About Breast Implants
You have choices to make when it comes to breast implants. Sacramento plastic surgeons Dr. David Kaufman and Dr. Christa Clark encourage you to learn all you can, then request a consultation. They'll talk you through the pros and cons, show you different implants and make recommendations based on your body type and goals.
Here are some of the basics you need to know.
Filling: Saline vs. Silicone
Breast implant shells are all made of the same material; it's the filling that differs. Saline filling is essentially salt water, which makes up about 70% of the human body. Silicone filling, a viscous gel, is inert and non-reactive. Silicone gel was recently re-approved by the Food and Drug Administration (FDA) for breast augmentation in Sacramento and across the country after a careful review of its safety and efficacy.
Browse studies on silicone safety and other information we've gathered for you. And read on to find out more about how saline and silicone implants differ.
Filling and sizing
Saline implants are inserted into the breast pocket and filled with varying amounts of fluid (within a certain range). The fill tube is then removed and the port closed. The surgeon can make up for small differences in breast volume to achieve better symmetry.
Silicone implants come pre-filled and do not allow for size adjustments.
Rupture
Patients do not need to plan specific times to change their breast implants. Sacramento women do need to be alert for possible ruptures, however. If a saline implant ruptures, the leak can be fast or slow. You will notice deflation as your body absorbs the fluid. It's a good idea to get your implant replaced within about a month to avoid breast pocket changes.
Ruptures and leaks in silicone implants are harder to detect. If the implant shell is slightly damaged, it's unlikely the viscous gel will leak. If it does, it may stay within the pocket (intracapsular leak) or migrate outside the pocket (extracapsular leak).
The FDA currently recommends periodic MRI screenings to test for leaks. This is unrealistic for many women due to the cost of these tests. Furthermore, if there is a leak that doesn't result in a difference you can see or feel, we believe changing the implant may not be necessary. Multiple studies have shown there is no danger from silicone gel. It has not been shown to cause fibromyalgia, rheumatoid arthritis, scleroderma or other conditions.
Mammograms
Patients with breast implants need mammograms as usual. You'll need to inform your mammographer so they can take special views. Interestingly, although mammograms are less sensitive in picking up abnormalities in women with implants - with silicone impairing the view more than saline - women who develop breast cancer tend to discover it at the same stage of the disease and experience a similar survival rate as those without implants.
Look and feel
Saline and silicone breast augmentations generally look the same. Visible implant wrinkling or rippling occasionally occurs in women with thin skin or insufficient tissue to cover the implant.
One of the most important considerations for patients is the feel of their breast implants. Sacramento women want their results to look and feel natural; that's why many choose silicone implants. They feel soft and pliable - more like natural breasts. For women who have small breasts and less tissue to hide implants, and for women who want to "go larger," silicone is often the best choice.
Shape: Round vs. Anatomic
Implants come in two primary shapes: round and anatomic (teardrop). Our choice is primarily based on patient preference. Anatomic saline implants tend to have a slightly higher leak rate, and one study demonstrated that it's hard to tell the difference between round and teardrop shaped implants after surgery. We most often use round implants because of these factors and to preserve volume at the top of the breast where most patients are deficient.
Anatomic implants are often a better choice when patients have no breast (after breast cancer treatment) or very little breast tissue. In those cases, the implants are usually silicone filled and they make up the entire shape of the breast.
Profile: Moderate, Moderate Plus, High
Round implants come in three profiles. Comparing implants with a diameter of 13 centimeters - a common breast base diameter – the "moderate profile" implant has a volume of 275 cubic centimeters (cc). The "moderate plus" profile model has a volume of 400 cc, and the "high profile" implant has a volume of 500 cc.
Ultimately, breast implants need to be wide enough to create cleavage without wrapping around the chest. This so-called "base width" is our starting point for selecting breast implants for Sacramento area patients.
Cover: Smooth vs. Textured
Breast implants can be covered with smooth or textured shells. There is great debate among plastic surgeons about which is better. Smooth implants move around in their pockets, textured implants do not. Some studies have shown fewer complications - specifically capsular contracture - with textured implants, but others have shown the opposite.
We choose smooth implants for women who do not have a lot of redundant skin and do not need the implant to "anchor" the breast. Textured implants can be best when anatomical implants are used or when patients have redundant skin or a lot of droop, such as a weight loss patient. Learn more about post bariatric plastic surgery for reshaping breasts after weight loss.
Take the Next Step
If you invest time in researching breast implants yet still have many questions, don't be discouraged. You're off to a good start - now take the next step and choose an experienced, board certified plastic surgeon like Dr. Kaufman and Dr. Clark. Selecting your plastic surgeon wisely is one of the most important choices you can make.
We look forward to meeting you and learning your goals. Request your consultation online or give us a call at (916) 235-8838.
