Breast augmentation is one of the most commonly performed plastic surgery procedures. It involves the use of an implant or tissue to increase the size of the breast. Options include silicone breast implants, saline breast implants, or one’s own fat. Currently silicone implants are most commonly used, with saline implants now being used less often. Ultimately, however, it is the patient’s choice. After learning about the benefits of each, the patient will be able to make an educated, well informed decision.
Saline implants consist of a shell that is made out of silica. The shell comes empty and, once in place, is filled with saline (salt water) until the desire size is reached. Benefits of saline implants is that they can be placed through a very small incision since they are not brought up to size until after they are in place. Additionally many women feel very comfortable knowing that the implant is filled with saline.
Silicone implants contain a similar shell, but are pre-filled with a specific amount of silicone gel. Benefits of silicone implants include a more natural feel and a less likely chance of feeling implant rippling. With the latest generation of “highly cohesive” silicon implants, you can actually cut the implant in half and the silicon will not leak anywhere. At one time, it was thought that silicone breast implants lead to strange autoimmune symptoms in women, and for a time, silicone breast implants were forbidden from use in the United States. After multiple large studies looked at this problem, however, it was found that silicon breast implants did not cause any of these symptoms, and the restriction of silicone breast implants was lifted in 2006. Since that time, silicone implants have quickly become the most common implant choice for augmentation in the United States.
Choosing the perfect breast implant involves choosing between silicon and saline implants, deciding what size will be used, and selecting how the implant will be placed. Once a patient has chosen the type of implant, the decision on size is a balance between the patient’s desired size, and what size her body and tissues will safely and naturally accommodate. An implant that is too big can put stress on the patient’s tissues and lead to stretching and thinning of the tissues. This is more likely to occur in thinner patients with thinner tissues and in patients whose breasts have undergone changes associates with pregnancy. Measurements that will be performed during your consultation will help guide the selection of an appropriate implant size.
The implant can either be placed through an incision at the bottom of the breast where it is hidden in the natural fold in this location, through an incision that is placed at the junction between the darker areola and lighter breast skin that hides the incision in this natural appearing line, or in through an incision in the armpit. The first two options allow the greatest ability to control the position of the implant. The third option is excellent for some women, but not for those that will require adjustments in the position of the implant at the time of placement.
Breast implants are either placed above or below the chest muscle. Placement above the muscle is only appropriate for women who have enough natural breast tissue to hide all of the contours of the implant and to protect the implant. Placement below the muscle adds a natural layer of tissue between the implant and the skin, smoothening transition zones, cushioning the implant, and protecting the implant from infection and trauma.
Breast augmentation is typically performed in an outpatient setting. The procedure itself takes a few hours, is performed under full anesthesia but with a technique that decreases the chance of nausea following the procedure, and in a way that leads to more rapid recovery from anesthesia. Patients usually return to work after a few days and may resume full exercising and activity by two weeks.
Mammography of the breast is affected by the presence of a breast implant, and it is known that a portion of the breast is harder to visualize with a mammogram. For this reason, specialized mammographic images called Eklund views are performed. When thousands of women with and without implants were compared, there was no significant difference between the two groups regarding rates of breast cancer diagnosis, time at which the cancer was diagnosed, or risk of mortality from breast cancer.
Similarly, concern for breast feeding after breast implantation was studied and it was found that while breast milk in patients with breast implants may contain trace amount of silicone, it is significantly less than the levels of silicone found in infant formula and bottled milk. While breast augmentation may affect the ability to produce milk in some women, it appears that women who want to breast feed are able to do so; though small studies show that some may require supplementation, just like women without breast implants who attempt to breast feed.
THE NO IMPLANT BREAST AUGMENTATION
Doctor Cross is now offering a revolutionary way to provide breast enhancement. Using a patient’s own fat, their breasts can be enlarged by transferring this fat to the breast similar to how fillers like Juvederm or Restylane are used to provide volume to the face. Advanced liposuction techniques are used to take fat from areas of the body such as the love handles, hips, or belly. This fat is cleaned and purified and injected into the breast in many small doses, gradually adding volume to the breast using nothing more than a needle. No incisions are necessary, and no implants are used. It is an excellent way of giving the breast a volume increase that is similar to what is seen when one wears a padded bra, however, this improvement in appearance is achieved using tissue that becomes a permanent part of the woman’s breast and with the added benefit of liposculpting in the regions where the fat is harvested.