Plastic Surgery
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Breast Implants

What Are Breast Implants?

Breast implants are artificial substances which are placed in the breasts to increase their size and improve their shape.  The breasts are an important part of a woman's physique.  They help to define her figure and can help to give the hourglass shape that so many women covet.  Many women wish that they could improve the appearance of their breasts.  Breast implants are one of the most popular ways of doing that.

The History Of Breast Implants

In some ways it is not surprising that breast implants have a long history.  Given that the breasts are such an important symbol of femininity and sexuality in Western culture, it is no surprise that people have looked for ways to increase their size.

It seems that the first attempts at breast implants in modern times came in the late 1800s, when an Austrian doctor began injecting paraffin into women's breasts.  Although the paraffin helped to increase the size of the breasts, the waxy substance eventually grew lumpy and hard.  This and the high level of dangerous infections led to the abandonment of this technique.

Doctors experimented with a wide variety of different (and strange) substances for breast implants for the next fifty years.  These included ivory, wood, ox cartilage, ground rubber, and Terylene wool.  In the 1950s, surgeons began to experiment with using silicone to enhance the breasts.  However this was not the silicone implants that we are familiar with.  Rather, the silicone was injected directly into the breasts.  In hindsight, we see that this was dangerous and that it led to infections, granulomas, breast hardening, and other deformities.

The first genuine breast implant were invented in 1961 by American surgeons Thomas Cronin and Frank Gerow.  It was made of silicone and filled with silicone gel.  The first breast augmentation was performed one year later.

In 1964, the first saline breast implant was created by Laboratoires Arion, a French company.  This implant was comprised of a silicone shell which was filled with saline solution.  Silicone and saline breast implants remain the two main forms of breast implant on the market.

Since the 1960s, scientists have continued to develop and perfect silicone and saline breast implants.  They have gone through a number of different shapes and shell thicknesses, and they have made many developments which can help to increase the safety and aesthetic appeal of the implants.

During the 1990s there was a large-scale debate regarding the safety of silicone breast implants.  The FDA reviewed data from silicone breast implant manufacturers as well as numerous claims that silicone implants had caused autoimmune and connective tissue diseases in women.  Because of this, the FDA pulled all silicone breast implants from the market in 1992.

From 1992 to 2005, silicone breast implants were only used in breast reconstruction and revision breast augmentation, and they could only be used by surgeons who were participating in silicone studies.  After continuing to study silicone implants, the FDA re-approved silicone breast implants in 2006.  The FDA continues to monitor and review safety information regarding silicone implants.  Currently, silicone implants are approved for breast augmentation in women ages 22 and older and for breast reconstruction in all women.

Common Types Of Breast Implants

A lot of women want to know what the best type of breast implant is.  This is a difficult question because there is no simple and obvious right or wrong answer.  Each form of breast implant has its own unique benefits and drawbacks.

Saline Breast Implants

Saline breast implants consist of a silicone shell which is filled with saline solution.  Saline breast implants are typically inserted into the body while empty and then filled afterward.  This has a number of benefits.  It makes it possible for the surgeon to use smaller incisions than are possible with silicone implants, which are filled before they are inserted.  For example, saline implants can be inserted through the belly button, but silicone implants cannot be.  Even when saline implants are inserted in other places, they tend to leave smaller scars than silicone implants.  Also, saline implants can be adjusted to a certain degree after surgery.  Using a syringe, the doctor can either add or remove liquid. 

From a health standpoint, saline breast implants seem to be safer if the breast implant ruptures, which is always something of a risk.  When a saline implant ruptures, it is immediately obvious, because it will instantly deflate, alerting the woman that she needs to see her surgeon.  Also, the saline solution which fills the implant is simply made of saltwater, which makes it much easier for it to be safely absorbed by the body.

Furthermore, saline breast implants are cheaper.  They typically will cost about $1,000 less than silicone breast implants.

