The Implant

The implant will be placed through one of the incisions made to perform the lift and is usually positioned below the muscle. Determination of whether a silicone (gel) or saline implant is used, as well as the size of the implant will be discussed during your first consultation. Often times, Dr. Parson will ask patients to bring in pictures of their desired size and shape. This helps foster communication between you and Dr. Parson so that we can help you achieve your desired results with reasonable expectations.

Several varieties of implants have been developed for breast augmentation over the last several decades. The implants used today in the United States all have a silicone shell. One type is filled with saline, the other with silicone. Saline implants have the advantage of being able to be adjusted intra-operatively because they are implanted as a flat balloon, and then filled up with saline during surgery. These implants may be better suited for patients who have a significant size difference between breasts. The silicone-filled implants have the advantage of a more natural feel and may be better suited for women are thin and do not have a lot of breast tissue.

In addition, both implants 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. Lastly, there are several profiles of implants. Your chest shape, breast size and desired result will help us determine which implant is right for you.

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.

Every plastic surgeon has their preference for incision and each approach has its benefits and disadvantages. No one way is correct all of the time. Dr. Parson varies his choice of incision depending on the specific characteristics of the individual.