Breast Augmentation Article

For Hilton Head Island, Bluffton, SC, Beaufort, SC and Savannah, GA.
An Informative Article by Frederick G. Weniger, M.D., F.A.C.S.

Summer and beach weather are just around the corner! As spring begins, we are already seeing the surge of women getting ready for the swimsuit season. Breast augmentation seems to be once again topping the wish list for new patients in the plastic surgery office.

Despite our country’s interest in and acceptance of breast augmentation, women have many questions about this procedure. The volume of circulating misinformation about breast implants is astounding and confusing to many women.

This article presents scientific data from published, peer-reviewed clinical studies in order to answer some of the most common questions about breast augmentation. Hopefully, this factual approach to a sometimes emotional topic can help women to make whatever choice is best for them. Happy sunbathing! (with sunscreen on…)

The Basics

Breast augmentation helps women by adding volume (size) to the breasts. Patients getting breast augmentation usually fall into 1 of 2 categories. The younger group of women (in their 20’s) was never happy with their breast development at puberty. The second group is mothers who hope to correct the “deflated” look of their breast by achieving a more youthful fullness.

In contrast, for some mothers, the problem can be more than just a lack of breast fullness. These women may have drooping of the breasts characterized by nipples which point down instead of forward. Such patients will benefit from a breast lift (mastopexy) which can sometimes be done by itself or in combination with breast implants for added volume and perkiness. Still other women experience drooping of the breasts, but actually would prefer that the breasts were smaller as opposed to larger. For such patients, a breast reduction would be beneficial.

Breast augmentation is an outpatient procedure lasting approximately 1 hour. Most patients can return to work after a long weekend. Most women can resume their full aerobic exercise routine 4 weeks after breast augmentation.

Breast Implants Safety

Hilton Head Island, Bluffton and Savannah GA

Breast implants are among the most studied of all medical devices. During a 14 year moratorium (delay) on the cosmetic use of silicone gel implants, literally thousands of studies on breast implants safety and effectiveness were reviewed. No research was found to support claims that silicone breast implants had caused autoimmune diseases (Lupus, Rheumatoid Arthritis, etc.) or other systemic diseases. Therefore, in the fall on 2006, the FDA once again made silicone gel implants available for cosmetic breast augmentation. Now patients may choose either silicone or saline breast implants for their cosmetic augmentations.

This is not to say that patients should regard breast augmentation as a risk-free endeavor. All surgery carries with it surgical and anesthetic risk, and breast augmentation also poses the risk of implant-related complications. For example, breast implants (like all devices implanted in the body) form scar tissue capsules around them. These capsules can harden and hurt the appearance and softness of the breasts. Also, nipple sensation can be affected. Although most patients have temporary postop numbness which returns to normal, some patients can have a permanent decrease or loss of nipple sensation, while others have a permanent increase in sensation. Additionally, there is a risk of implant rupture that is about 1% per year for both saline and silicone-filled implants. A few studies suggest that breast augmentation may affect a woman’s ability to breast feed in the future as well. Patients should also note that after breast augmentation, gravity will cause stretching of the breast over time (ptosis), and that this stretching will be more severe when larger (heavier) implants are placed.

Despite these risks, breast augmentation does not affect a woman’s chance of developing breast cancer. Furthermore, the ability to detect a breast cancer by mammography is not decreased by breast augmentation so long as the implants are placed under the pectoralis major muscle, and so long as the appropriate 5-view mammogram is done.

Augmentation Choices

At this time, the vast majority of breast implants used are smooth, round implants, as opposed to textured or shaped devices which were more popular several years ago. Most implants are now placed underneath the pectoralis major muscle, giving the advantage of a hiding the implants better, making mammography easier, and in many cases, giving a more natural result. More than 90% of breast implants are placed through small incisions in the fold underneath the breast (inframammary fold), although implants can also be placed through incisions in the armpit as well as through incisions around the border of the areola (pigmented skin around the nipple). Placement of implants through a belly-button incision has not gained popularity with either surgeons or patients.

Patients must also choose between silicone-filled and saline-filled breast implants. Silicone implants have the benefit of being softer and more natural-feeling. In contrast, silicone implants are also more expensive and require a slightly longer incision to insert the implant. Also, the FDA requires that an MRI be done to evaluate for silicone implants rupture every 2 years which can be expensive. Finally, the chance of forming hard scar tissue (capsular contracture) around the implants is higher with silicone implants than with saline as well.

Finally, patients must choose the size of implant. Often patients can often “shop” for their new breast size by trying on different size implants, which can be both fun and confusing for some patients as it is difficult to make a final decision about size. Although one study showed that 90% of women wished they went bigger, it is important to keep in mind that larger implants increase the risk of certain complications. Additionally, not any size implant will fit reasonably for any patient. For this reason, the sizing process is something to be worked through with your Plastic Surgeon and his/her staff.