Breast augmentation is a surgical procedure to enhance the size and shape of a woman’s breasts. Some of the variables discussed in Part I of this article included implant size, shape, and surface texture. Some additional choices will be discussed here, along with my thoughts based on an experience of more than 1,000 augmentation procedures.
Implants can be placed “over” or “under” the chest wall muscles (and sometimes a combination of the two). I believe that submuscular (“under”) placement is preferable in most cases because the muscle acts like an internal bra to support the weight of the implant and minimize future sagging, the extra padding provided by the muscle reduces the chance of feeling wrinkles in the implant surface, the risk of capsular contracture is less, and implants interfere less with mammograms when they are under the muscle.
Saline (salt water) filled implants remain available, but the Food and Drug Administration (FDA) reapproved silicone implants in late 2006 when studies exonerated silicone as a cause of human illness. Silicone is especially beneficial for thin, small-breasted women because it has a more natural feel, but saline implants remain a good choice in women that have enough breast tissue and body fat to cover the implant.
The incision through which an implant is inserted can be in the armpit or under the breast, but my preference is for an incision along the lower border of the areola. This approach allows good visualization, leaves a very faint scar, and can be reused in the future in case an implant needs to be replaced. A few doctors insert implants through the bellybutton, but this is not a generally accepted technique at present.
A qualified plastic surgeon will guide his or her patient through the maze of different augmentation options to give a result that she wants, rather than one simply conforming to the doctor’s preferences. Patients who are well educated preoperatively are generally the happiest after their breast augmentation.
For more information, please call Edward Pechter, MD at 661-255-2151, e-mail drpechter@aol.com or visit www.drpechter.com . Located 25880 Tournament Road #217, Valencia 91355.