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Breast Implants

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Augmentation mammoplasty, or breast augmentation, is typically performed to enlarge small, underdeveloped breasts or breasts that have decreased in size after a woman has had children. Breast augmentation is accomplished by surgically inserting an implant behind each breast.

Many women consider undergoing breast implant surgery to enhance the size and shape of the natural bustline. Breast implants are also commonly used to restore a breast that has been removed or disfigured as a result of a mastectomy. A feminine body image is important to many women, and that includes the appearance of the breasts. In fact, breast implants come in a variety of sizes, shapes and profiles to achieve a natural-looking physique. Other important features include the texture of an implant’s shell and the substance that fills the shell. Implants approved the U.S. Food and Drug Administration (FDA) are filled with saline or silicone which impact the look and feel of a breast implant, which affect the overall appearance of your breasts.

Am I a good candidate for breast implants?

One or more of the following feelings or conditions may indicate that you are a good candidate for breast implants:
you have a sense of low self-esteem that your breasts are too small
»apparel that fit well around your hips is often too large at the bustline
»you feel self-conscious wearing form-fitting clothing or a swimsuit
»your breasts have decreased in size and lost their firmness after having children
»fluctuation in weight has changed the size and shape of your breasts
»asymmetry exists where one of your breasts is noticeably smaller than the other

Breast Implants Standard Procedure Techniques

Individual factors and personal preferences will help you and your plastic surgeon to determine your appropriate breast size, the location of incisions, and whether breast implants will be placed on top of or underneath the chest muscle.

The size, type, and location of your breast implant may be determined by your goals for breast enhancement, your existing body frame, and mass, your existing breast tissue, and the preferences you and your plastic surgeon discuss.
A patient education video features a real patient who talks about her real breast implant surgery to help you make an informed decision and safely achieve a satisfied outcome.

Saline Implants vs. Silicone Implants

Saline breast implants: Solid silicone rubber outer shell filled with sterile salt water. .Saline implants are filled at the time of surgery; thus may be inserted via a smaller incision than silicone implants. Saline implants allow for minor modifications in implant size at the time of the operation. If saline implants deflate, it is obvious in short time.
Silicone filled breast implants: Solid silicone rubber outer shell filled with cohesive silicone gel. Silicone is a naturally occurring element found in sand, quartz and rock. Silicone can be manufactured in a variety of ways, including oils, gels and solids. Silicone products have been shown to be bio-compatible, reliable, flexible and easy to sterilize. All silicone breast implants are pre-filled and may require a longer incision for implant placement. Patients tend to think that silicone implants feel more natural. If silicone implants rupture, it may not be obvious immediately. Current FDA recommendations include getting an MRI every other year starting with the third year to look for silent ruptures. With the recent FDA approval, all women over 22 years of age seeking cosmetic breast augmentation and women seeking breast reconstruction surgery will be able to select silicone breast implants.

Textured Implants vs. Smooth Implants

Textured implants: implants with a rough surface. Textured implants are intended to stay in one place and not move. Shaped implants should be textured so that they are more likely to stay in the appropriate location and orientation. Round implants may also be textured. The idea being that a rough surface may help to decrease capsular contracture.
Smooth implants: implants with a smooth surface. Smooth implants are intended to move within the pocket. Some patients think that smooth implants are less palpable.

Round Implants vs. Shaped Implants

Round implants: round implants. Does not have an orientation.
Shaped implants: various shapes available. In the United States currently, limited to saline implants.

Options for Breast Implant Surgery Incisions

Inframammary (under the breast)
Periareolar (around the nipple)
Transaxillary (in the armpit region)
Transumbilical (through the belly button)

Options for Breast Implant Pocket Location

Subpectoral – under the pectoralis major muscle
Subglandular – over the pectoralis major muscle

Breast Implants Benefits / Advantages / Options

Increases fullness of the breasts
Increases the size of the breasts
If different sizes are used in each side, breast size asymmetry may improve
May improve sagging breasts, depending on how large the implant and how much your breasts sag
May improve the proportion of breast size to match the rest of the body
May improve the fit of clothing
May improve self–confidence

Other Considerations for Breast Implant Surgery

After having breast implants, it may be recommended that you take prophylactic antibiotics when any dental work is done to protect the implant from infection for a short period of time.
Check with your insurance carrier to see if getting breast implants will affect your coverage or premiums.
Breast implants do not last forever. Expect to have another breast operation in the future.

