Types of Implants
When you're planning breast augmentation in Sacramento, you'll find there are things to learn about breast implants and choices to make. But you won't make decisions alone. After you've learned the basics, jot down your questions and request a consultation with Dr. David Kaufman or Dr. Christa Clark. They'll work with you to settle all the details and create a surgical plan that fits your needs.
Here are some of the breast implant facts you need to know.
Saline vs. Silicone Filling
Put simply, breast implants are filled with either saline or silicone. The outer shell of the implant is the same in either case. Saline is sterile salt water, already present in large quantities in the human body. As a viscous, inert gel, silicone filling is non-reactive in the body. The Food and Drug Administration (FDA) re-approved silicone gel filling in 2006 after years of extensive study. Now, women seeking breast augmentation in Sacramento and across the country have a choice of filling.
Ready to know more? Read articles on silicone safety and the information below about breast implants. Sacramento plastic surgeons Dr. Kaufman and Dr. Clark have gathered this material to help you learn about how implants differ from each other.
Filling and sizing
Saline breast implants are placed inside the breast pocket, then filled with an amount of saline solution that can vary within a given range. The surgeon then removes the fill tube and closes the port. The surgeon can compensate for small differences in breast sizes to improve symmetry when needed.
Silicone breast implants are filled and closed by the manufacturer. They don't offer the opportunity to make adjustments in size. They come in many sizes so Dr. Kaufman and Dr. Clark can select the implant needed for your desired result and to adjust for pre-existing asymmetry, if needed.
Rupture
You will not need to change your implants at arbitrary time points. If you should experience a rupture in a saline implant, the fluid will leak out (quickly or slowly) and be harmlessly absorbed by your body. You should get the implant replaced within about a month so your breast pocket doesn't change.
It's harder to know when a silicone implant ruptures. If the shell is only slightly damaged, the silicone gel may not leak at all. If it does, it may still remain within the breast pocket - this is called an intracapsular leak. In extracapsular leaks the material migrates outside the pocket.
The FDA suggests women with silicone implants have periodic MRI tests to check for leaks. Due to the cost, this may not be realistic for many patients. And if there is a leak that can't be detected by look and feel, there may be no need to change the implant at all. Studies have shown that silicone gel poses no danger within the body.
Mammograms
No matter which implant you choose, you'll have mammograms as you normally would. Your technician should be informed of your implants and take special views. Mammograms are somewhat less able to pick up abnormalities in women with breast implants, with silicone hampering the view more than saline. That said, women without implants don't tend to discover breast cancer any sooner than women with implants, and the survival rate is similar.
Look and feel
Breast augmentations with silicone and saline implants look much the same. Visible implant rippling can occur in women lacking enough tissue to cover the implant and those with thin skin.
Women are always concerned about the feel of their breast implants. Sacramento patients want their breasts to feel natural, that's why so many choose silicone implants. They feel more like natural tissue - soft and pliable. Especially for women who have little breast tissue to cover implants and those thinking about "going larger," silicone can be the best choice.
Round vs. Anatomic Shape
Round and anatomic (teardrop) are the two primary shapes for breast implants. The decision about which to use is primarily based on patient preference.
For most women, we tend to suggest round implants. Anatomic saline implants seem to have a bit higher incidence of leaks, and a recent study shows it's hard to tell the difference in implant shape after surgery. Round implants also help give more volume at the top of the breast where most women lack tissue.
Anatomic silicone implants can be the right choice after breast cancer treatment when very little tissue remains and the implant makes up almost the entire breast.
Moderate, Moderate Plus, High Profile
When learning about implants, there's a concept most women take a little time to understand: that of "profile." Simply put, it's the degree to which breast implants project, or "stick out" from the chest wall. It's an important concept because, no matter if your plan is to be a little or a lot larger, looking natural after surgery depends on the right combination of profile and base width in addition to volume.
For instance, if your frame is relatively large, you will likely look best with an implant with a larger base width and moderate profile, or perhaps moderate plus. This choice will fit the natural shape of your body best. On the other hand, if you're a petite woman, you will need a smaller base width and moderate plus to high profile implant.
Round breast implants are offered in these three profiles. Starting with a 13-centimeter diameter, a common breast base size, the "moderate profile" model has a volume of 275 cc (cubic centimeters). The "moderate plus" implant has a 400 cc volume, and the "high profile" model has a 500 cc volume.
Our goal is to identify the right implant to create cleavage without causing the implant to spill over the sides of the chest. This is the "base width" we use for selecting breast implants for the patients we work with.
Smooth vs. Textured Cover
Breast implants can have either a textured or smooth cover, and there's still debate among plastic surgeons about which is better. Implants with smooth covers move inside the breast pocket while textured implants don't move. Some studies have indicated that textured shells lead to fewer complications like capsular contracture, but other studies have shown the reverse to be true.
When working with a patient who does not have a lot of extra skin and does not need the implant to "anchor" the breast, we most often select implants with smooth covers. Textured covers can be a good choice for anatomical implants. We also recommend them for patients with significant droop or redundant skin - weight loss patients, for example. Read more on breast surgery after weight loss at our post bariatric specialty site.
Take the Next Step
If you've spent time reading about breast implants, take a moment and view before and after photos of real patients. We hope you'll see that selecting the right implant is both a science and an art. We also hope that the enjoyment and satisfaction Dr. Kaufman and Dr. Clark get from creating beautiful, natural results is obvious.
We look forward to welcoming you soon to our quiet, private offices at 2220 East Bidwell Street in Folsom. Call us at (916) 235-8838.
