasts.  You need much more fat liposuctioned out than you think you need to ultimately increase breast volume by a cup size or two.

Q8:  Sorry but if I may interrupt there – why do you need so much fat if you said the objective is subtle enhancements?

A8: So, if you think you want to enhance the breast by 150-200 cc’s each, that means permanent volume increase. Not all the fat stays or takes.  It is impossible.  And anyone who says all the fat stays either has very little experience or is not truthful. Fat take is related to location of implantation and the female breast is not as reliable a recipient site as say the buttock is.  Fat likes fat; meaning it likes to be placed where other fat is.  It doesn’t like being placed in or around gland tissue.  And it performs better being placed into already larger breasts.  But that is not what ballerina or yoga breast augmentations patients have. They are leaner and more fit to begin with.  They have small breasts to start with and far less fat to use as donor fat. 

Back to the story: so, you need 150-200 cc per breast that means you need 300-400 cc to remain in total.  If you expect 50% to dissolve, then you actually need 600-800 of healthy reliable post processed fat to be placed.  I happen to be very particular with the processing and injecting and I see a high percentage take. To get 800 cc of fat post processing you need about 1000-1600 of liposuction aspirated.  That could be multiple donor areas if even achievable from a fit lean body. So problem one is donor availability of fat and problem two is the lack of predictable take in the female breast as compared with other areas like buttock.

Q9: You mentioned four issues?

A9: Yes, so once fat is placed in the female breast some will naturally dissolve away but some may micro calcify or form micro or macro cysts.  Not a big deal in buttocks but a big deal in breasts that get imaged with mammogram and ultrasound. It could lead to unnecessary drama for those patients.  That’s problem number three.  Problem number four is the stem cells that go along for the ride in the transfer process. Stem cells with fat transfer is the holy grail in remodeling of tissues when fat transfer is used in face and hands and buttocks and is a good thing.  In breasts, however, stem cells are very controversial.  It is unknown if they can transform or entice pre-cancer cells to become cancer cells.  Hence, fat transfer into existing native tissues (not mastectomy tissues where there is no longer a breast) have many variables detracting from ideal predictable outcomes.  Breast implants are just more predictable and quite frankly simpler and more safe.

Q10: Ok, back to implants.  What type of implants are used in the ballerina breast augmentation.

A10: Most implants used today by far are silicone gel filled implants but saline implant can also be used.  The knock on saline implants are the potential for rippling and greater gravity traction malposition issues such as downward drift or lateralization.

Q11: Gravity related issues? Please explain.

A11: Well many of those who are listening to this podcast have heard me say in my other podcasts that gravity is king.  It is undefeated.  Has never lost a match.  Water (saline) happens to be more affected by gravity than silicone gel due to its physical properties.  It will tend to drop and or lateralize over time more so than gel filled implants.  The larger and more round any implant is, the greater the likelihood is to lateralize or drop.  Shear physics.  Adding to this are the biomechanical forces at play when implants are placed under the muscle.  But again in Ballerina Breast Augmentation, we are using small implants so gravity related complications are far less of a concerns. 

Q12: Wow, fascinating insight you bring to this topic.  Your understanding of this is really amazing.  How long have you been doing breast augmentation?

A12: 29 years in private practice and 8 years of training before that.  Here’s the thing; I’ve done thousands of breast surgeries. I spent the first nine years of practice doing exclusively saline implants for augmentation because of the 90s moratorium on previous generation gel implants.  So, I got very good at fighting gravity.  Very creative. I have the perspective that many don’t have.  I’ve seen us go from generation 4 to generation 6 implants and the irrational exuberance of textured implants.  Small volume saline flatter profile implants are actually ok. Smaller volume silicone gel implants too.  They both behave more predictably and are well suited for the ballerina breast.  Fit Breast Augmentation, Ballerina, and Yoga Breast Augmentation have an athletic connotation which means these concepts go hand in hand with pre-pectoral over the muscle implant placement.  Combined with an internal bra strap, like support of slowly absorbable mesh, the small implant augmentation has really taken hold.

Q13: Dr. Spiro you are an artist, very accomplished, I might add if patients don’t know that about you.  You’ve had exhibits, painted murals for Art Basel Miami Art Week so that’s really unique. How does that set you up for success?  You seem to think and see things differently than other surgeons.

A13:  Well, I appreciate the acknowledgement.  Art is a passion of mine. Ingrained in everything I do: painting, furniture design, interior design, architecture.  So that is why I am so passionate about this subject. A perfect marriage of art and beauty.  I love shape and proportion.  I’ve heard that said about me by my colleagues before.  I appreciate it.

Q14:  That is why you are known as “surgeon by trade, artist at heart” on all your tag lines.  Perfectly fitting I can see.  Can you take us through the surgery process?

A14: Certainly.  During consultation I perform a detailed exam and form a plan instantly.  But I respect patients, and I want their insight. I gain insight by listening. I pride myself on being a good listener.  And I love collaboration. I let patients tell me what and why they want from an outcome.  I gently guide them along the decision-making path. I have patients show me “like images” of what they want as outcomes.  It is a 2 step and 2 visit process.  Other than artistry, I like to pride myself on precision and caring.  Surgery is done under general anesthesia at the hospital across the street from our office.  A simple outpatient procedure with weekly follow ups for the first four weeks so I can be assured everything is healing according to my standards which are exacting and super high.  By four weeks full exercise can be resumed.

Q15:  I can hear your passion and quiet intensity and precision in your voice as you describe this process.  What more can you tell us that we may not already know about.

A15: I am so happy you asked this. Many listeners have heard my last podcast where I talk about the paradigm shift in breast augmentation which is related to a return back to implant placement over the muscle.  Now refined as subfascial or prepectoral breast augmentation. This is key and ties everything here together.  In fitness and yoga, physique building are a primary concern.  The shift away from submuscular implant placement allows and facilities this.  Hence it is joined perfectly well and compliments the notion of yoga breast augmentation where chest and pectoralis function and preservation is so important.

Q16: Dr. Spiro, this has been such an amazing learning experience for me and I am certain for our listeners. How can they learn more about you.

A16: I encourage people to listen to my other podcasts, explore the website, read our google reviews and come in for a consultation.  They can find us on Instagram, YouTube, Facebook @spiroplasticsurgery and our website drspiro.com.