Breast Implant Surgery Risks / Complications / Patient Safety

Every year, many thousands of women undergo successful breast implant surgery; however, anyone considering breast surgery should be aware of both the benefits and risks.
The subject of risks and potential complications of breast implant surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon’s office.
General risks of breast implant surgery: Some of the potential complications from breast implant surgery that may be discussed with you include reactions to anesthesia, blood accumulation that may need to be drained surgically and infection. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant.
Capsular contracture: When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast’s appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.
Implant rupture: Breast implants are not lifetime devices and cannot be expected to last forever. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours. A definite change in the size of the breast is clearly noticed. The implant may be removed and replaced if desired. If a silicone implant is used, a rupture may not be immediately obvious. Your may notice that your breasts seem to change shape, feel different, or start to have capsular contracture. A ruptured silicone implant should be removed and if desired, replaced. Rupture can occur as a result of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant, if desired.
Breast cancer screening: If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. Your plastic surgeon, in some instances, may recommend other types of examinations such as ultrasound or magnetic resonance imaging. An implant may obscure some of the mammogram. It is possible that the presence of breast implants could delay or hinder the early detection of breast cancer.

Other risks of breast implants: Other risks include changes in sensation of the nipple or breast and changes in the ability to breastfeed. Changes in sensation may either be increased or decreased or altered sensation. These changes may be temporary or permanent. Also, implant visibility, rippling, and asymmetry may also occur.
Other considerations of breast implants: Some women with breast implants have reported problems including certain connective tissue and immune-related diseases. Women without implants also have these disorders, so the key question is whether breast implants increase the risk of developing the conditions. Several large studies have been completed that provide reassurance that women with breast implants do not have a significantly increased risk for these diseases.

Breast Implants Recovery Process

At the conclusion of your breast implant procedure, you may be placed in a surgical dressing that may include a support bra or garment. You should follow your plastic surgeon’s directions as prescribed. Prior to your discharge, you and your caregiver will be given detailed instructions about your post-surgical care including drains if they have been placed, the normal symptoms you will experience, and any potential signs of complication.

You should be walking under your own strength immediately after your breast implant surgery. It is very important that you walk a few minutes every few hours to reduce the risk of blood clot formation in your legs.
The first 2-5 days following your breast implant surgery you may feel stiff and sore in the chest region. Any dressings will be removed within several days, and you may be instructed to wear a support bra. Your breasts may feel tight and sensitive to the touch, and your skin may feel warm or itchy. You may experience difficulty raising your arms. You should not lift, push or pull anything, or engage in any strenuous activity or twisting of the upper body. Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.

Your surgeon may instruct you to do displacement exercises/implant massage. This is usually recommended when round smooth implants are used, and are done to try to keep the breast pocket open. The idea is to allow room for the implant to move and try to keep the breast soft and more natural looking.
It is important to follow your surgeon’s instructions as directed.

Breast Implants Frequently Asked Questions:

Will breast implant surgery be painful?

Usually, pain after the breast implant operation is controlled by pain pills. Patients may feel stiff and sore in the chest region. They may feel tight, numb, itchy, or sensitive to the touch. Some patients may feel discomfort when raising their arms. However, the amount and duration of pain varies. Some patients have only minor discomfort. Others may have more severe pain or pain for a longer time.

Will there be scarring from breast implant surgery?

Anytime the layers of the skin are cut through, a scar forms. Thus there will be a scar along the incision that will not be able to be erased. Your surgeon will make it as thin and least noticeable as he/she can; however, the ultimate healing will be determined by your body’s healing potential.

What are some typical short-term side-effects from breast implant surgery?

Soreness, pain (see Will it be painful?), swelling are to be expected. A collection of fluid (seroma) may occur that may need to be drained either with a needle or with another operation. A collection of blood (hematoma) or bleeding may occur that may need another operation. Implant asymmetry, rippling, contracture, rupture, may also occur. Poor healing, poor scarring, alterations in sensation may also occur. Breast implant infection that may need antibiotics or even removal may occur.

What type of anesthesia, if any, will be used during breast implant surgery?

Breast augmentation may be done under sedation or general anesthesia. Speak to your surgeon regarding his/her preferences and your options. Many surgeons also use numbing medication (local anesthetic) during the operation to help with pain after the operation.

How long will my implants last?

Implants will not last forever and will likely need to be replaced with a subsequent operation. The length of time varies in each patient. However, if your breast implants do not give you problems, there is no set time at which “old” implants need to be replaced.

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