Everything you wanted to know about Breast Implants, but were afraid to ask

1. What to do before seeing a Plastic Surgeon.

The first step is to get a small pad and carry it around with you to write questions down as you think of them. Next, peruse the web to get some basic information, but not too much. There are sooo many self proclaimed ‘experts’ out there giving you wrong information. Next, it’s time to pick a Plastic Surgeon. You may try to go on sites that rate different physicians such as RateMD.com. Speaking to friends to try to get referrals is also very important. Make sure that your surgeon is a board certified Plastic Surgeon. You may also consider going on a physician profile web site (usually state run) to see if there are an unusual number of cases brought against them. Ask to see actual before and after photos of the doctors work. http://www.taranow.com/TAR_List.asp?type=Proc&data=Breast_Augmentation

Don’t be afraid to insult the doctor with any questions you may have. Consider his/her personality. You will be having a ‘foreign body’ (implant) inserted inside you and you want to make sure that this surgeon is one you feel a connection to and know that they will be available to you if ever you have a question or problem. Ask them how many breast augmentations they perform each year.

2. What are the different types of incisions used to place the implants?

There are four types of incisions:
a. Transaxillary- armpit incision
b. Periareolar- around the bottom of the areola (colored area below the nipple)
c. Inframammary- in the crease below the breast
d. Transumbilical- through the belly button

My favorite is the transaxillary incision which leaves no scar on the breast. The periareolar is my second favorite with the scar hidden in between the dark area of the lower areola and light area of the breast skin. The inframammary is the easiest and most commonly used incision, but it leaves a visible scar on the bottom of the breast and may become darker especially in Hispanic or Dark Skin patients. The transumbilical is the furthest incision from the breast and a long tunnel must be made to insert the implants.

3. Types of implants.

There are two different types of implants:
Saline- salt water filled
Silicone- silicone gel filled
Saline filled implants are safe and do not require any monitoring outside of the recommended yearly mammograms for breast cancer detection. They are known to ‘ripple’ or develop small creases on the outside of the implant which may in some instances be felt or even seen. Silicone implants tend to feel more ‘natural’ and ripple much less. As such, they are not as easily felt or seen through the skin. The silicone implants are recommended to have an MRI three years after their placement and every two years there after to monitor for leakage.
The outside of the implant called the shell comes in two different types. Smooth (just like it sounds) and textured (fuzzy outside). Both types are made of a solid (non-gel) silicone. The type used is based on the surgeons preference. I allow the patient to decide which implant best fits their situation and lifestyle. Make sure you ask your surgeon to let you feel the implants.

4. Round versus shaped (anatomical).

The round implant is the most common breast implant used today. Some surgeons prefer a shaped or anatomical implant. The choice of implant is based solely on the surgeons preference.

5. Placement of the implants.

Submuscular- under the chest muscle (under the breast) and subglandular-under the breast tissue on TOP of the chest muscle are the two options. Placement depends on you shape, size, chest wall, implant selection and physician’s preference. More commonly, I place my implants under the muscle unless there is significant breast droopiness (ptosis), very wide cleavage or sternum (breast bone) or tubular type breasts.

Implants just like hip replacements etc are man made and will NOT last for life. The saline implants are easy to diagnose when they leak as your breast will rapidly deflate over several days if one leaks. The leaking silicone implant may not be detectable without performing an MRI. The implant companies warrantee their implants for several years and there is even a low cost insurance available through the companies that you may consider.

Please feel free to watch my video on Breast Augmentation in my Video Gallery-Breast Augmentation by Dr Douglas Taranow