Breast Augmentation Options and Types

Houston - Sugar Land - Katy, Texas

Saline vs. Silicone Breast Implants

There are two types of breast implant materials - saline and silicone gel. Saline breast implants have a thin shell, like a bag, which is filled with a saltwater solution to achieve the desired size. Because they are placed while still empty and deflated, saline breast implants can be inserted through very small incisions that are easily hidden. Additionally, saline breast implants are generally slightly firmer in feel than silicone gel implants.

Meanwhile, silicone gel implants (commonly referred to simply as "gel" implants) come in various sizes pre-filled by the manufacturer. They must be placed using larger incisions, but many patients prefer the naturalistic look and feel of the silicone implant over saline breast implants. Silicone gel mimics the softer feel of real breast tissue, making it difficult to tell that implants have been placed at all.

Rippling - a wrinkling of the breast implant's surface that is occasionally visible through the breast tissue - can occur with either type of implant, but it is slightly less common with silicone gel implants.

Both saline and silicone breast implants have the potential for rupture. When a saline breast implant ruptures, the salt water solution contained within the shell will leak out, causing your breasts to "deflate" and making it obvious that a rupture has occurred. However, the gel used in silicone implants is designed to stay in place during a rupture, making it difficult to tell when one has occurred. If you have silicone breast implants, Dr. Kutty recommends having a periodic evaluation by MRI to check for possible rupture.

Incision Sizes

Saline implants are placed when empty. This allows them to be rolled up tightly and placed through a very small incision (which is placed where it can be easily hidden). In contrast, silicone gel implants are pre-filled as a single unit, and will therefore require a slightly longer incision. However, this incision is still strategically placed where it will be least visible. In some cases, Dr. Kutty will use a special device to further reduce the size of your incision for silicone gel implants.

European PIP Breast Implants

You may have recently read that France and the United Kingdom have been publicizing concerns about silicone gel breast implants manufactured in France by a company called Poly Implant Prothese (PIP).

It was recently discovered that PIP used industrial grade silicone gel in those implants, instead of gel manufactured specifically for medical use. Because of this, the breast implants are more prone to rupture than other gel implants, and this can allow gel to leak into surrounding tissues.

It is estimated that 50,000 women in the UK and 30,000 in France have the PIP breast implants, and their respective governments have begun advising the women to consult their surgeons about the necessity of removing them. It is possible that women who had breast implant surgery in the United States have implants made by PIP, but those were likely pre-filled saline implants.

PIP implants have been imported into the US by PIP/USA until 2000. If you had breast implant surgery abroad, or are concerned that you may have PIP implants for any other reason, contact your surgeon to find out whether removal of the implants is advisable.

Breast Implant Generation Bleed

Silicone gel implants were introduced many years ago, and have undergone several transformations since then. Early implants were filled with a viscous gel that easily leaked out when the shell ruptured. Over time, the technology of breast implants has changed and improved. Today's implants have a gel that is less likely to leak in the event of rupture.

Earlier breast implants also had more "bleed" of the gel, which is a slow transfer of gel through the shell. This has also been significantly reduced with current breast implants.

Breast Implant Manufacturers

Most breast implants in use today are made by two manufacturers, Allergan and Mentor. Both companies produce implants that are similar in quality, but have slightly different offerings in terms of size, shape and implant profile. Each also produces both saline and silicone gel implants.

Beware of the use by some practitioners of lesser-quality implants. These are far less expensive, and are used by some practitioners to make more money on the procedure or offer it at a much lower price. Either way, a modest amount saved on breast augmentation surgery is not worth the higher likelihood of problems later on.

Breast Implant Warranty

Both of the major breast implant manufacturers offer warranties on their breast implants. This includes free replacement of the implants in the event of rupture, as well as a certain amount toward the cost of surgical and facility charges to replace a ruptured breast implant. The warranty generally also covers replacement of the opposite side implant as well.

Breast Implant Sizing and Cup Sizes

During your consultation for breast augmentation surgery, a significant amount of time will be devoted to determining the breast size and shape that you want to achieve. Dr. Kutty will provide you with a "sizing bra" that allows you to actually try on different implants. This is an excellent opportunity for you to see if what you had in mind looks the way you hoped.

Breast implants are available in a large variety of sizes, from 120cc to 800cc. While you are trying on different sizes, you may realize that you feel more comfortable with larger or smaller implants than you intended. This allows Dr. Kutty to plan your procedure precisely.

