More about breast augmentation

Although deciding which implant material you want for your breast augmentation is a big step, there are other important decisions to me made- like implant shape, incision type, and implant location.

To start with, there are different shapes of implants. Most people only think of the round ones but in fact there are more options available to you. Teardrop shaped implants are becoming quite popular, they have a sloping portion that is at the top which many feel makes the implant look more natural once inserted. These implants require a textured surface because if they rotate, the breast will look deformed (a problem that won’t occur with a round shaped implant since it is perfectly symmetrical).

Another aspect of implant shape is the profile you want. Most of the time, doctors assume that you want a medium profile- those are what the majority of people get. However, depending on the look you are trying to achieve a higher or lower profile might be appropriate. Basically this aspect is when you set and implant down on the table, how tall is it.

This is an example of a patient who has gotten high profile implants. Keep in mind, these look relatively new and therefore they have not fully settled yet, but they ARE high profile and are probably not going to drop down very much—they will continue to have that very full appearance at the top of the breast. On a related note, you should always remember that what you look like immediately post surgery is not what you will look like permanently. Breast implants often take a couple months to fully “settle”. The body is recovering from a trauma (the surgery) and is adjusting to a foreign body (the implants) so there will be swelling and adjustments that the body makes before everything reaches its final positioning.

Below, is a patient who got low profile implants. You can clearly see the difference between these two types. If you are on the smaller side to begin with and are aiming for a very natural look with a modest size increase, low profile implants might be right for you!

The next important thing to consider is the incision type. As I mentioned before, silicone implants are at a disadvantage to saline implants in that they require larger incision types. The implant comes pre-filled and so you require a large incision to provide the surgeon access to place the implant. I know that reducing scarring is one of the TOP priorities for you and your doctor, so it is important to weigh incision types before you decide implant material.

Periareolar incisions are right around the nipple. This incision can be used for silicone implants, but they would need to be small since that would be very difficult—however it is not unheard of, just uncommon. These scars will be less noticeable than other methods and often blend in with the areola. One major advantage of this type of incision is that it permits the doctor great accuracy in placing the implants. The image below gives you an idea of where this incision is located; the scarring will be quite light, and really only noticeable upon close inspection… if somebody’s that close to your boobs, I’m pretty sure they aren’t going to complain about a faint line.

Inframammary incisions are located in an area called the inframammary fold. This is pretty much the crease where the bottom of your breast meets your rib cage. This type of incision can leave pretty noticeable scars, but is the ideal type for silicone implants. Again, if you think you wan silicone implants, you need to decide if they are worth the additional scarring.

A transaxillary incision will be located in the armpit and placed through a tunnel that is made to the breast. This is a nice option for those who do not want any visible scars on their breasts, but will leave scarring in the armpit (it’s quite small though) and can NOT be done with a silicone implant. One disadvantage however, is that this incision type more often has issues with symmetry of implants.

Now I’m sure that most of you have come hear about “no scarring” breast augmentation. That is achieved using a transumbilical (often called TUBA) incision. Saying that this has NO scarring is a bit misleading, really it is simply placing the incision inside of an existing scar—your belly button. The doctor makes a small incision in the belly button, makes two tunnels up to the breasts and places the implants. There are no visible scars on the breasts, and usually the scar inside the belly button is completely invisible. This incision is ONLY for saline implants and you must find a specific doctor who has been trained in this, since it is a relatively new procedure and not all surgeons perform this type.

Finally, implant location is one more choice you can make. An implant may be complete submuscular, partial submuscular, or subglandular.

Complete submuscular is where the implant is located completely below the pectoralis. This is often the best option for those undergoing reconstructive surgery after a mastectomy since the muscle will add tissue between the implant and the skin and allow for a more natural appearance.

Partial submuscular is when the implant is placed mostly under the pectoralis with the bottom portion only covered by breast tissue, not muscle.

Subglandular is when the implant is located on top of the muscle and underneath of the breast tissues. Many feel that this is the ideal location for realistic results, however this placement type is thought to lead to a higher rate of capsular contracture than the other locations.

On the left is subglandular and on the right is complete submuscular.

