Breast Augmentation

There is a lot of information out there regarding breast augmentation so instead of explaining my philosophy on this I want to define some terms so that hopefully you can have a better consultation.

Implant Position

Submuscular: Implants are under the muscle and under the breast. This position is chosen more often because it has a lower incidence of capsular contracture, rippling, and makes it easier to see breast tissue during a mammogram. The muscle also holds the implant up and minimizes problems in the breast from the weight of the implant.

Subglandular: this means the implant is only under the breast. This position is useful in patients who do a lot of upper body, especially pectoralis muscle, work. Also useful in patients with very widely spaced breasts. When implants are submuscular there is sometimes upward displacement of implants during exercise. This does not occur with subglandular placement. The downside of subglandular is that there is a higher incidence of capsular contracture, rippling, and visible implant edges.

Implant Type

Saline: Saline implants are filled with liquid. Their advantages are that if they wear out it is obvious to the naked eye, and they were felt to have a lower incidence of capsular contracture. They are also less expensive than silicone. Their disadvantage is that they look a little less natural and are more likely than silicone to show rippling.

Silicone: These implants are filled with a silicone gel. The latest silicone gel implants contain a gel called “cohesive gel’. This looks like the inside of a gummy bear. These are not the true “gummy implant”. Those are the anatomic implants which contain a firmer gel. Silicone implants are more expensive than saline and the anatomic implant is the most expensive.

Both types of implants now have lifetime warranties. There is no need to get a new implant every 10 years.

Capsule/ Capsular Contracture

All implants are “foreign’ to your body. Anytime something is placed in your body that is not you, the body’s response is to form a layer of scar tissue around that object to wall it off from the rest of the body. There is nothing wrong with this unless the scar tissue becomes firm. This can make the breast feel hard and can sometimes be painful. This is capsular contracture. It is one of the risks of breast augmentation.

This is meant to help you understand what you might read online or hear from your friends. As with all procedures, a consult with a plastic surgeon is the only way to truly know your options.

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