What is Breast Augmentation?
Breast augmentation is the most popular plastic surgery procedure in the United States, with over 300,000 women enjoying it yearly. This procedure is designed to enhance the size and shape of a woman’s breast through the placement of implants, namely silicone, saline (salt water), or gummy bear. These can be placed beneath the breast tissue (sub-glandular) or beneath the chest muscle (sub-muscular). In most cases, Dr. Marin places the implant through an incision around the areola or at the breast crease. The type, size, profile, and placement of the implants are largely based on a patient’s anatomy and her ultimate cosmetic desire.
WHAT TO EXPECT FOR YOUR BREAST AUGMENTATION
Pain, bleeding, infection, asymmetry, implant failure, capsular contracture
6-8 weeks for implants to completely descend into the final position
General or local with sedation
Back to work: 3 days Strenuous activities: 2-3 weeks
DURATION OF RESULTS
Breast implants are warrantied for life. Replacement only entails a minor procedure.
Temporary swelling, bruising, mild pain
Breast implants invented in 1962 by Dr. Frank Gerow and Dr. Thomas Cronin at the Baylor College of Medicine – the same institution where Dr. Marin trained in plastic surgery. The implants initially were much less structurally sound, but very soft and almost undetectable. Since that time, the implants have been under intense scrutiny by both physicians as well as the FDA. They are now significantly improved, and have been demonstrated to be safe in hundreds of peer reviewed journals; many of which have been published in one of the premiere plastic surgery journals – Plastic and Reconstructive Surgery. Older models of the breast implant were often wide and made with a very thin silicone shell, failing to help “re-shape” a woman’s breast. When placed upright, the implants would collapse and not hold their form, making the breast less full in the upper aspect. The newer “4th generation” silicone models are much more effective at producing a more attractive shape. Learn more about the evolution of breast implants.
4 Types of Breast Implants
There are more breast implant options available today than ever before. Every breast implant, saline or silicone, has the same outer “shell” made of a solid silicone elastomer. Thus, what is in contact with the body is the same no matter the fill of the implant. The outer shell can be either smooth or textured and the implant can be either shaped or round. Smooth implants can be either smooth or textured, but all shaped devices must be textured. That is to prevent the rotation of the shaped device to prevent “malposition” or the implant ending up in the wrong orientation. In the United States, the most common approach for breast augmentation is with a smooth, round implant placed beneath the muscle.
- Saline Breast Implants
Saline breast implants are shipped empty and then routinely filled to a specified volume range (CCs) with the equivalent to IV fluid. This allows the implant to be placed through a slightly smaller incision (roughly 1 inch) as the implant is inserted empty and then filled once it is placed in the body through a small fill tube. Having a “fill range” for each implant allows for the greatest degree of flexibility in controlling the volume of each implant; this is particularly helpful in cases with significant pre-existing asymmetry. This implant produces a “more augmented” result and tends to push against the tissues more aggressively than the silicone counterpart – much like a water balloon. Also, the implant tends to be more “firm” to the touch and has the reputation of having the highest incidence of postoperative rippling of any of the available implant choices.
- Silicone Breast Implants
Silicone breast implants are now available in three different fills – traditional silicone, soft touch and the “gummy-bear” variety. All of these implants are “pre-filled” from the manufacturer and arrive in sterile containers with similar shapes for each different fill type. Thus, no specific adjustments can be made to an individual implant in the operating room to “fine tune” the result. However, there are options to use different sized implants, a combination of different projections but the volume (CCs) are predetermined by the manufacturers. Traditional silicone implants are softer, more natural, behave more like a natural breast and have less rippling than the saline counterpart. Silicone breast implants are what 99 percent of our patients choose. We have almost no patients who request saline once they feel the difference.
All current silicone breast implants are considered “solid.” Silicone implants are not filled with a liquid that will leak out if the shell is ruptured. The implant fill becomes more “cohesive” or more like a solid as you go from traditional silicone implants to soft touch to “gummy bear.” Think of this like going from a marshmallow, to jello to a gummy bear as a rough estimate of increasing cohesiveness. Allergan, one of the makers of breast implants in the US, has recently released the FDA approved “Soft Touch” breast implant which is slightly more “cohesive” than the traditional silicone implant. This allows the implant to maintain its height better than the traditional implants. This helps maintain upper pole fullness and reduce the incidence of rippling seen in thin women.
- Gummy Bear Breast Implants
“Gummy bear” breast implants are the most cohesive – meaning that they hold their form even when cut in half. These implants come in a round and anatomic or “teardrop” shape. These implants are a bit more firm than the traditional implants, as a result, these implants hold their upper pole volume better than any other implant, but can be firmer to the touch. Each one of these implant types can be placed through a relatively small 3.5 cm (1.5 inches) incision around the areola or at the breast crease.
