A breast implant always contains a silicone shell. The silicone shell is then filled with either saline (which is a liquid) or silicone (which is a gel). The breast implant is placed into a pocket either above or below the pectoralis muscle, and that produces an enlarged, or augmented, breast.
There are many different types of breast implants, but the main differences are saline versus silicone. Patients need to explore this important difference before making a final decision.
The next big implant difference is whether they are shaped or round, as well as textured or smooth. There is currently a big interest in shaped implants. A shaped implant is a teardrop that some surgeons think gives a more natural look to the breast. While many surgeons believe that superior results may come from a shaped implant, others feel the same about round implants.
Many women like to have more fullness in the upper part of the breast and that may be better achieved with a round implant. A round implant can move or turn with no problem because it will stay the same. A teardrop-shaped implant needs to be textured so it will not rotate side to side and cause a malposition. Textured implants do not move freely like smooth implants do.
The other differences in the implants is the range of sizes, and what are known as profiles. There is a moderate profile, a moderate plus profile, and a high profile, which means the breast gets more projection for a given implant size.
The choice between saline and silicone for breast implants depends on the patient’s needs and desire. Many plastic surgeons agree that silicone is a superior implant because it is a soft and more natural looking implant. There was a time when patients were concerned about the safety of silicone. Now it seems patients are more interested in silicone and trust that silicone implants are safe. Silicone implants have always been safe and no one has ever shown that a silicone implant has caused any systemic disease. Silicone implants are also new generation and much safer than they used to be.
Breast enlargement is a relatively straightforward surgery that can be done in about an hour. It is much faster than fat grafting surgery. Breast implant surgery is very predictable while fat grafting is not as predictable because sometimes the fat lasts and sometimes it does not. A breast implant is very long-lasting. Breast implant surgery usually requires just one surgery. Fat grafting may require multiple surgeries to achieve an augmented and acceptable result.
Placing the implant below or above the pectoralis muscle depend on the patient’s characteristics and desires as well as surgeon preference. Many surgeons like to place the implants below the muscle because the pectoralis muscle helps to camouflage the implants. Having said that, there are certain times where the implant may be better placed above the muscle. An acceptable result can be achieved either way.
One limitation of breast implants involves problems with a patient’s breasts. If a patient has saggy breasts, they may not be a candidate for breast augmentation alone. They may need to have an additional surgery, such as a breast lift, along with the breast augmentation. Another limitation is that breast implants do not last forever. At some point in the future, patients may need to have the implants replaced or removed.
Implants may last forever but the breast around the implant will change as a woman ages, so sometimes further breast surgery is necessary. Also, let’s say a woman had a breast augmentation in her 40s and she later decides in her middle 50s that she wants a smaller size, the implants will need to be replaced.
The short term breast enhancement complications are the same complications as any surgery. These include bleeding, infection, and wound healing problems. Fortunately, these complications are all uncommon.
The most common long term complication of breast implants is capsular contracture. This is a hardening of the normally soft capsule which forms around the breast implant. It is like a scar tissue that forms around the breast implants. Unfortunately, nobody knows exactly what causes capsular contraction.
Most breast implant patients are up and around immediately, meaning they can walk, climb stairs, and do everyday activities. There is some pain in the short term, particularly if the implants are placed beneath the muscle. However, this is usually controlled with pain medicine. The patient can go back to work quickly if they have a sedentary job. Patients often do these kinds of surgeries at the end of a week (Thursday or Friday) so they can get back to work on Monday.
Patients cannot do any heavy lifting or heavy activities involving the chest or arms for three to four weeks. This includes going to the gym, lifting luggage, lifting grocery bags, and lifting children. Normal everyday activities, including some types of exercise like walking on a treadmill, can be resumed almost immediately.
The results that a patient sees from breast implants are immediate. The implants can last between 10 and 20 years. The patient will see swelling for up to six weeks after the implant procedure. They may look a little larger at first but will settle as the swelling subsides.
Breast implants are very safe and have always been. It is important for patients to find an American Board of Plastic Surgery certified plastic surgeon that has experience in performing breast augmentation surgery. It is also important for the patient and the surgeon to have the same expectations going into the surgery. Having realistic expectations is vital so the patient will not be surprised or disappointed by the final results.
Written by Cosmetic Town Editorial Team- MA
Based on an exclusive interview with John A. Perrotti, MD in New York, NY