Silicone Breast Augmentation
Breast Augmentation is the most popular surgical cosmetic procedure in the United States. In 2009, 289,328 of these procedures were performed in the USA, as noted by the statistics of the American Society of Plastic Surgeons. It is an operation for women who are looking for more volume and better shape as well as those that have had children and have lost breast volume after breast-feeding. This is my most popular surgical procedure and I perform as many as ten per week.
Until recently, saline implants were available for everyone, while silicone implants were regulated by the FDA study and less readily available. The FDA ended this study in November 2007 because they found no statistically significant increase of any disease in those women who had silicone gel breast implants after many years of study. Currently both are available and both are popular.
Silicone implants are softer and tend to look and feel more natural. They are a bit more conservative and tend to look less round. They have less rippling and palpability and tend to look more natural over time. The incision is a bit larger than for saline but it can hide well at the inframammary fold or areola. Silicone implants are more popular in my practice these days and I think that is probably because they look and feel more natural.
Saline implants tend to look a bit rounder and feel a bit firmer. They have more rippling and palpability. They can be placed through a very small incision compared to the silicone implants, which are pre-filled. My favorite location is a small 1.5 cm incision at the nipple edge. I pioneered this incision and over the past 10 years I have performed it over 6000 times. The scar it leaves is nearly undetectable. The implant is inserted deflated so it can be rolled up and fit through the very small incision.
Both saline and silicone implants come in a variety of profiles. In general the flatter profiles are more conservative and the more projecting implants are perkier and less conservative. As a general rule the projections for the silicone implants are more conservative than the saline implants.
In general I prefer to place the implants under the muscle so that they look and feel more natural. This also helps decrease capsular contracture and decreases rippling and palpability. There are important techniques that I perform when I do this procedure under the muscle however, so that the implants settle nicely, give good cleavage, have lower pole fullness and look natural.
During the complimentary office consultation, I review the risks as well as the recovery from this operation with the goal that my patients are well informed and have had their questions answered. I always size the patients with the real implants so that they can accurately pick the look that is right for them. In the end they have a clear image of what they will look like. I strive to provide an exemplary educational experience that is informative, pleasant and thorough so that a patient can ultimately decide if this is the right surgery for her.
Tubular Breast Shape is congenitally present in some women. This requires releasing constricting bands in the inferior pole of the breast during breast augmentation. With this the breast tissues become a bit thinner and are more likely to show rippling and palpability. For this reason I almost always use silicone gel when performing breast augmentation on these patients.
Breast Augmentation Silicone: