Saline breast implants have always remained a positive choice for patients when deciding what type of implant to use for breast augmentation. Because these implants comprise a sterile saltwater solution, any potential leakage does not pose a threat as the body safely absorbs the solution. Saline implants also cost less than the silicone type. One of the disadvantages of saline implants is that in some cases, rippling can appear. Rippling is especially something to consider for women who are thin and have low breast tissue. Those who opt for this type of implant must be at least 18 years old. Manufacturers approved by the FDA include Natrelle by Allergen, Mentor and Sientra.
Silicone breast implants are very popular today and recommended by surgeons for patients who are thin and desire a natural look. Since the FDA validated their safety and efficacy, safety concerns surrounding these implants are today almost no different than that of saline. The silicone shell is pre-filled with silicone gel and comes in different sizes, shapes, and textures. Unlike saline implants in which the body absorbs leakage, and implant volume appears visibly flat, it is difficult to tell when a silicone implant ruptures. An MRI is required to detect any rupture. Patients considering silicone implants must be at least 22 years old. Sientra is a common manufacturer of silicone-based implants approved by the FDA.
For patients who desire fuller breasts but do not want an artificial implant to achieve this look, there is also an option known as a fat transfer. In this procedure, the doctor will harvest fat from donor sites of the patient, such as the flanks, abdomen, and thighs via liposuction. The fat collected will undergo a process of refinement and purification and then will be gradually reinjected into the breasts with small syringes so that the shape distributes evenly.
Breast implants come in a variety of different profiles. The right profile depends on how enhanced the breasts’ projection would be, as well as how wide the implant will be on the chest wall in relation to the base width. Since the silicone implants are already pre-filled, the standard profiles come in low, moderate, high, and extra high. Saline implants, however, come in variants that are either pre-filled, filled with saline solution up to the patient’s preferred profile once the doctor has inserted the silicone shell. Choosing the right profile can sometimes be a difficult decision, and it is up to a skilled surgeon to help guide the patient accordingly. High profile breast implants will have greater projection, but less width on each side, whereas a moderate profile, for example, will not have as much projection, but will be broader.
The standard shape of a breast implant can either be rounded or tear-shaped. Each shape serves a different aesthetic function as it pertains to the patient’s goals. Rounded implants produce a shapelier curve on the top portion of the breast. The teardrop implants copy the natural appearance of the breast, so they will not appear as high.
Implants with either a smooth or a textured surface. In general, smooth implants cost less and are more common. The textured implants reduce the chances of capsular contracture (the constriction of scar tissue around the implant), though this claim is not definitive. The textured type is more common with the teardrop shape as the rough texture adheres to tissues helping the implant stay in place.
The two most common placements are either on top of the chest muscle or underneath it. When placed under the muscle, the implant creates a pocket within the pectoralis major muscle. The implant also can create a pocket behind the muscle. This method helps to keep the implant in place for a longer time and takes into consideration factors such as implant size, weight, gravity, and time. Placing the implant behind the muscle also provides a natural look and provides the implant with the long-term support it needs to stay in position.
There are several standard incision approaches for breast implants. The most common is known as an inframammary incision, which is an incision near the breast fold. Second is an incision made under the areola, which is known as a periareolar incision? A third option is to place the incision within the armpit, known as a transaxillary approach. There is also an incision approach that takes place around the belly button, but this is the least recommended way. It is up to the patient’s desires and the surgeon’s recommendation as to what approach is best to take. Scarring also factors in choosing the correct approach.
Breast augmentation is an outpatient procedure that may last from an hour to several hours. It involves general anesthesia in an accredited surgical facility. Patients must limit all physical activities within 48 hours after surgery. There will be bruising and swelling, and a compression support bra will help in healing. It is normal to feel tightness around the chest area as the skin adjusts to the breast’s new shape. Most patients can resume normal activities within 7 days; avoid exercise for 4-6 weeks. It takes approximately 6 months for the breasts to look, feel, and function normally in regards to softness, sensation, and final placement.