Breast Implant - Breast Augmentation

Breast Reduction – (Click Here)

A woman’s breasts are a very personal and defining feature of her body, and of her self-image.  For some women the desire to improve breast appearance includes the consideration of breast implants.  Breast augmentation is not only a medical decision, it is a personal one. 

The perception we have of ourselves defines who we are and how we introduce ourselves to the world.  There are many options available today for the woman who decides that breast augmentation is right for her.  The more you know about the procedure and the options involved, the better equipped you will be to make the decision that is best for you.

A breast implant is a medical device placed in a woman’s body to enhance her breast size, to improve breast shape, or to enhance the firmness of natural breast tissue.  Breast implants can be used to improve symmetry (similar size and shape) between a woman’s breasts, or to correct minor or dramatic irregularities in breast development.  In addition, breast implants may be considered to reconstruct a breast that has been disfigured or removed to treat breast cancer.

A woman has a choice between saline and silicone breast implants to fulfill her personal goals for her appearance.  All breast implants have an outer pliable envelope enclosing either a liquid (saline) or soft-solid (gel) substance (silicone). Choosing an implant begins with an understanding of all of the options available to you. Saline implants are filled with sterile salt water.  Saline is much like the fluid that makes up 70% of the human body. For some women, they may feel somewhat firmer than natural breast tissue.

Should the implant shell leak (a very uncommon issue), a saline implant will deflate and the saline will be absorbed and naturally expelled by the body.  Silicone implants are filled with an elastic gel.  The gel has a softness that feels and moves more like natural breast tissue.  Should the implant shell leak, elastic silicone gel may remain within the implant shell, or may escape into the breast implant pocket.  A leaking implant filled with silicone gel may not deflate. 

For this reason, you are advised to visit your plastic surgeon annually to access that the implants are functioning well.  An ultrasound or MRI screening can access the condition of breast implants; after 3 years, it is recommended that all silicone and saline implants be properly screened. Some doctors don't feel this is necessary if you get a mammogram done every year.

  • Texture:  the implant shell may be smooth or textured
  • Shape:  the implant may have a round profile or one that is anatomic (teardrop  or tapered shape)
  • Profile:  the implant may have a low, medium  or high projection (the depth of the implant  from the base to the highest point of  the  implant curve)
  • Diameter:  the width of the implant measured across its base (the side of the implant that  will be positioned over the chest wall)

The uses for FDA approved saline and silicone breast implants include:

  • To enlarge a naturally small breast
  • To restore breast volume lost due to weight loss or following pregnancy
  • To achieve better symmetry when breasts are moderately disproportionate in size and shape
  • To improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure
  • To provide the foundation of a breast contour when a breast has been removed or disfigured by surgery to treat breast cancer
  • To improve breast appearance or create the appearance of a breast that is missing or disfigured due to trauma, heredity, or congenital abnormalities.

Saline implants are FDA approved for augmentation in women 18 years or older.  Silicone implants are FDA approved for augmentation in women age 22 and older.  However, saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

Who Chooses Breast Implants?
Good candidates are defined as:

  • Healthy individuals  who do not have a life-threatening  illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and realistic goals in mind for improving their body image

Breast implants do not generally interfere with a woman’s ability to breast feed, or present a health hazard during pregnancy to a woman or her baby.   However, pregnancy and the associated changes to a woman’s body may alter the results of any breast surgery, including surgery to place breast implants.  Therefore, it is important to discuss the options of breast augmentation with your plastic surgeon if you are planning to become pregnant and breast-feed.

Where Do I Start?
A consultation with a board certified plastic surgeon is the first step to learn about your choices to improve your body image with breast implants.  A consultation is designed to fully educate you about breast implants in a non-pressured environment and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The breast implant options available to you
  • The likely outcomes of breast implant surgery and any risks and potential complications
  • The course of treatment recommended by your plastic surgeon

The Breast Implant Evaluation
The success of your procedure, safety and overall satisfaction requires that you:

  • Honestly share your expectations
  • Fully disclose your health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs
  • Be candid about any history of breast cancer in your family and your personal breast health
  • Commit to precisely following all of your plastic surgeons instructions

Breast augmentation does not correct sagging breasts.  In cases where a woman desires to enhance breast fullness and at the same time improve the position and shape of sagging breasts, a breast lift may be performed in conjunction with breast augmentation.  A breast lift, technically called mastopexy, is surgery to uplift and improve the shape of your breasts.

