Shaking Things Up

Augmented breasts are looking — and feeling — more natural than ever. Plastic surgeon Jerry "Dr. Chiddy" Chidester weighs in on the boob job revolution.

Did you happen to catch my latest for Allure: The Makings of a Modern Boob Job? I gotta say: It was a little bit of a relief to not be writing about facelifts and fillers for a minute (just a minute, though, as my next six stories will all focus on face).

For those who haven’t read the breast augmentation piece, it explores a shift that’s occurring in some plastics practices, where surgeons are routinely placing implants above the chest muscle (in the “subfascial” plane) rather than below the muscle. Doctors who take the subfascial approach often support the implants using soft tissue scaffolds — materials, like Galaflex, commonly called “internal bras.” They insist that by preserving the pectoralis — rather than cutting it to slip implants behind the muscle — they can deliver a more comfortable and natural-looking outcome without compromising normal muscle function.

As with almost everything in aesthetics, there’s a fair amount of debate and disagreement surrounding ideal implant pocket placement, the drawbacks associated with each method of augmentation, and the true usefulness of add-ons, like the internal bra. So while some breast specialists, like Jerry Chidester, MD, a board-certified plastic surgeon in Salt Lake City, are predicting a subfascial takeover in the near future, other surgeons are staunchly defending more conventional submuscular techniques, believing they offer superior long-term results. (There are pros and cons to both, of course. The key is to find a reputable, ethical, board-certified plastic surgeon who is confident in their approach and considerate of your unique anatomy, goals, and lifestyle.)

📸 via Jerry Chidester, MD, Plastic Surgery

As loyal readers know, whenever I interview multiple doctors on a nuanced topic such as this, there are inevitably educational leftovers — savory facts and juicy anecdotes that don’t make it into the story, but I can’t bear to discard. Since my discussion with Dr. Chidester went especially deep — covering breast aesthetics, how his technique has evolved since residency, the ease with which his patients recover, the latest breast implant safety data — it felt almost gluttonous not to share said leftovers. Please enjoy the “uncut” version of our call, edited slightly for length and clarity.