Current Trend in Breast Implant Size

The trend in cosmetic surgery nowadays is the natural look.  This is particularly true in breast augmentation that most patients are choosing implants which come in “conservative sizes.”

Anecdotal evidence shows that a significant number of patients choose breast implant sizes (described in cubic centimeter) between 350cc and 500cc.  They can provide enough volume especially in the upper poles without leading to inappropriately large, grapefruit-shaped breasts.

Women should remember that cc alone does not determine the final size, although in many cases a 150-200cc can increase the breast to one cup. 

(Important note:  Implants with a size of 250-350cc may transform a petite lady’s AA cup to D cup, while the same size may only increase the bust size of a larger and/or taller lady by a cup or two.)

Large breast implants usually start at 600cc, and women with a large body frame more often than not have no problem using them.  This is particularly true if they have sufficient amounts of breast tissue and fat, reducing the risk of visible and palpable wrinkling.

By contrast, large implants can be very problematic for thin and petite women not only because they often lead to a “heavy top look,” but they also result to higher risk of wrinkling and rippling.

Also, when large implants are used on thin women or patients with very little tissue, more often than not their breasts appear unusually round—the most common telltale sign of plastic surgery.

Meanwhile, there are two kinds of breast implants used in the US:  the saline implant which is filled with a sterile mixture of salt and water, and the silicone implant which contains a cohesive gel.

Currently, breast manufacturers in the US do not produce silicone implants larger than 850cc, even if there is no law prohibiting them to do so.  This is because common sense tells that excessively large sizes can lead to chronic back pain, longer recovery, stretch marks, and bottoming out which will eventually force a patient to downsize her implants.

But some saline implants, which are filled once inside the breast pocket, are larger than 850cc.  However, they are rarely used as [ethical] plastic surgeons will not push the body’s limit for the sake of aesthetic goals.  

Contrary to popular belief, patients can achieve a prominent cleavage without having to choose larger implants.  In fact, some smaller implants can provide this sexy feature by offering more projection.

Tips for Flat-Chested Women Considering Breast Augmentation

As its name suggests, breast augmentation is performed to augment the bust size of patients, making this particularly appealing to flat-chested women or those with AA and A cup.

Flat-chested women have very little tissue and fat, a feature which must be given importance to achieve natural results and prevent complications particularly wrinkling and rippling.

First and foremost, patients with small breasts should stay away from textured implants that have a rough surface, a feature always found in teardrop-shaped implants to prevent them from rotating and causing visible deformity. 

Some textured implants also come in round shape.  The theory behind this is that the rough outer shell can prevent the tissue from becoming too thick—a condition called capsular contracture—that it results to deformity and pain.  However, no extensive study has proven this claim.

Textured implants, particularly those with large “graininess,” should be avoided by flat-chested women because they face a higher risk of palpable and visible wrinkling.  For this reason, they are generally advised to choose smooth implants, which are also believed to last longer because they are less prone to “folding” that can lead to rupture over time.

Aside from smooth shell, the breast implants for flat-chested patients are ideally filled with silicone gel rather than saline (or a sterile mixture of salt and water) to simulate the feel of natural tissue—something which they definitely lack.

The result between the saline and silicone implants is the same when there is an ample amount of tissue and fats, although this is not the case if the breasts are very small as the saline implants, more often than not, lead to an unusually round appearance.   

A dome-shaped breast is one of the most common telltale signs of plastic surgery, so it is not surprising that most patients do not want this look.

Another technique to avoid the “fake” look is to choose the appropriate implant size.  The general rule is that natural appearance is easily achieved if the breast volume mostly consists of natural tissue rather than implants.

When plastic surgeons refer to large breast implant, it often means a size that is more than 600-700 cubic centimeters.

Meanwhile, the amount of tissue also dictates the most ideal breast augmentation technique.  More often than not, flat-chested women have undefined breast crease, making this incision site more challenging, although not impossible.

Plastic surgeons are extra careful when using the breast crease incision site on small-busted women to avoid a low- or high-riding scar. 

Breast Augmentation for Body Builders

It is not uncommon for female body builders to have breast augmentation surgery to further enhance their figure.  However, certain factors must be considered to achieve the best result and prevent or at least reduce the risk of complications.

One important thing to consider is that body builders in general have a very low percentage of body fats which predisposes them to higher risk of implant visibility and palpable rippling.  This is more of a concern if a patient’s breast has less tissue.

Because of this specific feature, plastic surgeons usually recommend the submuscular implant placement for female body builders.  With this technique, the breast implants are covered not just by the tissue and skin but also by pec muscle, reducing the risk of wrinkling and shell visibility.

However, the submuscular implant placement has its own downside.  While a body builder contracts her pectoralis muscle, chances are the breast implants will move along with it—something which is undesirable for some patients.  Also, they should bear in mind that it is difficult to predict “the degree of movement” after surgery.

By contrast, the subglandular implant placement or positioning of the device above the pec muscle does not pose the same problem.  For this reason, the technique may sound appealing to female body builders compared with the submuscular breast augmentation technique.

But as mentioned earlier, body builders are prone to implant rippling and wrinkling since they often have a low percentage of fats.  For this reason, they also have to consider what they are getting into if they would choose the subglandular implant placement over the submuscular.

Fortunately, a board certified plastic surgeon with extensive experience in breast augmentation can guide his patient to make the right decision.

To put it succinctly, patients should choose which of those problems they definitely want to avoid, and think about the ramifications that will be acceptable for them.

The next issue to consider is whether to use saline or silicone breast implants.  Patients should bear in mind that the right implant type is determined by the amount of tissue and fat, the bust size they want to achieve, and the ramifications they are willing to accept.

In general, female body builders will benefit more with silicone breast implants because these are filled with a cohesive gel that mimics the way natural tissue feels.  By contrast, saline implants—due to their watery consistency—should be avoided particularly if the patients have low body fats because they usually lead to unnatural result. 

Things You Should Know During Your Breast Augmentation Recovery

Of course you are fully aware that breast augmentation, as with any cosmetic surgery, involves weeks of recovery.  However, you may be surprise that “weird” things—but still considered normal by plastic surgeons—may happen during your healing time.

If you are considering breast implant surgery, these are some of the things you might want to know about:

*  Squeaks and gushes in your breasts

In case that you hear these weird noises coming from your augmented breasts, don’t be alarmed since these are usually caused by air bubbles and/or fluid build-up within the implant pocket.

The buzzing, gurgling, and crackling noises that typically last a few weeks may also be caused by implants as they settle to their natural position.

*  Exaggerated fullness in the upper poles

If the upper poles of your breasts appear unusually round (which gives you the operated, fake look), don’t worry because weeks or months following your breast augmentation, the implants will settle to their natural position.

Some plastic surgeons recommend breast massage and compression exercise after the incision site is completely healed.  The theory is that massaging the breasts would allow the implants to settle naturally, and prevent the scar tissue around the devices to become too tight and dense.

In addition, it is not uncommon for the augmented breasts to be quite firm and sit high up on your chest.  In general, they will soften up and drop to a more natural position.

Your plastic surgeon may recommend strap or elastic bandage wrapped around the upper chest, under the arms, before reaching the top half of the breasts; in this way, the implants will go down.

* One breast sits higher on your chest

The breast implant on your dominant side (right- vs left-handed) may not drop as fast as the other one, leading to asymmetrical appearance.  If this happens, don’t worry since both implants will settle properly weeks or months after your breast augmentation surgery. 

*  Oversensitive nipples

More often than not, oversensitive nipple (right after breast augmentation) is associated with some “erection” which further aggravates the sensitivity.  For this reason, don’t be surprised if your plastic surgeon recommends using Band-Aid (especially if you have large ones) or nursing pads that will protect the area from the abrasiveness of your clothing.

* Numbness in the nipples

While some patients experience oversensitive nipples, others complain about numbness in the area, which is also something normal during the first few weeks or months following the surgery.

For most women, the sensation returns although the process often involves some itchiness, heat, tingling, and sometimes pains, which are all temporary. 

Knowing If Breast Implant Surgery Is Right for You

For the past couple of years, breast implant surgery has been the most sought-after aesthetic operation that in 2011 alone, about 307,000 procedures were performed, according to survey released by the American Society of Plastic Surgeons.

But despite the growing popularity of breast implant surgery, not all people who desire to increase their bust size and/or want to achieve a more prominent cleavage are good candidates for this procedure.

As with any cosmetic surgery, breast augmentation involves some risks, recovery, and of course money.  For these reasons, you should be able to answer these questions before you consult a plastic surgeon:

*  Do you have “healthy” motivations?

If you want to undergo a cosmetic surgery, bear in mind that your motivations should be based on your personal happiness.  But if you want this to please other people (your partner or colleagues), you would most likely end up dissatisfied since physical improvements do not automatically result to “better relationships.”

*  Do you have realistic goals and expectations?

If you have very small breasts (double A cup), desiring to achieve a full D cup is definitely over the top.  Take note that because you have limited breast tissue and fat, “inappropriately” large implants can lead not just to fake look but also to higher risk of wrinkling/rippling and bottoming out.

*  Do you have enough money?

Because breast augmentation is an elective procedure, don’t expect that your health insurance will cover the surgical expenses; this means you have to spend your own savings or seek loans.

Aside from the surgical costs, you should also consider the possibility of a revision breast augmentation, MRI screening (if you would choose silicone implants), and other expenses after your operation.

*  Are you physically healthy?

Your plastic surgeon will interview you and ask you to undergo laboratory examinations to determine if you are healthy and are not suffering from medical conditions that may compromise your recovery.

Be as honest as you can, particularly when your doctor asks you about your previous surgeries, medical conditions, allergies, and current medications.  Also, you should tell the truth if your surgeon raises the topic of smoking and drinking habits.

*  Are you emotionally stable?

If you are emotionally stable and fully understand and accept the ramifications of having breast implant surgery, you can proceed with the procedure as long as you meet the other requirements.  But if you’re suffering from depression and other psychological and emotional issues, talking to a therapist is way better than consulting a plastic surgeon.

Cohesive Breast Implants—Benefits and Disadvantages

In March 2012, the US Food and Drug Administration has approved the cohesive breast implants which use a form-stable gel; this means that unlike the 4^th generation silicone implants, they do not leak in case the shell cracks.

The cohesive silicone implants, also referred to as gummy bear implants due to their firm structure (just like the popular sweet candy), have benefits over the ordinary silicone- and saline-filled implants.  However, they also have shortcomings, which must be considered.

The Main Benefits of Cohesive Breast Implants

*  Less prone to shell collapse

Because the filler material is form-stable, it does not shift from one area of the shell to the other (which is the case in saline and traditional silicone implants).  For this reason, the folds and wrinkles—which are known to affect the device’s durability in the long run—do not occur.

It is safe to surmise that cohesive breast implants can last longer than the other types since they are not prone to folds and wrinkles.

*  Leak is almost not a concern

While the shell is susceptible to breakage, leak is not a problem since the filler material maintain its shape; however some microscopic diffusion of silicone will always occur, but some experts believe that it will be somewhat harmless.

*  Lower risk of capsular contracture

Some studies—while not as extensive as they should be—conducted in Europe suggest that capsular contracture occurs less often with cohesive breast implants.

Capsular contracture happens when a layer of scar tissue becomes too dense and thick that it squeezes the implant.  Some experts say the implant’s cohesiveness, firmness, and/or less diffusion of silicone (than traditional silicone implants) are the reasons why there is a lower risk.

The Disadvantages of Cohesive Breast Implants

*  They only come in teardrop shape

Because the cohesive breast implant is form-stable, it does not come in round version and is only available in teardrop shape, which has more volume at the bottom than the top.

By contrast, ordinary silicone and saline implants are available in round shape because their filler material is affected by the gravity and forces of the breasts.

While teardrop implants provide natural results, some women still prefer the round version which can give them the dome-shaped breast in which there is an exaggerated fullness in the upper poles.  

*  Feel

The cohesive breast implants do feel a little bit firmer than the traditional silicone implants, although the level would depend on how much breast tissue a patient has, how supple or flaccid the tissue is, and how large or small the implant is.

However, most patients—particularly those who would choose implants with an “appropriate” size—do not have problem with the firmness of cohesive breast implants.

*  Cohesive implants require longer incisions

Because the filler material is form-stable, these implants need longer incisions (between 4.5-5.5cm) to squeeze through inside the breast pocket.  For this reason, plastic surgeons rarely recommend the areola incision site when using this type of implant.

Armpit incision is also difficult when using cohesive breast implants, which is why doctors prefer the breast crease technique.

*  Risk of rotation

With the teardrop shape of the cohesive implants, rotation can result to deformity.  Fortunately, this can be prevented with the right pocket dissection and insertion.

But still, rotation is more of a problem for patients wanting to replace their teardrop breast implants with smaller ones.  Meanwhile, round implants do not result to distortion even if they rotate inside the pocket because their sides are all symmetrical.

*  More expensive

As with most new technologies, cohesive breast implants are hundreds of dollars more expensive than older designs. 

Woman Fakes Breast Cancer to Raise Money for Plastic Surgery

In an effort to raise funds for her breast augmentation surgery, a 27-year-old Arizona woman lied to her family, friends, and co-workers saying she had breast cancer and needed double mastectomy and breast reconstruction.

Jami Lynn Toler, who worked at a local hospice, has been charged with fraud and theft, police authorities said.

Toler’s former co-workers said she solicited money by making up stories and even crying in front of her boss to persuade them to give her “funds” for her cancer treatments and reconstructive breast surgery. 

According to police reports, Toler’s boss helped her raised funds amounting to more than $8,000 since September.  Meanwhile, one co-worker said “people were scammed simply because of their good intentions and sincerity to help the suspect.”

Aside from Toler’s friends and co-workers, she also deceived her mother and grandmother who also gave a portion of their savings to help the suspect.  

Meanwhile, Toler’s co-workers and friends became suspicious when one doctor offered to treat her cancer for free but she declined.  She also paid a cosmetic plastic surgery in cash, according to police reports.

When investigators checked Toler’s medical records, they found that she was not suffering from breast cancer.

This is not the first time a woman faked breast cancer to raise funds for her breast augmentation surgery.  A few years ago, Trista Joy Lathern from Texas lied about having the disease and raised about $10,000.

To make her story believable, the suspect has even shaved her head to look like she was receiving chemotherapy.

Asian Breast Augmentation

About 307,000 breast augmentation surgeries were performed in 2011, making it the most popular cosmetic plastic surgery during the period.

In a 2011 survey released by the American Society of Plastic Surgeons, breast augmentation was one of the top three cosmetic surgeries performed on Asian-Americans, which has always been the trend. 

Because Asian women often have a smaller frame than Caucasians, the general rule is to limit the implant size particularly if the aim is to create a natural appearance instead of an operated look.

Small- to moderate-sized breast implants are particularly ideal when dealing with patients who have little breast tissue to prevent or at least minimize the risk of visible wrinkling and rippling. 

Nowadays, the trend is the natural look which can be easily achieved by using smaller breast implants.  In fact, many plastic surgeons have noticed that most of their recent patients asked for implants filled between 300 and 350 cubic centimeter or cc which is often enough to add volume without giving a heavy top look.

Aside from the implant size, Asian women should also consider the implant profile or the projection off the chest wall.  As mentioned earlier, they generally have a smaller frame and chest “band” than Caucasians so these certain anatomical features should be taken into consideration.

In general, patients with a small chest “band” should use high-profile implants which offer more forward projection and smaller base, which is important to avoid the unnatural look. 

On the other hand, petite patients in general should avoid low-profile implants which have a bigger base but offer less projection as they can occupy too much space on the chest band, resulting to “bursting” appearance.

To date, a growing number of women choose silicone breast implant over the saline version because it provides a more natural look and feel with its viscous filling.  Meanwhile, the US Food and Drug Administration has recently approved the fifth generation of silicone implant which has a more cohesive gel than its predecessor, in addition to being form-stable.

But still, salineimplants, which are filled with a sterile mixture of salt and water, can provide a natural look and feel as long as there is an ample amount of breast tissue and fat; but if this is not the case, unnatural contour and higher risk of wrinkling are usually the results.

But despite some concerns, saline implants are still endorsed due to their surgical flexibility and are easy to replace during a revision breast augmentation.

Gummy Bear Implants Seen to Create a New Trend

In March 2012, the US Food and Drug Administration has finally approved gummy bear breast implants (from implant manufacturer Sientra) after several years of clinical trials.  Meanwhile, the new devices have already been around for 10 years in Europe.

Compared to earlier versions of silicone implants, gummy bear implants have a more cohesive silicone gel that even if their shell is cut in half, the filling would not leak.  And with this characteristic, many plastic surgeons around the world believe that the new devices are probably safer than other types of breast implants.

Plastic surgeons coined the term “gummy bear” because the implants’ soft but firm structure is somewhat similar to the sweet candy.

Leading Los Angeles plastic surgeon Dr. Tarick Smaili believes the recently approved breast implants may further push the popularity of breast augmentation surgery in the country.  Last year, the procedure ranked first on the list of the most commonly performed cosmetic plastic surgeries.

In terms of advantages, Smaili said that gummy bear implants are “quite notable” particularly when it comes to safety.

“With the cohesive silicone gel, the possibility of rupture and leak is close to nothing.  Another advantage is that the implant is form-stable and would not lose its shape,” Smaili said.

And because the risk of leak is almost not a concern, regular MRI screening is no longer needed.  (This is a requirement for women with traditional silicone breast implants because their somewhat fluid gel would seep out in the event of rupture.)

Another advantage, Smaili said, is the lower risk of capsular contracture which happens when the surrounding scar tissue squeezes the implant shell to the point that it causes breast deformity, pain, and other complications.

The newest implant is also called “type 5 gel” because it is the fifth generation silicone implant in the market since 1962.  Meanwhile, silicone implants currently produced by Allergan and Mentor fall under the category of “type 4 gel” which is cohesive but not form-stable.

But because gummy bear implants are firmer than the earlier versions of silicone implant, they require a longer incision. Fortunately, patients can choose from four incision sites which are designed to make the scar less visible.

Another consideration is the risk of rotation.  Since the implants come in teardrop shape, they may result to deformity in case they rotate inside the breast pocket (though the textured or “grainy” surface can prevent this problem from happening).

Pricing for Breast Augmentation

Breast augmentation ranked first in the most commonly performed cosmetic plastic surgery last year, with about 307, 000 procedures conducted in the US, or an increase of 4 percent since 2010.

The price for breast augmentation varies, sometimes significantly because it is affected by the surgeon’s fee, location of the surgical center or hospital, and type of implant used during the surgery.  Meanwhile, patients should always bear in mind that the cost should not be the sole factor when choosing a doctor.

Nevertheless, the most expensive breast augmentation plastic surgeon does not necessarily mean that he is the best one to conduct the surgery.

If the surgery uses saline breast implants, the average cost is around $7,000—this already includes all the pre- and post-operative visits, anesthesiologist, surgical facilities, and body garments.  But if the procedure uses silicone implant, the price would be $800 to $1,000 higher.

Silicone is more expensive than saline implant because making it involves a higher manufacturing cost.  Another consideration to make is the plastic surgeon’s fee is usually higher if this implant type is used.

Patients should always bear in mind that the cost of cosmetic plastic surgery is higher in large cities than in most areas because the demand for such procedure is quite high.

People should always be cautious with extremely cheap or discounted plastic surgery because this is often a red flag; the surgery is most likely to be conducted by a non-specialist, or it may be an attempt to fill an empty O.R schedule—which should be a concern.  And in some cases, a very low price is just an advertising hype and may not be the inclusive cost of surgery.

Because breast augmentation and most cosmetic surgeries are quite expensive here, some patients are tempted to go abroad (in Thailand, the cost of breast implant surgery is said to be 50 to 70 percent less).  While there is nothing wrong with “medical tourism,” they should be extra careful since not all countries are as strict as the US.

Patients should always bear in mind that in case their surgery abroad leads to botched results, it may be difficult—or sometimes even impossible—to go after the doctor.  By contrast, the US is very strict when it comes to medical malpractice law; in fact, the records of doctors who have been sued or charged with a disciplinary action can be easily accessed via Internet, although some states require a letter of request before they disclose such information. 

Smaller Breast Implants—A Growing Trend These Days

In the 1990s, Pamela Anderson arguably popularized the “larger than life breasts” and was even flaunting them in Baywatch with her scanty, one-piece, red swimsuit.  But after two decades, the blonde beauty has downsized her breast implants in an effort to achieve a more natural look.

Plastic surgeons have noticed that smaller breast implants are the new trend these days.  In fact, many Hollywood stars have been reported to have “downsized” including Victoria Beckham, Drew Barrymore, Denise Richards, and Dolly Parton.  Also, Beyonce and Kate Hudson have been rumored to have had breast augmentations using small implants.

Take note that in the past, big-bosom celebrities were popular and frequently represented in the media.

In terms of aesthetic results, leading Los Angeles plastic surgeon Dr. Tarick Smaili believes that smaller implants look more natural especially when used by women with small frame.

“Smaller implants look very flattering on petite women simply because they add curve to the body without creating the heavy top look.  They also look natural that it would be hard to tell if someone has them,” Smaili said.

According to a recent survey, most breast augmentation patients today choose breast implants size between 200cc and 300cc because of the growing popularity of “natural look.”

However, women with a relatively large body-frame can also benefit from smaller or at least moderate-sized breast implants which can give a slimmer appearance.

Aside from giving a natural look, smaller breast implants also make it easy to do physical activities and exercise; in fact these are the popular choice of athletes and women with an active lifestyle.

Because of the risk associated with extremely large breast implants, US implant manufacturers Allergan and Mentor do not produce sizes that are over 800 cubic centimeter (cc), and while there are bigger saline implants, rarely these are used because of the potential problems they can cause.

In fact, no ethical board-certified plastic surgeon would use extremely large breast implants for cosmetic reasons as doing so can lead to a wide range of health problems such as chronic back pain, shoulder strain, bad posture, and difficulty in moving—symptoms that Sheyla Hershey, the woman who holds the world record for having the largest breast implants, are experiencing.

According to reports, Hershey, who is from Houston, Texas, has undergone several breast augmentations to achieve the 38KKK bust size.  But because no US doctors would dare to operate on her, she traveled abroad just to receive surgeries.    

Saline Breast Implants—Overfilling Vs Underfilling

Saline breast implants are filled with a sterile mixture of salt and water while their shell is made of solid silicone that is durable.  However, there is no guaranty that the device can last a lifetime because it is still subjected to the natural wear and tear; for this reason, there is always the possibility of needing a revision surgery at some point in a patient’s life.

One advantage of saline implants over silicone version is that in case of a leak, they will not lead to inflammation of the tissue although patients have to remember that the affected breast will appear deflated right after the rupture.  To correct this problem, the implant must be replaced with a new one during a revision breast augmentation.

However, saline implant has its shortfall; because of its watery consistency, it is prone to sloshing effect, which is attributed to the higher risk of downward displacement. 

One way to prevent the sloshing effect is to overfill the implants with a saline that is more than the amount recommended by the manufacturer.  Patients should remember that overfilling the implants does not lead to a bigger size but only firmer appearance.

For instance, implant manufacturer Mentor recommends its device to be filled with a maximum amount of 300 cubic centimeter or cc, but a plastic surgeon inflates it with 325cc.  Aside from making the implant firmer, the technique has also been said to reduce the sloshing effect.

Another probable advantage of overfilling saline implants is that the need for a revision breast augmentation can be postponed.  Because saline has a natural deflation rate of 1 percent every year, putting content more than the recommended amount of the manufacturer may help prolong the “viable volume” of the implant.

But one downside of overfilling saline implants is that it gives manufacturers the right to cancel the warranty of their products.  However, it does not mean that they will automatically void it, but the technique gives them that option.

While overfilling saline implant is a common practice, underfilling its shell is not since it can lead to a wide range of problems including higher risk of rippling and implant failure; this is because the constant “rubbing” of the folds can affect the integrity of the device.

Another common problem with underfilled saline implants is the visible ripple, which is more of a concern if the breast tissue and fat is limited.

Saline Breast Implants Info

Saline breast implants are used to increase the bust size or create more fullness especially in the cleavage and upper poles.  However, these devices are also used to reconstruct the breasts after mastectomy or cancer surgery in which the affected tissue or tumor is removed.

Saline implants vary in volume (defined by cubic centimeter or cc), shell thickness, shape (round vs teardrop), and shell surface (smooth vs textured).  They are also available in inflatable and prefilled version.

In the US, only the inflatable saline implants are available, meaning they are filled at the time of breast augmentation surgery.  With this design, plastic surgeons can insert the device using a very small incision, thereby minimizing the appearance of scars.

