When discussing breast augmentation with my patients, one of the considerations is “side boob.” It isn’t a medical term, but it is referring to the slight extension of the breast past the anterior axillary line – the vertical line drawn down from the armpit crease. It’s the extra show of breast curve you can see in bikinis, tank tops, and sleeveless dresses. It’s not for everyone – some patients who want a very natural look don’t want this, but many women like to have a slightly fuller shape.
Both pre-operative planning and intra-operative technique are critical to creating the perfect side boob. The implant must be chosen taking into consideration the patient’s native breast width, where the pec muscle inserts on the chest, and the thickness of the patient’s own breast tissue to create the proper width. During surgery, creation of the perfect precise pocket is critical.
When placing implants under the muscle, I make sure to detach the muscle exactly the same (many of the revisions I have performed have asymmetry because the muscle is different on each side) and that the pockets created are exactly the same. When expanding the pocket laterally, it is really important not to make it too wide and have the implant slip into the armpit or side of the chest (many of the revisions I have performed have been because the implants are too wide apart).
I not only check my patients’ implant placement by sitting them up on the OR table, but also with their arms in different positions, and also with them lying down and looking from the foot of the bed at the implant projection and position. The side boob should extend in a gentle curve from the armpit crease and not be overly wide.