Breast Surgery - Silicone & Saline Breast Implants
Surgery of the breast is performed to enhance the size or shape of a women's breast for cosmetic, medical or reconstructive reasons.
Breast Augmentation (Augmentation Mammaplasty)
Breast augmentation, or surgery to enhance the size and shape of a woman's breasts, is one of today's most in-demand cosmetic surgery procedures. And if you think it's only for movie stars, models, and the rich and famous, think again.
Actually, a wide variety of women, from virtually all walks of life, want augmentation mammaplasty, medical term for breast augmentation. These women include moms, business women, divorcees, students, college professors, and even grandmothers. Each woman has a slightly different reason for wanting the surgery. It all boils down in most cases, however, to wanting the enhance one's appearance. For indeed, breast augmentation can add something that nature did not provide in the first place or help restore what time and gravity have taken away.
Is it vain to have this kind of surgery? Is it wrong? Only if you think it's wrong to want to try to look your best...only if you approach the surgery with unrealistic expectations. And it's wise to remember that breast augmentation is a surgery. Like all surgeries, it has certain risks. Read on, and I'll tell you what you need to know to make an informed choice about breast augmentation for yourself.
What breast augmentation can-and cannot-do for you. Because a woman's breasts-natural or surgically modified-are an integral part of her physical and emotional identity, it's important to point out what breast augmentation can and cannot do. Some women approach this surgery unrealistically, thinking that a bigger, more shapely bustline will change their lives in extraordinary ways. Breast augmentation won't automatically make you the "perfect 10" you've always wanted to be, nor will it necessarily cause other people to treat you differently. The procedure can, however, give you greater self confidence, which in turn may change the way that people respond to you. And many of my breast augmentation patients tell me how much they enjoy shopping for clothes once they've had the surgery. Styles and fashions change, of course, but for some women, more shapely is indeed better.. and more fun.
The statistics bear it out Breast augmentation has one of the highest patient satisfaction rates in plastic surgery, and it's currently one of the most sought-after cosmetic surgery procedures in this country. There was a definite slow down in 1991, due to the unfortunate publicity regarding silicone breast implants and Dow Corning Chemical Company, but now, more and more women are having this operation once again.
According to The American Society of Plastic Surgeons, 122,285 breast augmentation procedures were performed in 1997, the latest year for which such statistics are available. Between 1992 and 1997, there was a +275% change in the number of breast augmentation procedures performed, and during the last five years the number of breast augmentations has more than tripled. In 1997, breast augmentation was second only to liposuction as the most popular cosmetic surgery procedure.
Why have breast augmentation surgery? Breast augmentation surgery is a highly personal decision, but there are certain unifying themes among the women seeking it. Some women feel their breast size is too small. Breast augmentation can increase one's bustline by one or more bra cup sizes. For some women, this can enhance both appearance and self-confidence.
Other women have breast augmentation in an attempt to bring back what they once had-before pregnancy and breast feeding, normal aging and gravity caused their breasts to move southward and lose their firmness. Some of these women want the more full and youthful-looking cleavage that they had in their early twenties. These women usually have breast lifts along with breast augmentation...the two procedures together produce a better aesthetic result.
Then, there are women who have certain breast deformities irregularities-such as one breast that is larger than the other, or a breast that is abnormally shaped. Finally, there are women who have had breast cancer surgery who want to recreate the body form they had before surgery.
Breast augmentation has something to offer all of these women. In fact, thanks to advanced plastic surgery techniques, almost any defect, abnormality, or size deficit can be corrected.
Implants: which are safe, which are approved? Currently, both Silicone Gel and Saline (salt-water) implants are FDA approved for use in Cosmetic and Reconstructive surgery. As of January 2007, the FDA approved Silicone Gel for women 22 years of age and older. The new generation of Silicone Gel implants have research showing that 92% of implants were still intact after 11 years, and can withstand force 25 times that of a mammogram. The implants also contain a cohesive gel that will not travel from the breast in the event of a rupture. Saline implants are approved for women 18 years of age and older, and 97.5% stay intact for 10 years. It is important to talk to your surgeon about which type of implant is right for you and to understand the safety measures and risks involved with either type of implant.
How do saline implants perform? In most cosmetic patients, Saline implants can look and feel very nice. In a thin woman, the side wall of the implant may be felt, and you may also see some wrinkling or rippling from the implant. This is typically not the case with Silicone Gel implants. With them, the edges are smoother and there is no visible wrinkling. Patients also appreciate a more natural "feel" with silicone gel implants. Again, speak with your surgeon about which type of implant is the most appropriate for your body.
