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Breast Implants

saline breast implantBreast implants are used in breast augmentation, they can be placed either under the chest muscle or directly under the breasts. Placement considerations include the anatomy of your breasts, soreness after surgery, exercise activities (upper body strength and conditioning sports such as weightlifting, tennis, volleyball and others) and interference with mammograms.

Silicone Gel vs. Saline Filled Breast Implants

There are two basic types of implants, silicone gel and saline filled. ALL implants consist of a silicone shell. Silicone gel implants are filled with liquid silicone. The FDA has restricted the use of silicone gel implants to only a select group of plastic surgeons and only certain of their patients. If you are interested in having silicone gel implants, be sure to ask if you might be eligible to participate in one of the approved protocols. To date, there have been numerous studies in the medical literature demonstrating no link between silicone gel implants and any type of disease. However, Silicone gel filled breast implants are only offered on a limited basis, under approved studies, due to questions about silicone implants correlated to autoimmune diseases. For further information on breast implants navigate to the following sites:

http://www.fda.gov/cdrh/breastimplants/indexbip.html
MentorCorp.com - breast implant makers.

Saline filled implants consist of an outer shell of silicone that is filled with saline, or salt water. Most breast implants used for breast augmentation are of this type. In addition, there is a new type of saline implant called a "high profile" saline implant. It is designed to give better breast projection and volume, because more of its volume is used in establishing projection rather than increasing the width of the implant. Please ask your plastic surgeon for further information regarding which implant might be right for your individual needs.

Smooth vs. Textured Surfaced breast implants

Breast implants may have a smooth surface or may have a rough, textured surface. The textured implants were produced in the hopes that they would decrease the incidence of the patient forming a scar around the implant, also known as a capsular contracture. This does appear to be the case, but only when the implant is placed beneath the breast but above the muscle of the chest wall (see Implant Placement Options, below).

Textured implants are not without their disadvantages, however. The texturing process makes the shell slightly thicker, which translates into an implant that might be more visible through the skin of the breast or might be more easily felt when the breast is touched.

Because of these disadvantages, most breast implants used today are of the smooth variety.

Round vs. Anatomical Shaped breast implants

Most breast implants used today are round. There are also implants that are teardrop shaped, called anatomical implants. These are in an attempt to better simulate the shape of the natural breast. In certain cases these may be recommended, but ALL anatomical implants are textured, with the accompanying disadvantages of textured implants.
Incision placement for breast implants
The incision for breast augmentation may be placed underneath the breast, around the areola (the pigmented skin surrounding the nipple), in the armpit, or in the belly button. Not all plastic surgeons perform all of these approaches because it may not have been a part of their training. If you have a specific preference with regard to incision placement, make sure your plastic surgeon is experienced with that approach.
Subglandular vs. Submuscular breast implant placement
Breast implants may be placed beneath the tissue of the breast (subglandular), or may be placed even deeper, beneath the muscle of the chest wall (submuscular). The decision is a very individual one, and it is determined by the natural shape of your breasts and chest wall muscles. Whenever possible, I prefer to place the implants in a submuscular position. This is for two main reasons. First, mammography is easier when the breast implant is separated from the breast tissue by the additional layer of muscle. Secondly, there is a lower incidence of capsular contracture when the implants are placed beneath the muscle. Capsular contracture occurs when the body produces scar tissue around the implant. This may change the shape of the implant and make the breasts asymmetric.

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