By contrast, prefilled saline and silicone gel implants require longer incisions.

As its name suggests, saline implant is filled with saline, which is a sterile mixture of salt and water.  And with its content, there is no serious risk in case of leak, although the tradeoff is that the affected breast will immediately look deflated and will need a revision surgery.

On the other hand, a leak in silicone implants that is undetected for a long period of time can lead to inflammation of the tissue, pain, and discomfort.  Because of such risks, patients with this implant type are required to undergo regular MRI breast screening at least every two years.

In the US, the typical size of saline implant ranges between 120cc and 850cc, although women who want to go larger will need custom-made implants.  But because of the risks associated with extreme sizes, most plastic surgeons would likely decline any surgery to patients who are “going overboard.”

All inflatable saline implants have valves, which are often located in front.  Most manufacturers use diaphragm valve; it has a “male portion” at the end of its tubing that when snapped into the “female receptor hole,” is left into the implant shell, thereby sealing the device. 

Meanwhile, women with limited tissue or small breasts are often advised to stay away from saline implant because it can lead to unnatural outcome (the bosom appears unusually round).  By contrast, patients with ample amounts of tissue have no problem with this implant; in fact, there is no visible difference if they use silicone or saline.

Because of the watery consistency, saline implants may lead to sloshing effect, thus increasing the risk of downward displacement.  To avoid this problem, many plastic surgeons intentionally overfill the shell with saline solution. 

Europe Seeks Tougher Breast Implant Test

With the controversies surrounding French-made PIP breast implants, the European Union is seeking tougher tests and inspections for these devices in an effort to protect consumers from substandard products.

Because of the slack system, some experts believe the implants manufactured by PIP have been sold in many parts of the world.  (But surprisingly, the devices did not reach the US after the FDA found the company’s failure to adhere in good manufacturing practices). 

Investigation shows that since 2000, PIP has developed a simple way to deceive third party auditors from discovering that it was using industrial grade silicone gel intended for making mattresses.  With this plan, the company was able to lower the manufacturing costs of its devices—of course at the expense of thousands of women who had the substandard implants.

According to estimates, about 400,000 PIP silicone breast implants were sold in UK, Spain, Australia, Brazil, Argentina, Colombia, and Chile.

To hide the industrial-grade silicone gel, PIP workers placed the barrels containing this substance in a separate warehouse while auditors were making a routine visit.  Meanwhile, one employee has admitted that he was asked to erase evidences from the computer system before the audits and add them again afterwards.

And as the company’s way to celebrate its fraudulent act, employees threw huge parties every time the auditors left the premise.

Going back to the EU regulators’ plan to overhaul the rules, the aim is to prevent medical device makers in charge of checking the safety of their own products, and to further beef up transparency. 

However, concrete plans to improve the oversight system are yet to be determined later this year.  But one possible solution is to carry out unannounced audits particularly when dealing with companies suspected of fraudulent acts.

In January 2012, PIP founder Jean-Claude Mas, 72, has been charged of involuntary injury two years after the French health ministry banned his company’s silicone breast implants which were sold in 65 countries.  The devices have been found to be prone to rupture because of their thin shell; in fact about 14 percent of women who have them removed suffered from leak.

Surprisingly, while Mas has admitted deceiving the French authorities for 13 years, he called the victims who filed complaints against him as those “who want to make money.”

The PIP founder has also criticized authorities for offering victims to pay for the removal of implants because it can put them to a “surgery risk.”

Myths Prevent Women with Breast Implants to Successfully Breastfeed

One of the most common misconceptions about breast implants is that they prevent women to successfully breastfeed their babies.  However, a study presented at the American Society of Plastic Surgeons showed that patients’ wrong belief is the main culprit rather than the devices themselves.

Mothers with breast implants who failed to breastfeed believed it can affect the appearance of their breasts.  However, pregnancy alone may cause some level of sagging because the ligament, skin, and tissue are stretched and may not be able to retract to their original position.

Women should bear in mind that the more pregnancies they experience, the more likely the appearance of their breasts is affected.  This simply means that even if a mother breastfeeds her baby or not, it does not make any difference in the appearance of her bust.