- Anatomic Teardrop Shaped Implants
Finally, anatomic or “teardrop” shaped implants are the final implant option. Due to the nature of the implant design, all of these implants must have a textured surface to prevent rotation of the implant that could lead to a “malposition” or the implant sitting in an improper orientation. These implants are filled with the same silicone gel as the “gummy bear” round implants, but have a narrower upper pole and are filled more substantially in the lower aspect of the implant. There are several instances where these implants are superior to the round implants. Most notably in patients who have a constricted breast and in those patients who need a slight lift to the nipple and areola. Unlike the initial thoughts about this shape, these implants are not necessarily more “natural” appearing than the round implants. However they will preferentially expand the lower aspect of the breast due to their shape which can be beneficial in the proper candidates.
Breast Augmentation Video
See Dr. Marin’s Fox 5 news segment on the topic for more information.
The largest manufacturer of breast implants in the United States, Allergan, now makes both saline and silicone implants in five specific profiles: in essence a low profile, low profile plus, moderate profile, high profile and ultra-high profile implant. To better understand this, for every volume where each implant will contain the same amount of fluid, the low profile will be wider and less projecting out from the chest, the moderate is a bit more narrow and projects slightly further out, the high profile is even more narrow with a more dramatic projection, and finally the ultra-high profile being the most narrow with the most dramatic projection. Each of these implant designs is designed to help different women with different chest and breast shapes achieve their desired aesthetic breast augmentation goals. This allows for better correction of asymmetry or chest wall differences that are quite common, making the silicone option nearly as flexible as saline in this arena.
Implant Shape and Texture
Saline and silicone breast implants are manufactured with both a smooth and textured surface, as well as a round and “teardrop” or anatomic shape. The most common combination in the United States for both saline and silicone implants is a smooth round implant. The smooth devices move more easily in a woman’s body creating a more natural appearance and feel. However, when there are significant issues with the shape of a woman’s chest, a textured device can be more appropriate. The texturing allows for tissue in-growth into the implant itself helping to secure it in place and prevent migration of the implant – much like a “velcro” effect. The negative is that these implants tend to be less mobile and fixed in place and do have a higher incidence of rippling since the tissue is more adhered to the implant itself. Finally, shaped implants are exclusively textured and we find them most useful in constricted breast shapes or for breast reconstruction in combination with fat grafting.
Undergoing Breast Augmentation Surgery
A typical breast augmentation procedure usually takes a little under an hour to complete and most patients are on their way home less than an hour after the completion of surgery. It is performed using either local anesthesia with sedation or general anesthesia. Our recommended approach is with a general anesthetic and always in a fully accredited (AAAASF) operating room under the supervision of a Board Certified anesthesiologist.
What to Expect after Breast Augmentation?
After your surgery, you may feel drowsy and sore for the next 2 days. It will be best if someone would accompany you within this time frame. Dr. Marin will also provide a surgical bra which you should wear for 23 hours a day, removing only when you shower. Patients are required to wear the bra for 6-8 weeks after surgery depending on how well they are healing.
You may notice your breasts will feel tender and sensitive right after your surgery. Your implants may also seem too big and hard, but this is only temporary and will subside as the swelling goes down.
Breast Augmentation Recovery and Scars
Recovery from breast augmentation is relatively shorter than other plastic surgery procedures. It may only take 4-6 weeks of proper rest for you to get back to your usual activities. Patients who chose the beneath-the-muscle placement may experience a longer recovery time. All sutures are dissolvable so there is no need for suture removal. Postoperative pain is also well controlled with prescription pain medication. Typically, patients may return to work after 3-4 days.
Breast Augmentation Recovery Tips
Still, it is crucial for you not to rush the recovery because this may only cause adverse effects. Let your body recuperate. If your need to take some time from work, do not hesitate to do so. Here are some important tips to recover well from breast augmentation:
- Keep your incisions dry to reduce the risk of infections.
- Do not apply creams or lotions on the incisions or anywhere near the area. This may cause inflammation.
- Avoid strenuous activities like lifting heavy things and exercise for at least three to four weeks after your surgery.
- Do not take pain relievers unless your doctor approves. This may cause excessive bleeding.
- If you feel well enough, walk around your home or neighborhood to reduce blood clotting and to relieve the swelling of your chest.
Like any other surgery, scarring is inevitable after breast augmentation. The position of your scar depends on the type of incision you chose and how the implants were inserted. Your scars will look pinkish for the next few weeks, but it will fade considerably over time if you carefully follow your doctor’s orders regarding your healing process.
Your New Look After Breast Augmentation
In your healing process, your body will gradually accommodate the addition of your implants. As you go through your recovery, your breasts will improve in appearance – gearing towards a more natural and softer look. Most women will begin to see their “final” result after three to six months.
Breast augmentation is highly personal, and enjoying the benefits depends on the perspective of the patient. Nonetheless, it is positive that breast augmentation may improve the confidence and self-image of a woman who’s looking for a great way to improve her appearance.
Request Your Consultation
To learn more, you can schedule an appointment online or you can call 858-638-9800