When choosing a board-certified plastic surgeon in your area for breast augmentation, remember that the surgeon's experience and your comfort with him or her are just as important as the final cost of the surgery.
In the latest Plastic Surgeons Talking About Their Plastic Surgery, Karen Horton, MD, shares her own breast augmentation journey with Jamie Moenster, DO, discussing why the subglandular position was best for her and why she's feeling more proportional.
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One of the decisions you'll make regarding your breast augmentation procedure involves the type of implant that will be used. Dr. Orringer offers a wide range of breast implant types, shapes, and sizes in order to provide you with a truly customized procedure that addresses your unique aesthetic goals and body type.
In recent years, saline implants have waned in popularity, mainly due to the fact that they tend to look and feel less natural than silicone gel options. This issue is even more pronounced for thinner women with less natural breast tissue.
If you choose the subglandular implant placement option, Dr. Orringer will place the breast implant behind your breast tissue and over the chest muscle. This option may be ideally suited for women with a significant amount of natural breast tissue.
One of the important decisions you'll have to make regarding your breast augmentation procedure involves the location of the incision used to place your breast implants. There are several different options, and the right one for you will be based on your aesthetic preference and the style and size of implant selected.
While modern breast implants are very durable and can last a very long time, it's not realistic to expect them to last for the rest of your life. Eventually, it is likely that you will need a breast augmentation revision procedure. There are a different set of challenges associated with revision procedures than are encountered during the initial breast augmentation surgery, and it's important that your surgeon understands the unique issues that need be addressed during revision surgery.
Breast augmentation technology and equipment is advancing rapidly, and it is likely that there will be a continued improvement in the durability and lifespan of breast implants in the near future. However, there will always remain a chance that your implants may potentially need to be replaced at some point down the road.
Based on this evaluation, he will explain the different options available to you and make customized recommendations regarding potential breast implant type, incision location, and implant place options.
There are several factors that will impact your breast augmentation procedure. Dr. Orringer will discuss these with you during your consultation in order to arrive at a customized treatment plan that addresses your unique needs and goals:
Silicone gel-filled implants are silicone shells filled with a plastic gel (silicone). Although many women say that silicone gel implants feel more like real breasts than saline, they pose more of a risk if they leak.
Start your breast implant research by getting a list of surgeons' names. Talk to friends who have had breast implant surgery. Talk to your general physician or gynecologist. Once you have a list of potential surgeons, schedule a free consultation with each doctor.
Because breasts can continue to develop until women reach their late teens or early 20s, the FDA requires that women be at least 18 years old to get breast augmentation with saline-filled implants and at least 22 years old to receive silicone implants.
Before your breast implant procedure, you will meet with your surgeon for a medical evaluation. You can talk about what you want and get feedback from the doctor. Your surgeon may ask you to stop taking certain medications a few days or weeks before your surgery.
It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.
Women who have silicone gel-filled implants need to get regular mammogram screenings yearly plus an MRI or ultrasound scan five to six years after the initial implant surgery and every two to three years after that to check for silent rupture. If you have symptoms at any time or uncertain ultrasound results for breast implant rupture, an MRI is recommended If your implants rupture, you will need to have them removed or replaced.
The final guidance, Breast Implants - Certain Labeling Recommendations to Improve Patient Communication, provides recommendations concerning the content and format for certain labeling information for saline and silicone gel-filled breast implants, including:
The following is a list of local complications and adverse outcomes that occur in at least 1 percent of breast implant patients at any time. You may need non-surgical treatments or additional surgeries to treat any of these, and you should discuss any complication and necessary treatment with your doctor. These complications are listed alphabetically, not in order of how often they occur.
If you elect to have your breast implants removed, or if it is medically indicated, there are two primary methods for implant removal. Your plastic surgeon may choose to remove your implant alone and leave the scar tissue that surrounds your implant in your body, also called the scar capsule. This option requires less surgical dissection and may pose less risk of local complications such as bleeding. Alternatively, your surgeon may also surgically remove the scar capsule when your breast implant is removed. This is called "en-bloc resection". You should discuss with your surgeon which method is best for your situation.
If you experience any symptoms of BIA-ALCL, such as persistent swelling or pain, or other changes in the area around your breast implant, talk to your surgeon or health care provider about the need for further evaluation. Evaluation for BIA-ALCL typically involves a physical exam, imaging, and/or assessment of the fluid or tissue around the breast implant. It is important to have an evaluation to diagnose BIA-ALCL because a confirmed BIA-ALCL diagnosis may change the type of operation that should be performed.Generally, patients with confirmed BIA-ALCL should undergo implant removal and removal of the surrounding scar capsule, which is a more extensive operation than implant removal alone. Talk to your surgeon about the method of removal most appropriate for you.
Removal of a breast implant, with or without replacement, is one type of reoperation. The life of breast implants varies by person and can't be predicted. You may need to have your implant removed at some time over the course of your life because of one or more local complications.
The photograph below shows a 29-year-old woman 1 year after having her silicone gel-filled breast implants removed, but not replaced. Women with large breast implants, especially those inserted on top of the chest muscles (subglandularly), may have major cosmetic deformity if they choose not to replace them or to undergo additional reconstructive surgery.
The term rupture is used for all types of breast implants, but the term deflation is only used for saline-filled implants. You and/or your doctor will be able to tell if your saline-filled implant ruptures because the saline solution leaks into your body immediately or over several days and deflates the implant. You will notice that your implant loses its original size or shape.
The photograph below shows a 30-year-old woman whose left saline-filled breast implant deflated. The implant is thought to have deflated due to a particular design, which is no longer used by the manufacturer.
If a silicone gel-filled breast implant ruptures, it is not likely that you or your doctor will immediately notice because most silicone implant ruptures are without symptoms, "silent ruptures". A silent rupture doesn't change the way an implant looks or feels, and your surgeon or health care provider may not be able to detect a silent rupture by a physical examination alone. Magnetic resonance imaging (MRI) is the most effective method for detecting silent rupture of silicone gel-filled breast implants.
However, occasionally when a silicone gel-filled implant ruptures, a woman may notice a decrease in breast size, change in breast implant shape, hard lumps over the implant or chest area, an uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation.
Generally, when silicone gel-filled implants rupture, the silicone gel escapes through a tear or hole in the implant shell but remains confined within the scar tissue capsule around the implant, called an intra-capsular rupture. If the gel migrates beyond the scar tissue around the breast implant, it is called an extracapsular rupture. Sometimes, after a rupture, the gel may move to other distant areas around the body, which is called extracapsular rupture with gel migration. It may be difficult to remove silicone gel after a rupture.
The FDA has not detected any association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems. However, the FDA has received reports of systemic symptoms (see below) by some patients with both saline and silicone gel-filled breast implants. In order to fully understand these complications, studies would need to be larger and longer than those conducted so far.
Symptoms such as fatigue, memory loss, rash, "brain fog," and joint pain may be associated with breast implants. Some patients may use the term "breast implant illness" (BII) to describe these symptoms. Researchers are investigating these symptoms to better understand their origins. These symptoms and what causes them are poorly understood. In some cases, removal of the breast implants without replacement is reported to reverse symptoms of breast implant illness. 2ff7e9595c
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