Breast augmentation has given women added confidence in their appearance. Breast Augmentation is one of the most frequently performed procedures in the United States today. Breast implants enhance the size and shape of the breast by adding firmness and fullness. Breast augmentation can be used to enhance body symmetry and self-image primarily or following pregnancy. Breast implants can also be used for correcting asymmetry and for reconstructive purposes.



There are many details you will want to know and although you discuss them personally with your surgeon, this packet is made available to you so that you may refer to it and review it at your leisure. Please read all the information several times. Discuss any questions or comments with your surgeon prior to making any final decision regarding breast augmentation.

Breast Augmentation is one of the most frequently performed cosmetic surgery procedures in the United States today. Breast implants enhance the size and shape of the breasts adding firmness and fullness while improving body image and self esteem. Breast Augmentation can be performed to make smaller breasts appear larger, balance breasts that are asymmetrical, or restore fullness that has diminished with age or as a result of pregnancy. Breast Implants can also be used for reconstructive purposes.

Types of Breast Implants

Plastic surgeons routinely perform breast augmentations using either saline filled breast implants or the new FDA approved cohesive gel silicone implants. Saline breast implants contain an outer shell of silicone within which the saline solution is placed. The new and improved silicone gel implants have the same outer silicone shell within which is a new cohesive silicone gel. Unlike the old silicone implants, which were more like a liquid, the new cohesive gel implants act more like a solid than a liquid holding together uniformly while still retaining the natural give and feel of natural breast tissue. This gelatin -like cohesive silicone gel is much less likely to leak, rupture or tear as compared to the older traditional silicone implants and, in demonstration, the implant does not leak even when cut in half.

Most surgeons and patients agree that the new cohesive silicone gel implants have a more natural feel and are less likely to produce rippling than saline implants. The cohesive gel implant, however will require a slightly larger incision to allow placement.

Breast Implants also come in different shapes and profiles. Anatomic or "teardrop" shaped implants were created with a more natural shape in mind and designed to be fuller at the lower half similar to a natural breast. However, this distinct vertical orientation can result in distortion or breast asymmetry if the implant should rotate. A textured surface allowing tissue in-growth helps reduce the chance of rotation however may result in more visible or palpable rippling. For these reasons, anatomic implants are not commonly used.

Many surgeons routinely use the most common, round implant. Since the breast implant is round, it is free to rotate without any adverse consequences. With gravity alone the saline or cohesive silicone gel will gravitate or fill the bottom portion of the implant when sitting or standing erect or fill the breast more uniformly when lying down supine, more closely imitating a natural breast.

Three distinct profiles also exist ranging from moderate profile to moderate plus/mid range to high profile. The moderate profile implant has a wider diameter with the least forward projection whereas the high profile implant has a narrower base diameter and the most forward projection. The moderate plus/mid range profile has, for most, the best in diameter and projection. Many surgeons, in their comprehensive physical examination, will help each patient choose the most appropriate size, shape and profile implant best suited for that individual patient.

The surface texture of the breast implant may also vary from smooth to one of a variety of textured or rough surfaces. Textured implants were originally designed to reduce capsular contracture (firmness and hardening of the tissue which heals around the implant). The textured surface allows tissue in-growth which fixes or adheres the implant to the surrounding tissues in a steady position. Since the tissues adhere to the implant, it is more likely to feel the ripples or waves which are natural in any implant. The smooth implant however does not adhere to any tissues and is free to move inside the implant "pocket." With a proper size implant and the proper creation of the breast implant "pocket," there is less chance of feeling and seeing the implants and a more natural feel and movement of the breast. Each type of surface seems to have certain possible advantages and disadvantages. Unless otherwise indicated, your surgeon may use smooth round implants.

Breast Implant Location

The breast implant may be placed above the chest muscle (pectoralis muscle) or under the chest muscle. Cosmetic surgeons generally place the implant under the chest muscle. Reasons for submuscular placement include a lower rate of capsular contracture (firmness and hardening of the healing tissues around the implant) and a more natural result due to more soft tissue coverage over the implant. Placement of the implant beneath the muscle may produce some movement and/or distortion of the breast and implant with active movement or exercise of the chest muscle, arms and shoulders.

There Are Several Different Locations For Incision Placement:

Infra mammary Incision: placed in or near the crease under the breast

Areolar Incision: placed in the border of the lower part of the areola (pigmented area around the nipple)

Axillary Incision: placed in a natural crease in the hair bearing skin of the armpit

Trans-umbilical: incision in the upper aspect of the "belly button" - reserved for saline implants only