FAQ Regarding Breast Augmentation

Dr. Heidi Regenass is a plastic surgeon at Gateway Aesthetic Institute and Laser Center and breaks down the fact from fiction.

How is breast augmentation performed?

After anesthesia is administered, an incision will be made either under the breast, in the armpit, or around the areola, depending on factors such as the patient’s anatomy and the type of implant being used. The implant used during breast augmentation surgery can either be saline or pre-filled silicone, and placed either below the muscle or behind the breast tissue.

How do the different types of implants compare? Is one type preferable to the other?

There are two main types of implants: saline and silicone. Both of these implants are encased with a solid shell made of silicone, a material which is derived from silica and has been safely used in other implantable medical devices, such as artificial heart valves.
The main difference between the two types is the filling: saline implants are filled with a liquid, sterile salt water; silicone implants are filled with a semi-solid, silicone gel.

Both types of implants have their advantages and disadvantages. Here is a brief overview:

Saline implants

Although silicone implants were approved by the FDA in 2006, saline implants, which were approved in 2000, remain the implant of choice (Reece, Aesthetic Surgery Journal 2009).

The advantages of saline is as follows:

• The implant is filled after being implanted, so the incision size is significantly reduced. (Silicone implants, on the other hand, are pre-filled, so the incision is slightly larger.)

• Saline implants are associated with a very low infection rate, as small as one to two percent.

• Implant rupturing is much easier to detect with saline implants than with silicone implants.

• The amount of liquid in a saline implant can be adjusted during surgery, allowing the best volume for each patient.

• They are less expensive than silicone implants.

Saline implants have two main disadvantages: they are more likely to ripple, and many patients feel they have a less natural look and feel compared to silicone implants.

Silicone implants

A great deal of controversy has surrounded silicone implants, due to a series of lawsuits in the late eighties and early nineties which alleged that silicone implants led to serious complications. In 1992, the FDA requested that the use of silicone implants be put on hold, and called for further research on the safety and efficacy of these products. In 2006, after years of rigorous scientific research, the FDA concluded that silicone implants were safe and effective (FDA News Release, 2006).

The main advantage of silicone implants is that they have a more natural look and feel compared to saline implants, as the gel filling of silicone implants is more similar to actual breast tissue.

Silicone implants, however, do have some disadvantages: implant rupture is more difficult to detect than with saline implants, and adjustment of implant size requires additional surgery.

Conclusion

A variety of factors, such as body type and the desired bust size, determine which type of implant should be used. Your plastic surgeon can help you decide which type of implant will provide the desired results.

What about the different shapes of implants? Is one shape preferable to the other?

The two most common shapes of implants are “round” and “teardrop.” Teardrop implants may be chosen by women who are seeking fullness in the lower breast only, but round implants are typically the implant of choice, because they provide an overall fuller look.

How much improvement can I expect from breast augmentation?

The vast majority of women are very satisfied with the results of breast augmentation.
In a 10-year follow-up with 450 women who had undergone breast augmentation, 93 percent of women were satisfied or very satisfied with the results (Cunningham, Plastic and Reconstructive Surgery, 2000).

What are the risks?

Like any significant surgery, breast augmentation carries certain risks. Complications of this surgery may include swelling, bleeding, infection, poor healing, and reaction to anesthesia. Rarely, permanent loss of sensation in the nipples or areas of the breast may occur.
Both silicone and saline implants carry a risk of certain complications, including capsular contracture, infection, pain, nerve damage, and needing to be replaced.
Under the care of a skilled plastic surgeon like Dr. Heidi Regenass, M.D., serious side effects are extremely rare, and even mild complications can be prevented. You can learn more about all possible complications in a consultation about this procedure.

How much downtime is involved?

Healing from breast augmentation surgery takes approximately one week, but some degree of swelling may persist for up to four weeks after the procedure.
The scar left by the incision will fade over a period of about one year.

Who would be the ideal candidate for breast augmentation?

Many women seek breast augmentation—it is one of the most popular cosmetic procedures performed in the United States—and for many reasons. Some women may have a naturally small cup size or have lost volume after childbearing or weight loss. Or, women recovering from a mastectomy may need reconstructive surgery.

The ideal candidate for breast augmentation is confident in her decision. It is important that breast augmentation patients be motivated by improving their own self-confidence and body image, rather than conforming to another person’s ideal. Also, it is essential that patients have realistic expectations.

You can find Dr Heidi Regenass at Gateway Aesthetic Institute and Laser Center at www.gatewaylasercenter.com