What are the many variables to consider in breast implant selection?
One reason that your plastic surgeon can deliver your One Right Results is because of the many breast implant options from which they are able to choose. After talking with you about your expectation for surgery, and considering your physical characteristics, your plastic surgeon will know which implant size, shape, filler and profile best fits you.
Breast Implant Size
Breast implants come in a variety of widths. Selecting the proper implant width is critical to helping ensure your long-term satisfaction with your breast augmentation surgery. If your breast implant is too wide, it can place stress on your breast tissue, leading to complications. If the breast implant is too narrow, the cosmetic result may not meet your expectations. You and your plastic surgeon may also want to discuss cup size. It's important to recognize that bra-cup sizes are not standard, so even though expressing your desired result in terms of cup size will help your doctor to understand your expectations, your implant size will ultimately be based on the measurements of your existing breasts, the characteristics of your skin and your body type.
Breast Implant Shape
You will be able to determine if you would like to re-shape your breast. Some saline-filled and silicone gel-filled breast implants give the breast a more rounded appearance, while other saline-filled breast implants create a breast shaped with a gentle slope in the upper pole and fullness in the lower portion of the breast.
Breast Implant Filler: Saline Breast Implants and Silicone Breast Implants
There are two approved options for breast implant fillers: saline and silicone. While each filler has been approved by the Food and Drug Administration (FDA) for breast implants, they have distinct features and benefits. The unique qualities of today's silicone gel-filled breast implants help make it the filler of choice for patients in countries where both saline-filled and silicone gel-filled breast implants are widely available, because patients and plastic surgeons alike favor the natural look and feel.
Breast Implant Profile
The profile is the forward projection of the implant from the chest wall. Inamed Silicone-Filled Breast Implants come in three profiles: Moderate, midrange and high.
Breast Implant Surface Texturing
Breast implants can be either smooth or textured. Texturing is designed to help keep the breast implant from shifting in place and to reduce the rate of capsular contracture in the long term.
How is the placement for your breast implants determined?
The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or over the muscle and under the breast glands (subglandular), depending on the thickness of your breast tissue and its ability to adequately cover the breast implant. You should discuss with your breast augmentation suregeon the pros and cons of the breast implant placement in order to obtain the result that is right for you.
How is the incision site for your breast implants determined?
There are three common incision sites for breast implants: under the arm (transaxillary), around the nipple (periareolar) or within the breast fold (inframammary).
Periareolar Incision for Breast Augmentation
The incision is typically more concealed, but is associated with a higher likelihood of inability to successfully breastfeed, as compared to the other incision sites.
Inframammary Incision for Breast Augmentation
This incision is generally less concealed than periareolar and associated with less difficulty than the periareolar incision site when breastfeeding.
Transaxillary Incision for Breast Augmentation
This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breastfeeding.
Surgical Setting and Anesthesia for Breast Augmentation Surgery
Breast Augmentation surgery is usually performed on an outpatient basis, either in a hospital operating room, surgery center, or surgical suite in the plastic surgeon's office. Breast Augmentation surgery usually lasts one to two hours and general anesthesia is commonly used, but local anesthesia is also an option.
Are you familiar with today's silicone?
Silicones are a family of chemical compounds. They are made from silicon, a naturally occurring element found in sand, quartz and rock. Next to oxygen, silicon is the most common element in the earth's crust and becomes silicone when it is combined with oxygen, carbon and hydrogen. Depending on the arrangement of the molecules, silicones can be manufactured in a variety of forms including oils, gels and solids.
Silicones have been part of the consumer industry for over 50 years. Because they can be manufactured in various ways, silicones appear in a wide variety of products that most of us use every day. Hairsprays, suntan lotions and moisturizing creams are just some of the consumer products that contain one form of silicone called dimethicone. Medical devices utilizing silicone include artificial joints, catheters, drainage systems, facial implants, tissue expanders and breast implants. Silicone products have been shown to be biocompatible, reliable, flexible and easy to sterilize, making them an ideal choice for both implantable and non-implantable medical devices.
What makes today's silicone a safe option for breast implants?
In 1992, the FDA called for a voluntary moratorium (delay) on the use of silicone gel-filled breast implants until new safety information could be thoroughly reviewed by the FDA's advisory panel. That same year, the FDA lifted this moratorium and announced its decision to allow access to silicone gel-filled breast implants for reconstruction patients under controlled clinical studies, called Adjunct Studies. In 1999, the FDA allowed the use of silicone gel-filled breast implants in Allergan's Core Clinical Study to assess the safety and effectiveness of these devices.
The Allergan Core Clinical Study
Allergan's Core Clinical Study is an ongoing 10-year study of 940 women who had breast augmentation, breast reconstruction or revision of a previous surgery between 1999 and 2000. Safety and effectiveness is evaluated through patient follow-up at zero to four weeks, six months, 12 months, 24 months, and annually through 10 years. Safety is assessed by complications, such as breast implant rupture, capsular contracture and reoperation. Benefit (effectiveness) is assessed by patient satisfaction and measures of body image/esteem and self-esteem.
The result: The FDA has evaluated Allergan's Core Clinical Study data at four years for 715 women and determined that Inamed Silicone-Filled Breast Implants are safe and effective for use in breast augmentation and breast reconstruction.
The Allergan Adjunct Clinical Study
Enrollment for the Allergan Adjunct Clinical Study was limited to reconstruction and revision surgery patients who met certain inclusion criteria. Between 1998 and 2006, when enrollment was terminated, more than 80,000 breast implants were placed in over 50,000 women enrolled in the Adjunct Study. Safety data is collected at one, three and five years and is used as supplemental data to support the safety of Inamed Silicone-Filled Breast Implants.
While these studies continue to collect information specific to Inamed Silicone-Filled Breast Implants, the National Institute of Health's Institute of Medicine (IOM) released a landmark 400-page report entitled "Safety of Silicone Breast Implants." This 1999 report on the safety of silicone concluded "There is insufficient evidence to support an association of silicone breast implants with defined connective tissue disease." The IOM also stated "There is no convincing evidence for atypical connective tissue disease or rheumatic disease or a novel constellation of signs and symptoms in women with silicone breast implants."
Part 3: Breast Augmentation Guide: Communicating with Your Breast Augmentation Surgeon
Part 4: Breast Augmentation Guide: Factors to Consider when Choosing Breast Implants