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Breast augmentation is one of the most popular cosmetic surgery procedures performed worldwide. It offers individuals the opportunity to enhance the size, shape, and overall appearance of their breasts. Breast implants are a versatile solution for breast enlargement or reconstruction after surgery. However, many people wonder, “How do breast implants work?” This comprehensive guide will explore the different types of breast implants, how they function, the procedure itself, potential risks, and how they fit into various aspects of cosmetic and reconstructive surgery.
Understanding Breast Implants
Breast implants are medical devices inserted under the breast tissue or chest muscle during breast implant surgery to increase the size of the breasts or to restore breast volume after weight loss, pregnancy, or mastectomy. They are typically made of a silicone outer shell filled with either silicone gel or saline (sterile salt water). The choice between saline and silicone implants depends on various factors, including personal preference and medical advice.
Types of Breast Implants
- Silicone Breast ImplantsSilicone breast implants are filled with a thick silicone gel that mimics the feel of natural breast tissue. Many women prefer silicone implants because they are often considered to provide a more natural feel and appearance compared to saline implants. Silicone implants are available in various shapes and sizes, with the gel designed to retain its consistency even if the implant shell ruptures.
Gummy Bear Implants: A type of silicone gel-filled implant known as gummy bear breast implants has gained popularity due to their cohesive silicone gel. This gel is firmer than traditional silicone gel, offering a more natural and stable look. The gummy bear breast implants retain their shape better and are less likely to leak than other silicone implants.
- Saline Breast ImplantsSaline breast implants are filled with sterile salt water and are typically inserted empty and then filled once in place. One of the benefits of saline implants is that if they rupture, the saline solution is harmlessly absorbed by the body. However, many people find that saline implants can feel less natural than their silicone counterparts, especially in women with less natural breast tissue.
Saline implants are also adjustable during the surgery, providing the flexibility to make final size adjustments. However, they are more prone to visible rippling, especially in women with thin skin or low amounts of natural breast tissue.
- Cohesive Silicone Gel ImplantsThese implants are a modern version of silicone implants and are filled with a more solid form of silicone gel, which is often referred to as “cohesive” or “form-stable”. They are known for maintaining shape and size, even if the implant shell is damaged. This makes them a desirable option for many individuals looking for long-term breast augmentation.
The Breast Implant Procedure
This section will provide an in-depth look at the breast implant procedure, focusing on the steps involved, the different implant types, and the possible breast implant complications that may arise.
1. Consultation with a Plastic Surgeon
The first step in the breast implant procedure is a comprehensive consultation with a board-certified plastic surgeon. This initial visit is essential for the patient and the surgeon to determine the desired outcome and establish a personalized plan.
During the Consultation:
- Health Assessment: Your plastic surgeon will review your medical history, including any chronic health conditions, previous surgeries, and breast health history (such as a history of breast cancer). This step helps ensure that you are a suitable candidate for breast surgery.
- Breast Tissue Evaluation: The surgeon will assess the size, shape, and elasticity of your breast tissue and the overall proportions of your chest. This evaluation will guide the choice of implant size and the surgical approach.
- Implant Selection: Your surgeon will discuss the pros and cons of different types of implants, such as saline or silicone implants, and help you choose the one that aligns with your aesthetic goals. Silicone breast implants tend to offer a more natural feel, while saline implants are filled with sterile salt water and are often preferred by those looking for a slightly firmer option. The choice will depend on your natural breast tissue, body type, and personal preferences.
- Surgical Technique: Based on your unique anatomy, the surgeon will also discuss the type of incision and implant placement, which could be under the muscle (submuscular) or over the muscle (subglandular).
2. Choosing the Type of Breast Implant
Choosing the right implant is a critical decision that impacts the surgery results. Several options are available, and the surgeon will guide you through these choices based on your goals, body type, and the type of breast surgery you are having.
a. Saline Breast Implants
Saline implants are filled with sterile salt water. These implants are often inserted while empty and then filled once positioned. They are typically a less expensive option compared to silicone breast implants, and their main benefit is that if they rupture, the saline solution is harmlessly absorbed by the body. However, saline implants can sometimes result in visible rippling under the skin, especially in women with thinner natural breast tissue.