This should cover most of the basics about breast augmentation. I’m going to start discussing other types of cosmetic surgeries and will come back later to address the potential complications that may arise from breast augmentation. In the meantime, let me know if there’s a particular surgery you would like to read about!

Image sources:

 http://hubpages.com/hub/Teardrop-Breast-Implants

http://www.locateadoc.com/pictures/breast-augmentation-breast-implants-15004after1.jpg

http://www.markhenley.co.uk/images/procedures/breast-augmentation/breastenlargement-augmentation-post6w-scar-patient1.jpg

http://www.breastsurgeryhawaii.com/_images/incision_options3.gif

Breast Augmentation

“Boob jobs”, the bread and butter of a plastic surgeon; this is easily one of the most common procedures and it is definitely one of the first things people think of when you say “plastic surgery”. Since this is such a popular procedure, countless variations exist from what type of implant material you choose to the implant location to the incision types. For this reason, I will be posting a few articles on the topic so I am able to go in-depth enough on these topics to give you all of the information you really need. Keep in mind, I am not a plastic surgeon, just an enthusiast; I know my stuff, but since I don’t know you and each patient is different, make sure you discuss your options with your doctor.

Ok, to start with you are able to get saline or silicone breast implants.

Although silicone implants have a bad reputation, that applies to PAST implants. The FDA took older models off the market but newer, better versions are currently available and are completely safe for use. Back in the day, silicone implants were what everybody used. Then they had lots of problems with capsular contracture and leakage of the implants. Once the silicone got in to your body, it caused a heck of a problem. Doctors would have to go in and remove a big, sticky mess. For this reason, older models are no longer available.

This is what a ruptured implant looks like. The tissue material on the side (the red stuff) is a capsule that had formed in the patient, likely in response to the leakage.

However, in the late ‘90’s though, the FDA looked in to silicone implants and decided that there was no significant difference in side-effects for patients with silicone implants. Prior to this, silicone implants were only permitted for patients having reconstructive breast surgeries done (like after a mastectomy).

Now that you have a bit of background and understand that both types of implant are safe, let me explain the benefits of each type to you.

Silicone:

These are often called “gummy bear” implants. They are made up of a silicone gel inside of a silicone shell. These newest models are much better than their predecessors. They have lower rates of capsular contracture (a side effect that I will go in to in a later post) and do not rupture as much as the older versions did.

These implants are available in various shapes, sizes, and profiles. However, their sizes are NOT adjustable. The implant comes to the surgeon pre-filled in certain increments and that is it. If you had been hoping to get a 643cc implant, you are going to have to settle for a 650cc or a 600cc.

Silicone implants are generally considered to be more “realistic” feeling than saline and have a similar texture to that of your natural breast tissue. A drawback for these is that they are more likely to rupture than saline implants. Also, if they do rupture, it is harder to detect since they retain their shape; if a ruptured implant goes unnoticed, the silicone could leak to surrounding areas and cause health problems.

Saline:

These implants are made of a silicone shell that is filled with a saline solution. They can be inserted into your body and then filled with saline; the doctor then closes the valve and stitches up incision. This means that these implants are available in virtually any size you want. A 600cc shell can be filled with 575cc or it can be over-filled with 625cc, for example. These will result in different appearances of the implant.

The drawback for these implants is that they have a higher rate of cosmetic side effects than silicone implants. There may be rippling or capsular contracture. One major benefit though, is if these rupture you will notice immediately. Saline solution is matched to your body’s saline levels and is similar to what you will find in an IV bag; because of this, if the implant leaks you will not have any problems from the saline entering your body. Your tissues will absorb the liquid and you only need to worry about getting in to have it fixed- unlike silicone ruptures which can lead to severe health problems.

Another benefit is that since these implants can be filled after they are placed in your body, the incision can be MUCH smaller than with silicone, and a smaller incision means a smaller and less noticeable scar. The “scar-less” techniques that you have heard about (and that I’ll talk about later) utilize saline implants.

Overall, you need to weigh what is important to you. You body type, desired results, and even your lifestyle can all affect which type of implant you want. Incision type is another important factor in picking the implant type, and I’ll discuss those later. Implant material is just one of a variety of choices that you can make to reach your ideal appearance and feel great about yourself.