By Steven Yarinsky, MD
Breast augmentation is done to increase the size of a woman’s breasts. The procedure is commonly performed on an outpatient basis, in a specialized operating room which may be located at a hospital, surgery center or surgical suite at a plastic surgeon’s office. In November 2006, after over 15 years of scientific research and debate, the Food and Drug Administration (FDA) determined that silicone-gel-filled breast implants are safe and effective for use in breast augmentation and reconstruction. Women now can choose between saline- or gel-filled implants for their breast augmentation. There are a few key differences between saline and gel implants.
Saline-filled implants have been FDA approved for many years for women over the age of 18 and are filled with sterile saltwater solution from an intravenous bag similar to the fluid that makes up most of the human body. They have a slightly firmer feel than silicone gel. Saline implants have a more flexible fill volume since they are filled at the time of breast augmentation. Different implant surface textures are available: smooth or textured. A woman should speak with her plastic surgeon about which surface type would be best for her. The implants come in shapes to fit different women. Saline implants can be placed through smaller incisions since they are filled at the time of the procedure. Although leaks are uncommon, when saline implants leak, the saline is absorbed by the body and a “flat tire” results. The breast cup size diminishes and an implant replacement is needed. In my experience there is no such thing as a “partial” or “silent” saline implant leak.
The FDA has approved silicone gel implants for women who are at least 22 years old. Gel-filled implants have a softer feel and are prefilled at the factory. Different implant volumes, shapes and surface textures are available. Larger incisions are used compared with saline implants, since the gel implant are already filled before they are inserted in the pocket. In contrast to saline-filled, the gel-filled implants often rupture silently, with the gel contained by the scar capsule that develops around the implant. In this event, there may be no noticeable change in cup size. The FDA recommends that women have breast MRI studies every two years after silicone gel implant placement to detect “silent” leaks. The MRI may or may not be covered by a woman’s health insurance benefits and therefore may be an ongoing out-of-pocket expense that does not apply to women who choose saline filled implants. Ruptured gel-filled implants should be replaced. Ask your plastic surgeon about your implant warranty.
There are precautions for women to take when choosing a plastic surgeon to assist them, contraindications to having breast enhancement, and potential complications that should be understood and accepted by women before they have a breast augmentation. All of these issues should be addressed by your plastic surgeon. Your plastic surgeon should help you choose the right size and shape breast implant to fit your figure and make sure that you have realistic expectations of the results that are likely to be achieved.
Some women feel that any plastic surgeon can give them a good result with a breast enhancement. Nothing can be farther from the truth. Breast augmentation is actually a more difficult procedure than it seems when it comes to getting consistently decent results. Rather than price shopping, I advise you to find an experienced board-certified plastic surgeon who is a member of the Aesthetic Society who answers all your questions, shows you before and after photos that you like, and whom you feel comfortable communicating with. Then save or finance if needed to pay for your procedure. Many companies offer convenient monthly payments for cosmetic surgery loans. Don’t go cheap when it comes to your cosmetic surgery, since you may truly regret what you paid for.
The emotional effects of breast enhancement can be immensely positive. Women are able to fit the clothing they desire. They become happy with an area of their body that really bothered them psychologically. “Looking and feeling your best” took on new meaning with the results of a study published this year in the Aesthetic Surgery Journal. The article entitled““Better Sex from the Knife? An Intimate Look at the Effects of Cosmetic Surgery of Sexual Practices” showed that there are physical and emotional benefits to cosmetic surgery. “Cosmetic surgery patients overwhelmingly tend to feel better about their body” after their procedure. The majority of women surveyed found that their sex lives and those of their partners were “strikingly enhanced” after their breast or body contouring cosmetic procedure, giving them “a significant quality of life benefit”! The recent FDA approval of gel-filled implants has calmed women’s fears of health risks. If you are interested in having breast enhancement I advise you to educate yourself about options, have realistic expectations, and above all, do it for you!
Steven Yarinsky, MD is a Board-Certified Plastic Surgeon, member of the American Society for Aesthetic Plastic Surgery, and has been a staff member at The Saratoga Hospital since 1989. Dr. Yarinsky specializes in cosmetic surgery of the breasts, body and face. He has participated in the Inamed® silicone gel filled implant adjunct clinical study since 1999 and is certified by Mentor® and Inamed® to use both brands of silicone gel breast implants. His office is in Saratoga Springs, New York.
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