Breast Implants
Breast Implants Guide
Written By: Dr Krisie McNealy Reviewed: 03 August 2010
Breast implants are used to enlarge and reshape the breasts during breast augmentation and some types of reconstructive breast surgery. They can also be used to correct size differences in women with asymmetrical breasts. Whether you want to reverse changes caused by pregnancy or weight loss or you just wants larger breasts, breast implants can create the look you're looking for.
What are Breast Implants
Breast implants are like a balloon made from a tough but flexible outer silicone shell. The shell is filled with either silicone or saline (salt water). In the early 90s, silicone breast implants were taken off the market due to safety concerns, but they are now available again, and are considered safe.
Generally, silicone filled implants are considered softer and smoother, and feel more realistic than saline implants. Silicone implants come pre-filled, so they require a larger incision for insertion, but they can be placed either over or under the muscle. Because of the concern for silent rupture of saline implants, MRI scans are recommended every few years to make sure the implants are intact.
Saline implants feel more like a water balloon. Because they are more likely to ripple, they are usually only placed under the muscle. However, because some saline implants can be filled after they are inserted, they have the advantage of being able to be inserted through smaller incisions.
There have also been breast implants available with other fillers, including soy oil and hydrogel, but these are no longer on the market.
Types of breast Implants
Breast implants come in a variety of profiles, shapes and textures. The breast implant which will work best for you depends a lot on your own anatomy.
For example, high profile implants work well for women with a narrow breast base, while moderate profile implants are better for women with wider breasts. The profile determines how far the breast projects out from the chest, with higher profile implants having a narrower base and projecting out further.
Breast implants can be either round, or have an anatomical teardrop shape. While many people assume that round implants look less natural, they actually assume the same shape as anatomical implants when held in a vertical position. Round implants have the advantage of looking the same regardless of how they turn within the breast. Anatomical implants on the other hand, must stay in one position.
Breast implants can either be smooth or textured. Textured implants are less likely to form capsular contractions, but they are also more visible under the skin. Anatomical implants are always textured to help them stay in the correct orientation.
All breast implants on the market today should last for at least ten years, but can last longer.
Breast Implant Placement
Breast implants can be placed either over or under the pectoral muscles of the chest. While silicone implants can be placed in either position, saline implants are usually placed under the muscle to reduce the appearance of rippling.
Each location has its own advantages and disadvantages. When implants are placed over the muscle the surgery and recovery are easier and less painful, and larger implants can be placed. However, placing implants over the muscle makes it easier to see ripples, increase the risk of capsular contractions and the risk the the implants will bottom out.
When implants are placed under the muscle, it is easier to see breast tissue on future mammograms, and the edges of the implant are more difficult to see under the skin. It is also less likely that the implant will sink on the chest. However, placing implants under the muscle makes recovery more painful, and the implants can be distorted when chest muscles contract.
Complications of Breast Implants
All surgery carries certain risks, such as infection, bleeding, scarring and pain. After getting breast implants, specific complications you may experience include:
- Bruising and hardness of the breasts.
- Rupture of the outer shell of the implant causing leaking, and possibly the need for more surgery.
- Scar tissue formation around the implant called capsular contraction requires additional surgery to remove and replace the implant.
- Breast implants can shift or rotate out of place.
What to Expect with Breast Implants
Consultation
Before getting breast implants, you'll need to have a consultation with your surgeon. During the consultation, your surgeon will examine your breasts, and recommend the shape, size and type of implant they think will work best with your body type, as well as the type of placement and incision site.
Your doctor will discuss the potential risks and complications of having breast implants inserted. Then, they will give you instructions for before and after your surgery.
Before Breast Implant Insertion
If you smoke, you will be asked to stop before surgery, because smoking can interfere with healing. You may also be advised to stop taking certain medications which could cause problems with bleeding during surgery or healing after surgery.
You'll need to buy a supportive bra without an underwire to wear after surgery.
Before surgery, a nurse will examine you and check your blood pressure, heart rate and breathing rate. Shortly before your operation, your surgeon will examine your breasts again. They may take measurements, or mark on your skin with a marker to help guide them during surgery.
During Surgery
Breast implants typically take 1 to 2 hours to insert. Once you are in the operating theatre, the anesthesiologist will use special medications to put you to sleep. Then your surgeon will clean the skin around your incision sites and begin the surgery. Once the surgeon makes the incision, they will make a space for the implant, and then insert it. If neede, your implants will be filled after they are inserted.
Small plastic drains may be placed in your breasts and left for a few days. Your incisions will be stitched closed with sutures, and your breasts will be bandaged with a supportive dressing or bra.
After Surgery
After breast implants are inserted, you'll experience some pain, but you'll be given medication to help you feel comfortable.
Depending on your surgeon, and your condition, you may stay in the hospital overnight or go home the same day as your surgery. Either way, you'll need someone to drive you home, because of the general anesthesia used when implants are inserted.
While you recover, you'll need to wear a supportive bra day and night. It's normal to have some swelling and bruising of your breasts. If drains have been left in place, they'll be removed after a few days. After 7 to 14 days, any stitches that need to be removed will be taken out.
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