It is important to note that cup size does not necessarily equate breast implant size. The final size of your new breasts will be affected by:

• The amount of pre-existing breast tissue
• The shape of your breasts
• The shape of your chosen breast implants
• The manufacturer of the bra you wear (manufacturers often try to make women feel better by printing a larger cup size on the label)

Implants are made in many shapes as well, the most common being round. Some are a teardrop shape to provide more fullness in the lower part of the breast. Even round implants are made in several different "profiles" to provide more or less projection from the chest.

Implant-Related Problems

Any surgical procedure carries with it the potential for post-operative problems, but breast augmentation complications are unusual, as long as your procedure is performed by an experienced breast surgeon.

If you have suffered complications or poor results with a prior breast augmentation, Dr. Kutty can help correct these problems, including:

• Breast implant rupture
• Inappropriate size
• Asymmetry
• Capsular contracture

Capsular contracture is a "hardening" of a breast implant, which can potentially occur many years after breast augmentation surgery. There is thought to be a slightly lower incidence of this problem with the use of textured implants, which have a pebbly appearance and feel on the surface (this cannot be felt through the skin). There is also a slightly lower incidence when the implant is placed behind the muscle.

Breast Augmentation Incision Types

Breast augmentation surgery can be performed via many different incision locations, including:

• In the fold under the breast
• At the edge of the areola
• In the armpit
• Through the bellybutton

Your incision location will be based on the type of breast implant you chose, whether it is being placed behind or in front of your chest muscle, and your own personal preference. None of the incisions require suture removal. Dr. Kutty will provide advice on how to minimize the appearance of your scar after surgery.

Breast Implant Placement Options (Over/Under the Muscle)

Breast implants are placed in one of two locations - in front of or behind the pectoral muscle. Placement in front of the muscle allows for a shorter recovery time with minimal post-operative discomfort. There is also less likelihood that your implant will move with arm motion. Silicone gel implants placed in front of the muscle provide a very natural shape and feel.

Placement behind the muscle allows saline breast implants to be hidden better at the upper part, and slightly lowers the chance of capsular contracture. However, there is slightly more postoperative discomfort with this placement method, and recovery can take several days longer.

Breast Augmentation Healing and Recovery

After breast augmentation surgery, recovery involves one week of rest without lifting. Normal activities are encouraged to facilitate healing. You are advised to avoid vigorous exercise for 3 weeks, but upper body strengthening type exercise can usually be resumed at 6 weeks. The incisions will be healed at one week. At this time, scar and implant massages are started. The support bra is worn for about 3 weeks.

Regular daily activities can be resumed almost immediately (including showering the same day). Ice helps relieve the modest discomfort after surgery. Swelling slowly resolves over the course of several weeks. Dr. Kutty advises waiting to buy new bras and swimsuits for at least one month.

Breast Augmentation With Breast Lift (Mastopexy):

After pregnancy and with aging, many women's breast tissue begins to sag and the skin stretches out. When your breast skin becomes loose, your nipple can fall into a lower position. A breast lift alone can be performed to reshape the breast tissue and bring the nipple to a more normal position in front of the breast. However, if you are looking to achieve more breast volume, a breast implant can also be placed to achieve the desired effect.

Recovery time for a combined breast augmentation/breast lift is the same as for breast augmentation alone. The same options for implant location (behind or in front of the muscle) and incision locations are available. Each of these options produce subtle differences in the final breast shape. Dr. Kutty will work with you to find just the right approach.

Breast Augmentation as Part of a Mommy Makeover

Body changes after pregnancy include:

• Loss of breast volume
• Sagging breasts
• Loose abdominal skin
• Abdominal muscle laxity

Dr. Kutty can help you address all of these problems with a mommy makeover. This includes reshaping the breast (with or without breast implants), breast lift, and abdominoplasty. These can safely be done at the same time, allowing for just one recovery and one instance of anesthesia.

A mommy makeover can also include liposuction or other procedures, depending on your cosmetic goals. Only those things that can safely be done in one surgical sitting will be performed. Procedures can be broken up if necessary. Your safety is always our primary concern.

If you are interested in breast augmentation, please contact us at (281) 606-4919 to schedule your initial consultation with experienced Houston cosmetic surgeon Dr. Malik Kutty. Luxe Plastic Surgery serves patients in the Houston, Sugar Land, and Katy areas of Texas.