Breast Augmentation

The Implant
Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an implant has been rigorously researched and tested, and reviewed by an independent panel of physicians for safety. Silicone implants are FDA approved for augmentation in women age 22 and older. Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Regular examinations for breast health and to evaluate the condition of your implants are important whether you have chosen saline or silicone breast implants.

The size of a breast implant is measured in cubic centimeters (ccs) based on the volume of the saline or silicone filler. Breast implants vary both by filler and in size, but there are additional features to consider:

• Texture: the implant shell may be smooth or textured
• Shape: the implant may have a round profile or one that is anatomic (teardrop or tapered shape)
• Profile: the implant may have a low, medium or high projection (the depth of the implant from the base to the highest point of the implant curve)
• Diameter: the width of the implant measured across it's base (the side of the implant that will be positioned over the chest wall)

Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a woman's breasts are fully developed prior to placement of breast implants.

The saline-filled implants in use today come in various forms. The silicone shell may be smooth or textured. Dr. Parson prefers the smooth kind because of the problem of visible wrinkling and unnatural feel that has been associated with textured implants. Implants also come in two shapes, round or anatomical. The "anatomical" implant has a tear drop shape that theoretically creates a more natural looking breast. In practice, however, the round and anatomical implant has the same appearance when implanted and the anatomic implant carries the risk of an unnatural feel. Dr. Parson uses the round implant.

Level of Placement
In addition to several types of incisions and implants, there are also two possible locations for placement of the implant. The implant can be placed beneath the breast tissue, but on top of the pectoralis muscle. The second, more common method is to place the implant beneath the pectoralis muscle, between the pectoralis and the ribs.

The advantages of placing the implant above the muscle are that it is less painful for the first few days and the appearance of the implanted breast matures faster. In addition, contraction of the pectoralis muscle, more noticeable in body-builders, has no effect on the appearance of the breast.

The advantages of placing the implant under the muscle are several. First, it provides a more natural appearing breast with a better transition from the upper chest to the breast mound. Second, the rates of scarring around the implant are significantly lower when the implant is placed beneath the muscle. Third, the risk of visible ripples or folds in the implant envelope (a more common problem with saline than with silicone implants) is diminished because of the greater amount of the patient's own tissue overlying the prosthesis. Fourth, the ability to obtain an adequate mammogram is enhanced with placement under the muscle, as the mammogram technician is better able to separate the breast from the implant when the muscle is interposed.

With the exception of patients who are body builders, Dr. Parson recommends the sub-pectoral technique to his patients.

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