Breast Augmentation Procedures:

Cost from $ 2,250

Cost with Financing $ 70 per month

Index: Overview and Pre-Op - Procedures and Techniques - Recovery

Anesthesia: General or Sedation

Location: Hospital

Surgery time: 2-4 hours

Breast augmentation will enlarge your breasts. It will not improve nipple asymmetry, move breasts closer together, or lift droopy breasts. If you have droopy breasts, consider a breast lift (mastopexy). Breast augmentation is performed to balance a difference in breast size, improve body contour or as a post-surgery reconstructive technique. Silicone shells filled with saline solution are implanted either directly under the breast tissue or beneath the chest wall muscle, giving breasts a fuller and more natural contour. Saline Implants The majority of implants being used today are saline-filled implants. These have a silicone rubber shell and are filled with sterile salt water. During pre-operative exams you and your surgeon will determine:

• Breast Implant shape: round or teardrop
• Breast Implant surface: smooth or textured
• Breast Implant size and volume: cup size/210 ml-500 ml
• Breast Implant placement: above or below the muscle
• Breast Surgery Incision site: armpit, areola, breast or belly button

Cohesive silicone gel are also known as gummy bear or memory gel implants and are quickly becoming the implant of choice for women in the United States. In fact more and more women are deciding to go under the knife once again to remove their saline implants and replace them for gummy bears. Why are these implants becoming so popular?  I have had both types of implants so I can tell you from personal experience and also from the experiences of the hundreds of women whom I have helped get breast augmentations what the positives and the negatives are of both.

1) Feel:  This is one of the biggest advantages of cohesive silicone implants over saline. They just feel more natural period.  Saline implants were always uncomfortable when I laid on my stomach, they rippled and then on top it they sloshed around. So basically hands down cohesive silicone is the choice to make if how your breasts feel is a priority.

2) Durability: When I first got my implants 16 years ago there were no other options than just saline. However my surgeon also never told me that I would need to replace my saline implants every 10 years because they will leak. Saline implants are something you have to continually upkeep throughout your life and replace. The cost of this is something you have to consider of course but you also have to consider that every time you have surgery you are increasing your risks of complications. With the cohesive gel you never have to replace them which in my mind and my pocket book are a big plus.

3) Durability and Safety: If saline implants leak your body just absorbs the water and that’s the end of that. There are no side effects on the surrounding tissue not to mention you will most likely immediately realize that the implant has leaked.  Now with the cohesive silicone gel this is not the case but the good news is that they are incredibly difficult to rupture and because they are made with cohesive gel the gel does not migrate into the surrounding tissue. I actually have several implants on my desk that I use to show my patients and everyone who walks through the door always seems drawn to the implants.. They pick them up, squeeze them, pull them, and twist them.  I guess they are a very good stress reliever.. I have had these implants on my desk for over two years and not one implant has ever broken, split, ruptured or leaked. Granted this is due to the fact that they are of excellent quality but it also attests to the strength of these implants.

4) Appearance: I have found that the overall appearance of both implants is the same other than the saline implants did ripple on the sides and the cohesive gels do not.

Breast Implant shape

Round breast implants are not affected by rotation and cost less than teardrop implants. They do not require a textured surface. There are no disadvantages to round breast implants. This is the most common implant employed.

Teardrop breast implants were developed to provide a more natural look. They cost more than round breast implants and require a textured surface to prevent rotation. In the event that the implants rotate, it creates a distorted breast shape. A recent study determined that a round breast implant takes on the same shape as the teardrop implant when standing. The study also concluded that when lying down, the round breast implant is more natural in appearance than the teardrop implant because it retains the teardrop shape and the round breast implant does not.

Breast Implant surface

Textured breast implants have an increased risk of rippling but a decreased risk of displacement. They also cost more (about $400).

A recent study showed that textured breast implants have a higher deflation rate and are firmer than smooth implants.

Smooth breast implants have a lower risk of rippling, are less firm than textured breast implants. Any rotation of the implant will not affect the appearance. Smooth breast implants are used in 90% of operations.

Breast Implant size and volume

Breast Implants that are less than 350 ml have a lower risk of displacement, but may not provide the desired size. Breast Implants that are more than 400 ml have a higher risk of displacement, but may provide the desired size. Choosing your desired size can be a difficult decision. You'll want to decide your cup size and that will determine how large your implant will be. A 400 ml implant placed on a woman with an A cup will produce a C cup. The same implant placed on a woman with a B cup will produce a D cup.

Breast Implant placement

Breast Implant position refers to whether the breast implant is placed above or below the pectoralis muscle. See Illustration below.

Subpectoral or submuscular breast implants: Placement under the pectoralis muscle is the approach most commonly used. It has a lower risk of capsular contracture, interferes less with a mammogram, and a better cosmetic result in women with small breasts and a worse cosmetic result in athletic women. It is associated with a lengthier recovery and more pain and swelling than placement above the muscle. This approach requires general anesthetic.

Subglandular breast implants: Breast Implants that are placed above the pectoralis muscle and below the breast tissue. This has a greater risk of capsular contraction, interferes more with a mammogram, and a worse cosmetic result in women with small breasts. It has a better cosmetic result in athletic women. It is associated with a shorter recovery and less pain and swelling than placement below the muscle. This approach can be performed with intravenous sedation and local anesthetic.

Incision site

Inframammary incision: The incision is made on the lower portion of the breast, in the crease where the breast meets the chest, so that any scar will still be hidden. This incision allows your surgeon the best visibility during surgery. Most commonly done.

Periareolar incision: The second most common incision is made in the areola. The incision is usually a small semi-circle. The scar is camouflaged by the nipple. However, if there are any imperfections in the scar, it will be highly visible. This type of incision has an increased risk for diminished nipple sensation.

Axillary incision: The incision is made in the armpit, and may require the use of an endoscope. The scar is well-hidden, but provides poor visibility for the surgeon.

Umbilical incision: The incision is made in the belly button. It usually requires the use of an endoscope, and it is very difficult to place the implants below the muscle utilizing this method.