My approach to breast augmentation I try to create a natural look in my patients. Saline implants, if they are too large for a woman's chest, will not conform to one's natural body shape like a gel implant does. Instead, they will give a very unnatural look to the body, which defeats the purpose of wanting to improve your appearance in the first place. This is why I recommend to my patients that they keep the size of the implants proportional to their natural chest and body size. Too large and you'll be bigger, but you won't necessarily look real.
Before and during surgery All of my cosmetic breast augmentation patients must have a mammogram before the surgery to be sure that their breasts are healthy. It is important to have a baseline mammogram because any breast implant can make early detection of breast cancer slightly more difficult.
I prefer placing the implants under the muscle. One can place them on top of the muscle, too, but if they're saline, the patient will notice more wrinkling and rippling. By putting the implants under the muscle, there is also less incidence of tissue hardening, and you can get a much better mammogram than when they're on top of the muscle. Furthermore, the breast implant manufacturer recommends that the implants go under the muscle as well because the implants are held up straighter this way and less likely to rupture.
I usually place the implant under the muscle through an incision along the infra-mammary line (the bra line). Other surgeons like to insert the implant through the armpit or through the areola (nipple) complex. I feel strongly that the infra-mammary incision allows me to place the implant in a more natural position, more gently, and with less bleeding. My incision is only about 3 cm (1.18 inches), and once you have the implant in, it is difficult to see the scar in most cases. At the end of surgery, I tape the breasts with a heavy tape to protect the incision site.
The surgery can be done in either a hospital or an ambulatory center. I like to perform breast augmentation performed with the patient under general anesthesia. The surgery takes approximately 2 and a half hours
Time to recover, time back to work. Patients recover after about an hour in the recovery room, and then someone can take them home. All my patients are given pain medication, something for nausea, and antibiotics.
The implants tend to ride a little high when they first go in, and then they come down over a period of months. Patients are instructed to start pushing and massaging to make sure the breasts are kept soft and that no scar tissue forms around the implants. We ask patients to wear a bra day and night for five weeks to set in the infra-mammary fold. If they don't, the implant can break through this line, and the result could be asymmetric. We advise patients not to lift or push anything over 15 pounds for five weeks. That means not returning to aerobics lifting or sports activities. They can usually return to work in 4 or 5 days. But they can't drive until they're no longer taking prescription pain medication, and most patients will continue taking the medication for about a week after the surgery.
Post-operative follow up We see the patient on the third day after surgery, to remove the heavy tape, to prevent skin blistering. The patient will then come back to see me again 4 days after that, and I show her how to massage her breasts. She'll get stitches out at two weeks. And then, I will typically see her weekly for about five weeks to make sure she's pushing on her breasts so they don't harden up. Then, at six months, I see the patient again...and again, at one year. I recommend a mammogram one year after the surgery, no matter what the age of the patient. With breast implants, she will need special-view mammograms for the rest of her life.
Who shouldn't have breast augmentation? Some women are not good candidates for breast implant surgery. Some mastectomy patients who have received radiation therapy will have very thin tissue that doesn't allow for breast reconstruction with implants. Women who have failed previously with implant reconstruction are usually not good candidates for the procedure. These women need breast reconstruction using tissue from other sites on their own bodies (tissue transfers), which is a different and more complicated surgery. See information on Breast reconstruction.
Risks and complications
As with any surgery, there are certain risks that go along with breast augmentation. You can lose sensation in your breasts or the ability to breastfeed, but such problems occur in only a very, very small percentage of patients. I've never had anyone say she couldn't breastfeed, and I've performed breast augmentation surgery on over 1,300 patients. Sometimes breast hardening can occur, but the incidence is less than 5% in cosmetic breast augmentation patients. Post op massage can help this from incurring. Bleeding can occur, but I've never had to take anyone back into the OR because of a post-surgical bleeding problem. Infection can occur as well, but the incidence reported in the literature is 1.5%, and it happens very infrequently in my experience.
Costs
Breast Augmentation costs vary. For the best results, I recommend that you select a surgeon who is board certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons. Please call our patient coordinator for more information about breast augmentation.
To learn more about saline breast implants and other augmentation options, contact a patient coordinator at 303-320-8618, or click here to schedule a consultation.