- Pros: Lower cost, adjustable size, and no risk of silicone leakage if ruptured.
- Cons: Less natural feel than silicone implants; visible ripples can sometimes appear, especially in thinner patients.
b. Silicone Breast Implants
Silicone implants are filled with a thick silicone gel that mimics the feel and appearance of natural breast tissue. Many women prefer these implants because they offer a more natural look and feel than saline implants. Silicone implants are less likely to show visible rippling, making them a popular choice for women with less breast tissue. However, if a silicone implant ruptures, the gel may remain inside the breast pocket, potentially causing complications.
- Pros: It has a more natural feel, less visible rippling, and is widely regarded as offering a more realistic look and texture.
- Cons: Higher cost, the potential for a rupture with no immediate signs (silent rupture), may require additional imaging like MRI for monitoring.
c. Gummy Bear Implants (Cohesive Silicone Gel Implants)
A newer type of silicone implant, known as gummy bear implants, is filled with a form-stable, cohesive silicone gel that stays intact even if the shell breaks. These implants retain their shape better and are less likely to leak than other silicone gel options, making them an excellent choice for those seeking long-term stability and a natural appearance.
- Pros: Form-stable, better shape retention, less risk of leakage, and more natural feel.
- Cons: Higher cost, more invasive surgery, and limited adjustability compared to saline implants.
3. Breast Implant Surgery: The Procedure
The breast implant procedure itself typically lasts between 1 and 2 hours, depending on the complexity of the surgery and the chosen technique. It is performed under general anesthesia to ensure the patient remains comfortable throughout the procedure.
a. Incision Options
There are a few different incision sites that the surgeon may use during the surgery:
- Inframammary Incision: This incision is made beneath the breast, where the natural fold occurs. It provides the surgeon the best access to place the implant and is the most commonly used method.
- Periareolar Incision: This incision is made along the edge of the areola (the pigmented area around the nipple). This approach can be particularly useful for those undergoing breast augmentation surgery with implants and those requiring a breast lift in addition to augmentation.
- Transaxillary Incision: Made in the armpit, this incision is used less frequently but offers the advantage of leaving no visible scars on the breast. However, the surgeon has less direct access to the breast area, which may not be suitable for all cases.
b. Implant Placement
After the incision is made, the surgeon creates a pocket in which to place the implant. The placement can be submuscular (under the chest muscle) or subglandular (over the muscle but under the breast tissue). The choice of placement is typically based on factors like the thickness of natural breast tissue, muscle tone, and the type of implant being used.
- Submuscular Placement: Often chosen for silicone implants because it provides a more natural appearance and reduces the risk of complications such as capsular contracture (hardening of scar tissue around the implant).
- Subglandular Placement: Placing the implant above the muscle is typically quicker and involves less postoperative pain, but it may not be ideal for women with limited breast tissue.
4. Post-Operative Care and Recovery
After breast implant surgery, patients will spend some time in recovery before being cleared to go home. Most individuals can resume light activities within a few days but should avoid strenuous exercise and heavy lifting for several weeks for proper healing.
a. Pain Management and Swelling
Patients can expect some pain and swelling post-surgery. Pain medication prescribed by the plastic surgeon will help manage discomfort, and ice packs or cold compresses can reduce swelling. Some discomfort is typical in the first few days following the procedure but usually subsides within a week.
b. Wearing a Surgical Bra
A surgical bra is typically worn to provide support to the breasts during the healing process. It helps to reduce swelling and keep the implants in place as they settle into their final position.
c. Follow-Up Appointments
Patients must attend follow-up appointments with their plastic surgeon to monitor the healing process and ensure no complications, such as infection or capsular contracture. During these appointments, the surgeon may also assess the final implant position and the appearance of the breasts.