However, saline breast implants do not typically feel as natural as breast implants.  They tend to be harder, and some women compare their texture to that of a water balloon.  This sensation may be particularly noticeable in women without much breast tissue.  Because these women do not have large and fatty breasts, the implant will be very palpable, and if its texture is very different from that of the breast tissue, it will be obvious.

Slightly overfilling the implant and inserting it under the muscle may help with this.  However, silicone breast implants almost always feel more natural.

Also, rippling and wrinkling are more common in saline breast implants than in silicone implants.  In saline implants, it is common for the edge of the shell to get a wrinkled or puckered appearance.  In women with small breasts or thin skin, this may be visible or palpable through the skin.

Silicone Breast Implants

Silicone breast implants, on the other hand, provide a much more natural feel.  They are filled with a semisolid gel which more closely resembles the feel of breast fat.  This may be especially important for women who have small breasts.  Because there will not be much covering the implant, it is more important that the implant itself feel natural.  Also, silicone implants will not wrinkle nearly as often, which can also be important to women without much breast tissue.

However, silicone breast implants are more expensive, and they may be more dangerous.  If a silicone breast implant ruptures, it will not necessarily deflate quickly and obviously.  Sometimes, the silicone fluid can slowly leak into the body in what surgeons call a “silent rupture.”  Because of the potential for this sort of leakage, the FDA recommend that women who have received silicone implants get an MRI three years after their surgery, and then every two years from there on out.  Also, the silicone gel may not absorb as easily or as harmlessly into the body as saline solution would.

Silicone breast implants cannot be adjusted after surgery because they are pre-filled.  Also, because they are pre-filled, they require a larger incision.  This means that certain incision sites are not available with silicone implants.  It also means that there will probably be more by way of visible scarring.

One additional potential drawback to silicone breast implants is that they were unavailable for so long.  This means that more surgeons are more experienced with saline implants, and when it comes to cosmetic surgery experience is just as important as the tools used.

Gummy Bear Breast Implants

One of the newest developments in breast augmentation is the arrival of “gummy bear implants,” or cohesive gel implants.  Gummy bear breast implants are a type of silicone implant that is meant to combine the natural feel of silicone with the safety of saline.  The silicone in a gummy bear implant is much thicker and more solid than that in traditional silicone breasts.  As the name suggests, the gel's consistency is comparable to that of a gummy bear candy.

This sort of implant is supposed to be much safer because it is “form stable.”  This means that if it ruptures, the contents will not spill out.  Rather, they will maintain their shape as a solid.

Gummy bear breast implants have not yet been approved by the FDA.  Rather, they are considered “investigational devices.”  As such, women who want to get gummy bear breast implants must be a part of a clinical trial.  Four different brands are currently being studied in the United States: Mentor's CPT, Silimed/Sientra's Nuance and Enhance, and Allergan's 410. 

Breast Implant Shapes

Not only can breast implants be made of different materials, they come in different shapes.  Each patient will need to decide which shape she would like.

Round Implants

Round implants are exactly what they sound like.  They are circular in shape.  When placed in the breasts, these implants give a lot of fulness to the upper breast.  Some people like them.  Some others feel that they look too artificial.

Teardrop Implants

Teardrop implants (also known as anatomical implants) are larger at the bottom than they are at the top.  They more closely mimic the natural shape of the breast, which can help them to give a less fake look.  However, occasionally these implants will rotate, and if they do they will look very unusual.

Breast Implant Size

When a person is undergoing a breast augmentation, one of the decisions that she will need to make is what size of implants to get.  Implants are usually measured in cubic centimeters (cc for short).  A larger implant will obviously give a more dramatic increase in size.  However, it may also look less natural, and if there is not enough breast tissue, it may look strange.

Sometimes women want to get breast implants that are bigger than their frame can naturally support.  This can result in an unnatural or unpleasant appearance.  Although the final decision is yours to make, you should take your doctor's advice into the equation.  Your surgeon has had a lot of experience, and he or she can help you to know what size implants will give you the results that you want.

