In 2008, breast implant surgery was the most popular cosmetic surgery procedure in the United States, with over 350,000 women electing to have them. The only “cosmetic procedures” more popular were the minimally invasive facial procedures like Botox injections and injection of line fillers. The numbers for breast implant surgery remained high despite a worldwide economic downturn. Because so many women have the procedure each year, and because women’s bodies differ so much in frame size, weight, and original breast size, breast implant techniques must be chosen carefully so that each patient gets the best results possible.
Different breast implant techniques are chosen based on numerous factors, such as:
- whether the surgery is the first implant surgery or revision of previous surgery
- whether the patient is having a breast lift at the same time
- whether the patient is having reconstructive breast surgery
- how large breast implants are
- whether the implants are or saline-filled breast implants
- how large the woman’s frame is compared with the size of the implants she has chosen
In addition, different surgeons often prefer a certain technique, and will rely on it more heavily than other techniques. A top breast implant surgeon, however, is willing to tailor the technique he or she uses to the specific needs of the patient.
What are some of the breast implant techniques?
The two main factors in breast implant technique are the placement of the implant and the placement of the breast implants incisions.
There are two options for implant placement: above the pectoralis muscle, or below the muscle. The submuscular (also called subpectoral) implant is placed underneath the pectoralis muscle. It is the most common placement for breast implants. The advantage of this placement is that the risk of hardening of scar tissue around the implants (capsular contracture) is lower than with above the muscle placement. This placement also interferes less with mammograms. In women, the cosmetic result is better in women with smaller breasts. However, the recovery time is longer, and more painful.
Subglandular placement is when implants are inserted above the muscle, yet below the breast tissue. With this placement, the risk is greater of capsular contracture, and this placement interferes more with mammogram interpretation. The cosmetic results are worse in women with small breasts, but better in women with athletic builds. The recovery time is shorter with subglandular implants, and there is generally less swelling and pain than submuscular placement. This technique can sometimes be performed with IV sedation and local anesthetics.
There are four choices for breast implants incision sites in breast implant techniques. The inframammary incision is made on the lower part of the breast in the crease where the breast connects to the chest. This ensures that scars will be hidden. It is the most common breast implants incision site and gives the surgeon the best visualization of the implantation.
Periareolar incision is the second most common breast implants incision. It is a small semi-circle around the edge of the nipple. This incision type has a higher risk of lowered nipple sensation after recovery.
Axillary breast implants incisions are made in the armpit. This technique is called transaxillary breast augmentation. It may require the surgeon to use an endoscope, but the scars are generally well hidden.
Umbilical breast implants incisions are made in the navel. It requires use of an endoscope, and is used primarily for subglandular placement. It is difficult for the surgeon to place implants underneath the pectoralis muscle using an umbilical incision.
What types of implants are there?
There are two basic types of breast implants, and they differ based on what they are filled with. Saline-filled implants are filled with a sterile saline solution. While they are more vulnerable to rupture, the sterile saline solution is not harmful to the body. Many surgeons and patients think that saline-filled breast implants do not look natural, and there is the possibility of a rippling effect on the skin.
The other type of breast implant is filled with silicone gel. Today’s silicone gel holds together better than the silicone gel used in the 1980s and 1990s, which could cause complications in the event of a rupture. silicone gel implants were only available to women seeking reconstructive breast surgery from 1992 to 2006, but in 2006 they were re-approved for general use and have since become the most popular choice. They are said to feel and look more natural, and the casing of today’s implants are less likely to rupture than in older implants.
Implants are also available with or without textured surface. The textured surface is said to look and feel more natural, and is believed to decrease the risk of capsular contracture.
What breast implant techniques are used in reconstruction and breast lift surgery?
Breast reconstruction, such as after a mastectomy, usually involves silicone implants. Depending on how long after the mastectomy the breast reconstruction takes place, the skin may need to be gradually stretched to accommodate an implant. Often, the breast that was not removed will be cosmetically enhanced to match the reconstructed breast.
Breast lift surgery is often done after a woman has lost a lot of weight, or after she has finished nursing babies. In this surgery, excess skin is removed, and often, silicone gel implants are inserted to bring the look of the breasts back to a younger, firmer look. Sometimes, in cases of breast lifts, the nipple must be repositioned for the most natural look.
How long does breast implant surgery take?
A routine breast implant surgery takes one to two hours. The first step of the surgery is anesthesia. Either general anesthesia or intravenous sedation and local anesthetics are used. The choice of anesthesia will depend on the surgeon’s preference and the placement of the implants. After the patient is anesthetized, the surgeon makes breast implants incisions. Incisions may go under the breasts, around the areola, under the arm, or in the belly button. After the implants are inserted and placed properly, the surgeon closes the incisions with sutures in the breast and with surtures, (or perhaps surgical tape or skin adhesive) to close the skin.
How long does recovery take with the various breast implant techniques?
After surgery, nausea is common, as is a feeling of tightness in the chest, as well as soreness in the arms and back. Surgeons will prescribe pain medication to keep discomfort to a minimum. Immediately after surgery, the breasts will appear high, and will be swollen and somewhat hard. It takes about a month for the swelling to be gone and for the implants to drop into place and soften. Sometimes it can take up to a year for the implants to settle into their final position. The first two weeks are generally the most uncomfortable, though recovery time is very individual and depends on several factors. A surgeon is the best source of information on how long recovery might take depending on a patient’s age, general health, size of implants, and placement of implants.
It is very important for patients to follow the surgeon’s instructions carefully following surgery as far as use of ice packs, sleeping position, avoiding strenuous activity, driving, and massaging the implants to help avoid capsular contracture.
What are the latest trends in breast implant techniques?
In the United States, trends will depend somewhat on where the patient lives. Patients in New York City tend to go for a more subtle effect with smaller implants, while patients in Los Angeles or San Diego will often go for large breast implants – some as large as 750 milliliters in volume. The surgery itself shows no sign of diminishing in popularity. Perhaps the main “trend” in breast implant techniques is increasing reliance on silicone breast implants rather than saline-filled breast implants now that better forms of silicone are available.
How should a prospective patient find a surgeon?
For best results, any prospective patient should choose a board certified plastic surgeon who has plenty of experience in performing breast implant surgery. Contrary to what many people believe, breast implant surgery does not have to be performed by a board certified plastic surgeon. Plastic surgeons have the intensive training and experience to do the job and get extremely satisfactory results. Price should not be a major factor in determining which surgeon to choose.
A less expensive option may indicate a surgeon who does not have extensive experience, and in that case there is a greater risk of complications, and a greater risk of requiring revision surgery later. Surgeons who do not listen, or who indicate that they will choose one of the breast implant techniques in all cases may not produce satisfactory results. Surgeons should listen to all the con cerns of a potential patient, and should be willing to explain which technique he or she recommends and why.
With so many breast implant techniques being performed, and with so many reality television shows on this and other types of plastic surgery, it may be tempting to think of having breast implant surgery as a simple beauty procedure similar to getting hair color. But it involves at least intravenous sedation and local anesthetics, and sometimes general anesthesia, and it is actual surgery with actual incisions and scars, and the risks that come with surgery.
The various breast implant techniques are a way for surgeons to adapt the surgery to fit the patient’s body and to achieve the best results. The technique that works best for one patient may not work best for another. The best breast implant surgeons understand the advantages and disadvantages to the various breast implant techniques as well as the advantages of the various types of implants.
Open communication with patients is important too. Any prospective patient who feels she is being rushed, or railroaded into choosing a particular size or shape of breast implant, or who feels that the surgeon does not listen to her needs and wants should probably search for another surgeon to ensure the best results possible.
Mail this post