Breast augmentation, or breast implant surgery, has been done in the modern way since the early 1960’s. After 1991, the FDA declared a moratorium on silicone gel breast implants since they felt that they had not been adequately studied for safety. From 1999 to 2006, saline or salt water, filled implants had been the standard. As of now, a new silicone gel implant is available for breast augmentation.
Saline filled breast implants offer several advantages over silicone gel implants. Since the implant can be filled inside of the body, they can be placed through a smaller incision, usually about one inch. In addition, they are less likely to develop hardening over time, and if they should leak, it is only salt water that escapes, which is in no way harmful to your body. With the many advanced styles and designs, extremely natural appearances can be created.
Silicone gel implants in the US are different than in other countries as they are more solid. In Dr. Yager’s opinion, they offer a benefit to women with very small breasts who want to be much larger, as they will feel more natural. The current FDA recommendations are to do an MRI in 3 years then every 2 years after. In addition they should be exchanged every 10 years.
A new type of silicone gel implant just introduced to the US market is the highly cohesive silicone gel device, known in the lay press as the “Gummy Bear” implant. It comes in 4 different height and width combinations, and has the lowest rate of capsular contraction and rippling of any implant available. This size matrix system offers Dr. Yager the ability to obtain a variety of looks for the same volume. It is not appropriate for everyone, and it is more expensive. For the right patient, it is definitely worth considering.
After a careful discussion, physical exam with measurements and viewing of sample results, the ideal implant type, surgical approach, and implant position is determined. Some patients actually have a sagging of the breast tissue and require a breast lift (mastopexy). In some instances, even with a lift, not enough tissue exists and an implant is needed as well. No one approach or implant is perfect for everyone, and a surgeon should not suggest the same operation for every patient. Familiarities with many techniques, incisions, implant types, as well as a willingness to understand a patient’s individual desires are essential for maximizing your chances for an excellent outcome.
At your consultation, we will discuss the approaches to place the implant in your body- under the breast fold, around the nipple and areola, under the arm, and through the belly button. We will also talk about placing the implant underneath the breast tissue alone or under the tissue and the muscle. Different implant shapes and sizes will be demonstrated, and Dr. Yager will also discuss potential complications and limits of the procedure. A mammogram may be required prior to surgery to serve as a baseline for the future.
The operation itself takes less than 1 hour, and monitored sedative anesthesia with a Board Certified Anesthesiologist is used. Sutures are underneath the skin to minimize scarring, and dissolve on their own. A simple surgical tape covers the 1 inch incision, and they virtually all heal well.
You are in recovery for 1-2 hours, and may have some discomfort. A strange stretching or tight sensation is often felt, and you might feel that it is difficult to take a deep breath. Strong pain medications are given, as well as antibiotics. A surgical bra is provided for you for use over the first 6 weeks. Lifting or straining with the arms and chest will cause discomfort for the first week or so, but most women can return to work after 1 week. Initially, the implants may appear slightly high, but will settle over 3-6 months into their natural position. If you should become pregnant following the procedure, it is not harmful to breast feed if you are able. The breast may change in appearance, as in any pregnancy.
Dr. Yager is extremely concerned about a balanced, natural result that is in harmony with your body. Breast implant surgery should be to compliment your body and help you look better in clothing, not to have people stare at your chest. It is a personal decision, and one a woman should make solely for themselves. These women are some of the happiest in our practice.