5. Breast Implant Complications
As with any surgery, there are potential risks and complications associated with breast implants. While most women experience successful outcomes, it’s important to be aware of potential issues:
a. Capsular Contracture
This occurs when the body forms excess scar tissue around the implant, which can cause the breast to feel hard and distort the shape. Capsular contracture can cause discomfort and may require further surgery to correct.
b. Breast Implant Rupture
A breast implant rupture happens when the implant shell breaks, causing the silicone gel or saline solution to leak. With saline implants, the body can absorb the saline if the implant ruptures, but for silicone implants, the gel may remain in the breast pocket, which could require surgical intervention.
c. Infection
While infection is rare, it can occur after breast surgery, especially if proper aftercare is not followed. Infection can lead to pain, swelling, and sometimes the need for further treatment or even implant removal.
d. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
Though extremely rare, there have been cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a type of cancer that is associated with certain types of textured implants. The risk is low, but patients should be aware of the possibility of complications like persistent fluid buildup or lumps near the implant site.
Recovery and Aftercare
After breast augmentation surgery, patients will need to follow specific post-operative care instructions to ensure proper healing and minimize complications. Most individuals can go home on the same day of surgery, although they should have someone available to help with transportation.
Post-Surgery Care Instructions
- Pain Management: Following surgery, you may experience some breast pain, swelling, and tenderness, which is normal. Pain medicine prescribed by your surgeon can help manage discomfort during recovery.
- Wearing a Surgical Bra: A surgical bra is often recommended to support the breasts during healing and reduce swelling.
- Activity Restrictions: Avoid strenuous activities and exercise for several weeks to allow for proper healing. Your surgeon will provide guidance on when it is safe to resume normal activities, including lifting and heavy exercise.
- Monitor for Complications: After surgery, it’s important to monitor the breast implant site for any signs of complications, such as breast implant rupture, infection, or capsular contracture (the formation of excessive scar tissue around the implant).
Potential Risks and Complications
Although breast augmentation surgery is generally safe, there are some risks and complications that patients should be aware of:
1. Breast Implant Rupture
Breast implant rupture occurs when the implant shell is damaged, causing the silicone gel or saline solution to leak. In the case of saline implants, the leak is typically harmless, and the body will absorb the saline. However, in the case of silicone implants, the gel may stay inside the breast pocket, which can lead to complications. If this happens, the implant will need to be removed and replaced.
2. Capsular Contracture
Capsular contracture occurs when the body forms too much scar tissue around the implant. This can cause the breast to feel firm or hard, and in severe cases, it may lead to changes in the shape of the breast and discomfort.
3. Breast Implant Illness
Some women report symptoms of breast implant illness (BII), which is characterized by fatigue, joint pain, and flu-like symptoms. Although not everyone experiences BII, individuals must discuss concerns with their plastic surgeon.
4. Breast Cancer Detection
While breast implants do not cause breast cancer, they can make breast imaging more difficult, potentially hindering the detection of tumors. Regular screening, including mammograms, is still essential for individuals with breast implants, but additional imaging techniques may be required.
Choosing the Right Breast Implant
When considering breast augmentation, it’s important to choose the type of breast implant that aligns with your aesthetic goals, lifestyle, and health considerations. Your plastic surgeon will guide you through the process, helping you choose between saline and silicone implants or even more advanced options like gummy bear implants. Ultimately, the right choice will depend on your desired results, body structure, and health factors.
Final Thoughts
Breast implants are a versatile and effective way to enhance breast size, restore volume after surgery or pregnancy, and boost self-confidence. Whether you opt for saline or silicone breast implants, it’s crucial to consult with an experienced board-certified plastic surgeon to understand the procedure, potential risks, and aftercare involved in breast augmentation surgery. By making informed decisions and following professional advice, you can achieve beautiful, natural-looking results that fit your body and lifestyle.
References
https://www.mayoclinic.org/tests-procedures/breast-augmentation/about/pac-20393178
https://medlineplus.gov/ency/article/002984.htm#:~:text=Description&text=Breast%20augmentation%20is%20done%20by,clinic%20or%20in%20a%20hospital.
https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/procedure
