Posted by Dr. Shareef Jandali
It is important to communicate with your plastic surgeon what kind of look you are trying to achieve with your augmentation, whether a more natural and conservative look is desired versus a fuller and more augmented look. Women will often refer to a friend that has certain size implants. Care must be taken to remember that each individual has a different size and shape to their chest, as well as a different amount of breast tissue. In other words, the exact size of a breast implant will look different on different people.
If too large of an implant is placed in a patient with a very thin and narrow chest, this can be unsafe and increase the risk of implant visibility, stretching of the tissues, bottoming out of the implant, and an undesirable outcome. The way an implant looks varies with different factors such as your chest size, ribcage size, the width of your sternum, and your current weight. It also very much depends on your current breast shape, volume, base dimension, and tissue quality. In our Connecticut plastic surgery office, we use the Mentor® Volume Sizing System to get an accurate idea of which size breast implant would fit each patient best.
Both silicone gel and saline implants are approved by the FDA and are proven to be safe. The FDA mandates that patients must be at least 22 years of age to have silicone gel implants placed. The majority of women choose silicone gel implants for the more natural feel and less of a chance of seeing implant rippling after augmentation.
Many women ask what will happen when either a silicone gel implant or a saline implant ruptures. Every implant has a lifespan of about 10-20 years. When a saline implant ruptures, the saline will be absorbed by your body over a period of a few weeks and that side of the chest will gradually flatten. When a silicone gel implant leaks or ruptures, it is often not noticed by the patient. The majority of gel leaks are intracapsular, which means that the gel stays within the natural scar capsule around the implant. This is known as a “silent” rupture because there are no changes in the breast and it is only detected on ultrasound or MRI of the breast. Once there is a documented leak of a gel implant, it is recommended to exchange both implants for new ones.
The vast majority of breast augmentations are performed with the implant placed behind the pectoralis muscle (subpectoral), or at least partially behind the muscle in a “dual-plane”. One advantages of subpectoral placement is that there is an extra layer of tissue covering the implant, which is especially important in thin women or women with very small breasts. This extra layer of muscle will lead to less visibility and rippling of the implant. In addition, subpectoral placement has been shown to have a slightly lower risk of capsular contracture, which is hardening of the capsule around the implant.
Implants are usually placed above the muscle in patients who are weight lifters or body builders, who constantly flex their pectoralis muscles. In these patients, placement behind the muscle would cause the implants to be squeezed and deformed with each flexion of the overly-developed muscles.
For a breast augmentation consultation, contact our Fairfield County, Connecticut plastic surgery practice today. Call us at 203-374-0310 to make an appointment with Board Certified plastic surgeon Dr. Shareef Jandali. We look forward to seeing you!