Breast Implant Profile

One final decision which needs to be made with regards to breast implants is the profile or projection of the implant.  An implant's size refers to its overall size.  An implant's projection has refers to how far it will cause your breast to protrude forward.  High profile implants project the furthest.  Low profile implants are flatter.  Moderate and moderate plus profiles fall somewhere in the middle.

High profile implants can sometimes be a good choice for women who want to get large implants, but who have a small frame.  On the other hand, they can sometimes result in a fake or “done” appearance.

Breast Implant Incision Sites

Breast implants are put into the body through a surgery known as breast augmentation.  For more information on that surgery, please visit our breast augmentation page.  A breast augmentation can use a number of different incision sites to insert the implants into the breasts.  Here are some of the most common.

Areolar Incision

The areola is the darker area of skin which surrounds the nipple.  An areolar incision makes a cut around the very edge of the areola.  This natural change in skin color makes it easier to hide the surgical scar.  With this sort of incision, the implant may be placed above or below the muscle.  Advantages of the areolar incision include that it is close tho the breast, making it easier to perform the surgery.  Some suggest that the potential for nipple numbness is greater with an areolar incision, especially in women with small areolas.

Inframammary Incision

An inframammary incision is made under the underside of the breast in the inframammary crease (also known as the inframammary fold).  This incision site allows for very good control over implant placement, and it is one of the very most common incisions sites.  Disadvantages include visible scarring and a more painful recovery.

Armpit Incision

The armpit incision can be a good choice for women who do not wish to have any chance of scarring on the breast.  Scarring may be visible in the armpit, but it frequently fades significantly with time.

Navel Incision

A navel incision (also known as transumbilical of TUBA incision) goes through the navel.  An endoscope is used to move the implant up toward the breast.  Not all doctors perform TUBA incisions.  Advantages include no visible scarring.  Disadvantages include that the incision is far away from the breast and that silicone breast implants cannot be used.

Breast Implant Placement

Breast implants can either be placed above the chest muscle, behind the muscle or behind a part of the muscle.  If the implant is placed above the muscle, the surgery is easier to perform and recover from.  However, it may not appear quite as natural.  It the implant is placed under the muscle, the surgery may be more difficult, but the results completely appear more natural.

What Kinds Of Problems Can Breast Implants Treat?

Breast implants can help to improve the size and shape of the breast.  They can help to increase a woman's bust size, and in some cases they can help to fill out breasts that have lost mass due to weight loss or breastfeeding.

Are The Results Of Breast Implants Permanent?

Breast implants are permanent in the sense that there will be permanent repercussions to getting them.  Once you have gotten breast implants, you may look strange if you decide to have them removed.  However, breast implants themselves can wear out, and the FDA recommends planning on having one surgery every decade to help maintain your breast implants.  You may not end up needing to get this many surgeries, but it is important that you understand that it is a very real possibility.

Drawbacks Of Breast Implants

Breast implants can help to improve your figure, but there are a number of potential drawbacks as well.  In addition to potential pain and cost, there is the probability that you will need future surgery later on.  Additionally, there is the risk of your implants rupturing or leaking.

Some women experience permanent loss of nipple sensation, and some women actually experience hypersensitivity.  Many women experience that their ability to breastfeed is altered.  In addition to this, implants will sometimes shift in the body, and this can lead to an unnatural appearance.

Breast Implant Recovery

The recovery time for breast implants will depend a lot on the techniques that are used.  In most cases, however, patients can return to work within around a week.  Full recovery will take much longer.  Swelling will usually be present for a month or more after the surgery, and it can equally long before a patient is able to resume strenuous activity.  Even after a woman is able to go about her daily business, her appearance will continue to improve as the implants settle into their permanent position.  This can take up to a year after the surgery.

Breast Implants Cost

Breast implant costs can vary.  Silicone breast implants tend to cost more than saline implants, sometimes by as much as $1,000.  In addition to the price of the implant, your cost will include paying the surgeon, paying for a surgical center, and paying for whatever anesthesia and medications you might need.  All in all, you will probably pay something like $5,000 to $10,000 for your breast implants.

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