Introduction and Overview

A breast implant is a prosthetic material that is used to make a person's breast bigger. These implants are typically used for breast reconstruction or breast augmentation procedures. At present, breast implant surgery is the most common cosmetic operation performed in the United States; with over 300,000 breast augmentation surgeries performed every year.

Saline Implants vs. Silicone Implants

There are two general kinds of breast implants on the market today, namely saline implants and silicone implants. In the past, implants with other fillers, like soy oil, were also manufactured; however, this kind of implants has already been phased out.

Saline implants are breast implants made of silicone shells that are filled with a specific saline solution. The major advantage of using saline implants is that they can be inserted through a much smaller incision than the pre-filled silicone types. The implants are first placed in the pockets created in the breasts, after which they are filled with the solution. Another advantage of saline implants is that they tend to be safer in case they leak. However, in comparison to silicone implants, saline breast implants tend to produce more cosmetic issues, specifically, wrinkling and irregularities of the skin over the breast. Also, saline implants tend to be more obvious and palpable than its silicone counterpart, especially when implanted in women with small breasts.

Silicone implants, on the other hand, are breast implants where both the shell and the gel inside are made of silicone. The main advantage of these implants is that they feel and appear more natural than the saline implants. At some point in the past, silicone implants were restricted for medical use by the FDA, because of increased reports of leakage of the silicone gel. However, newer generation silicone implants have already minimized this complication. The silicone breast implants used today are associated with low rates of rupture of the implant shell and contracture of the capsule. At present, silicone breast implants are deemed to be safe and technically easy to implant.

Breast implants can come in either a round or a teardrop shape. Choosing which implant shape to use will depend on the contour of the patient's breast. Breast implants may also have a smooth or a rough texture; the texture will not be visible on the skin once they have been implanted.

Breast Implants: The Procedure

A breast implants can be used in several instances. First, it can be used for breast reconstruction. This is commonly performed on patients with breast cancer who have undergone mastectomy. It can also be done for patients who have experienced trauma of the chest, including the breasts and patients with congenital defects that led to the failure of breast development. Other than for purposes of reconstruction, the more common use of breast implants is for breast augmentation. In this procedure, the size of the breast is enlarged and the form is enhanced.

There are several ways in which breast implants are inserted. The incisions can be made in several areas, such as underneath the breasts, around the areola, from the armpit, or through the navel or umbilicus. The implants can be placed between the muscles of the breast, or underneath the chest muscle itself. The surgical technique used in implantation depends on the type of implant to be inserted, the capability of the surgeon and the preference of the patient.

Breast augmentation takes approximately one to two hours and is performed under general anesthesia. It is usually performed in an outpatient setting, meaning patients will be able to go home on the same day as the procedure. Swelling is expected after the procedure, which will resolve in about a week or two. After the operation, patients are advised to avoid heavy activities for approximately 4 to 6 weeks. However, you will be taught specific exercises that will help minimize the pain you experience postoperatively. You will also be given medications to relieve any pain. Your breasts may appear unnatural in the beginning, but this usually improves over the next few months.

It is recommended that women getting breast implants be at least 18 years old to ensure that the breasts have completed their development. FDA also recommends that patients with breast implants undergo an MRI three years after the operation to monitor the status of the implant. Breast implants are expected to last for approximately 10 to 15 years; beyond this time, the implants may have to be removed or replaced.

Possible complications

As with any operation, breast augmentation may result in a number of complications. These include pain in the breast, infection, hematoma formation, asymmetry of the breasts, extrusion of the implants, and an odd sensation in the nipple. Some patients develop problems with breastfeeding. Also, mammography on augmented breasts may be more difficult, providing less accurate results. There have also been reports of displacement of the implants or change in location. Capsular contracture is a phenomenon where there is scar formation around the implant. This results in distortion of the breasts. Implant leakage is another serious complication, which occurs when there is trauma to the implants or the breasts. For saline implants, a hole or a rupture in the shell of the implant can result in deflation of the implant or asymmetrical breasts. Meanwhile, for silicone implants, rupture of the shell may not be evident. This may present as nodules in the breasts or the armpits while in some, these are only detected via an MRI.

Breast Implants: Cost

The cost of a breast implant varies depending on the type of implant used, as well as on the doctor and the location where the surgery will be performed. Breast augmentation, especially when performed for cosmetic reasons, is generally not covered by health insurance.

It is important to find a qualified doctor who will be able to answer all your questions about breast implants. A good surgeon will be able to help you formulate realistic and practical expectations regarding the operation, and will prepare you for all the possible risks of the procedure.


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