The Surgical Incision and Placement Choices

Usually breasts implants are surgically inserted utilizing one of three traditional incisions:  the inframammary incision (made in the skin fold below the breast) the periareola incision (made along the edge of the colored area around the nipple), or the transaxillary incision (made in the armpit). All of these incisions can allow the implant to be placed either sub muscular (below the chest muscle) or sub glandular (between the chest muscle and your breast tissue).

The Breast Implant Surgical Procedure

There are many important factors that may have an effect on your particular procedure, your recovery, and your results.  They should be well understood and carefully discussed with your doctor.   Some of these factors are:

  • Your overall health
  • Your chest  structure and overall body shape
  • Your healing capabilities (which can be affected by smoking, alcohol and various medications)
  • Prior breast surgeries
  • Bleeding tendencies
  • Infections
  • Shifting of implant
  • Scarring from  the incision
  • Predisposition to develop a hardened capsule around the implant

The implantation procedure can be performed as either an inpatient (requiring an overnight stay in the hospital), or outpatient (no overnight stay required), depending on your doctor and the method of surgery you have chosen.  Although every woman’s recovery period is different, you will experience the most discomfort during the first 24 hours.  Your breasts will be swollen and very tender.  You should be able to resume many of your regular activities in about a week.

Breast Reduction

Women with large breasts experience more than dissatisfaction with their body image - they may experience physical pain and discomfort.  Overly large breasts and the weight of excess breast tissue can cause pain and physical conditions that impair a woman’s ability to lead an active life.  The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.

If you have large breasts that limit your physical activity and cause pain, breast reduction may be right for you.  Breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with a woman’s body and to alleviate the discomfort associated with overly large breasts.  In general, breast reduction surgery will not only correct the functional symptoms associated with large breasts, but will also result in better-proportioned breasts, enhancing a woman’s body image and self-confidence.

What is Breast Reduction?
Breast reduction is a surgical procedure to reduce the size of large pendulous breasts that are disproportionate to a woman’s body and can cause physical pain.  Breast reduction improves breast size, shape and the associated conditions of large breasts that include:

  • Back, neck and shoulder pain caused by the weight of excess breast tissue
  • Shoulder discomfort  and indentation from bra straps that support  heavy, pendulous breasts
  • Restricted physical activity due to breast size and the associated discomfort
  • Skin irritation beneath the breast crease
  • Sagging, stretched skin and a low breast profile where, when unsupported, the nipple rests below the  breast crease
  • An enlarged areola (the dark skin surrounding the nipple) caused by stretched skin.

Breast reduction can be performed unilaterally (on one breast) or bilaterally (on both breasts).  It is generally considered a reconstructive procedure and may be covered by your health insurance when it is performed to relieve medical conditions.  Many insurers define breast reduction surgery as reconstructive based on the amount of tissue that will be removed.  However, pre-certification is often required for reimbursement or coverage. 

Good candidates are defined as:

  • Healthy individuals  who do not have a life-threatening  illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for improving their physical symptoms, breast size and shape

Where do I start?
A consultation with a board certified plastic surgeon is the first step to learn how a breast reduction can improve your overall  look and how it might relieve pain, discomfort and any associated symptoms you may have resulting from large, pendulous breasts.  A consultation is designed to fully educate you about breast implants in a non-pressured environment and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The breast reduction options available to you
  • The likely outcomes of breast reduction surgery and any risks and potential complications
  • The course of treatment recommended by your plastic surgeon
  • Be candid about any history of breast cancer in your family and your personal breast health
  • Commit to precisely following all of your plastic surgeons instructions

The Evaluation

  • Honestly share your expectations
  • Fully disclose your health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs