Breast Augmentation increases the volume of the breasts with the use of an implant. Women who desire breast augmentation are usually unhappy with the size of their breasts and want them to be slightly or significantly larger. Women who choose to have breast augmentation have many motivations. Some women feel that their breasts are out of proportion to the rest of their figure. Others are very self-conscious wearing formfitting tops or swimsuits because of small or disproportionate breasts. Many women lose breast volume with pregnancy and breast feeding or weight loss and want to regain volume and improve the shape of the breast. Others have a significant difference in the size of their breasts that they want to correct. Many women wear bras that give the impression of larger breasts for years before deciding to pursue breast augmentation.
At your first breast augmentation consultation with Dr. William Koenig, a detailed medical history will be taken including current and past medical conditions, medications and allergies, personal or family history of breast cancer or other breast issues, and the results of any prior mammograms. Dr. Koenig will then discuss with you the breast shape and overall size that you desire your breasts to be. Sizer breast implants will be available at your consultation to be placed in your bra to aide with volume decisions and expectations. Limitations based on the quality of the skin or characteristics of the breasts before breast augmentation surgery will be discussed. Most patients desire a natural appearing breast but some patients prefer a breast with more upper pole fullness. Dr. Koenig will review all options with you before you decide. The relative advantages of saline, silicone, and gummy bear implants will be reviewed and recommendations given.
Breast Augmentation: Implant Options
There are currently three implant options for prospective breast augmentation patients to consider.
Saline implants have a long record of safety and satisfaction. The implant is a silicone shell that is filled with saline or salt water at the time of operation. The implant has the lowest rate of capsular contracture when compared with silicone implants and is almost always placed in the submuscular space. The best patients for these implants are those who have a significant amount of their own breast tissue. The disadvantages of saline implants are how they feel. Since they are water filled, there is little viscosity to the inside of the implant and the difference in feel between the implant and the surrounding breast tissue is often noticeable. This can result in a rippling feeling and rarely visually noticeable rippling. These issues are most noticeable in the slim patient who has little breast tissue. When a saline implant ruptures or leaks, the saline will harmlessly be absorbed by the body and the implant will need to be replaced. Some patients take comfort in the fact that they know the implant is intact and will know when and if it ruptures.
Silicone Gel-Filled Implants
Silicone gel implants were reintroduced in 2006 after being off the market in the United States since 1992. They are now the most highly studied medical device and it is clear that these implants are safe for use in breast augmentation. Silicone implants are very popular because of their natural feel. Since they are gel filled, they are difficult to distinguish from the surrounding breast tissue and can be placed above or below the muscle. In the past, the silicone has been thinner and more like a liquid but current silicone implants have a thicker more cohesive gel. There is a higher rate of capsular contracture with silicone implants as compared to saline implants. To detect an implant rupture an MRI will probably be necessary.
410 Cohesive Implants (Gummy Bear Implants)
The Cohesive implant is the newest implant to hit the market and has only been available since 2013. The implant is form stable which means it is a true tear drop shaped implant. There have been shaped implants in the past but since the fill material was never a stable shape, the implants acted like round implants when they were placed in the body. These implants may give a more natural shape to the breast in some patients. The gummy bear implants have a textured shell and are firmer to the touch than other silicone implants. A larger incision is needed to insert the implant. There are many more size and shape options with this implant and a more custom result can be achieved in some patients. The rate of capsular contracture is lower compared to other silicone implants but there is a chance of rotation of the implant which may require correction.
- Breast Augmentation Guide
- Breast Augmentation Guide: Part 2
- Breast Augmentation Guide: Part 3
- Breast Augmentation Guide: Part 4
For more information about this procedure, call 585.244.1000 or send us a message.