Dr. Norma Cruz, the lead author of the study, said that “breastfeeding won’t harm their [women] breasts, and it has significant health advantages for both mother and baby.”

The study involved 160 breast augmentation patients who were breastfeeding their babies.  Successful breastfeeding was defined by two weeks or more of exclusively providing natural milk.

The researchers have chosen women with almost similar demographics particularly in age, body mass, incision site during their breast augmentation surgery, and implant size; with this consideration, it is safe to surmise that their findings are quite accurate.

Among the 63 mothers who had successfully breastfed, only 13 percent believed it could adversely affect the appearance of their breasts.  By contrast, about 86 percent of the 97 women who were “unsuccessful” thought that it could result to negative impact on the aesthetic quality of their bust.

While Cruz understands that some breast augmentation patients were concerned with the appearance of their bust—after all, they have invested time and money for the surgery—she reiterated the importance of breastfeeding not just to babies but also to mothers.

“Evidence shows that although breasts sag more with each pregnancy, breastfeeding doesn’t seem to worsen these effects in women with or without breast implants,” she added.

While there is nothing wrong getting breast implants before pregnancy, leading Los Angeles plastic surgeon Dr. Tarick Smaili believes that women who are concerned with sagging may consider postponing the procedure.

“Pregnancy may have a slight effect on the appearance of the breasts, but not always to the extent that you will need revisions.  But if you are truly concerned about this, perhaps postponing the surgery is a good choice if you’re considering having babies in the future,” Smaili added.  

Breastfeeding with Implants 101

Many women with breast implants wonder if they can still breastfeed their babies or not.  Patients should always bear in mind that breast augmentation may somewhat affect the sensation of the nipple, although the devices do not automatically prevent mothers to produce natural milk.

Majority of women with breast implants are able to breastfeed successfully, despite some rumors that the devices can prevent them to do so.  There are also some misconceptions that these can contaminate the milk, potentially harming the baby; in fact, studies have suggested that formula milk contains significantly higher amounts of silicone than the milk produced by breast augmentation patients.

Meanwhile, small amounts of silicone are naturally present in mother’s milk.

According to a recent study, most breast augmentation patients who were unable to breastfeed were concerned that doing so may lead to sagging; this means the “inability to breastfeed” is really not the issue but more likely their “unwillingness.”

But contrary to popular belief, breastfeeding does not cause sagging as pregnancy alone is the culprit.  And the more pregnancies a patient will experience, the more likely her breast tissue and ligament will droop.

Breast implant itself does not cause compromised ability to breastfeed.  Most plastic surgeons believe that the incision site (e.g., within the breast crease, around the areola, and inside the armpit) is the factor that primarily affects the sensation of nipple after surgery.

For women who are considering breast augmentation but are planning to have a baby in the future, the best thing is to avoid the peri-areolar incision in which a U-shaped cut is made within the dark pigmented part of skin.  During the technique, there is a higher chance that the nerves are severed, thereby affecting the sensation.

Patients should remember that loss of sensation in the nipple makes it difficult to breastfeed.

However, several studies have suggested that years after breast augmentation surgery, most of the severed nerves can repair themselves, a process called reinnervation.  This clearly shows the remarkable ability of the body to heal itself.

For women with breast implants, they often have a better chance to successfully breastfeed if longer time has transpired since their surgery.  In fact, one study has suggested that five years after the procedure, most of the nerves that were damaged during the incision have already reconnected and have been repaired by the body.

Nevertheless, many doctors believe that inserting breastimplants on the side or underneath the breast will cause the least amount of damage to the nerve endings and milk ducts. 

Fat Grafting and Breast Augmentation

This year, it has been estimated that nearly half a million American women will undergo breastaugmentation either to improve their appearance or reconstruct their breasts following cancer surgery or mastectomy.

Breast augmentation is traditionally conducted by placing saline or silicone breast implants inside the “pocket.”  Meanwhile, these devices have been approved by the US Food and Drug Administration due to their “reasonable safety,” although patients should bear in mind that there is always a risk of rejection and other complications.

Fortunately, there is an alternative to breast implants.  Called fat grafting, the technique involves collecting fats from one donor site (e.g., abdomen and thighs) and then introducing them to another area of the body; and because no synthetic implant is used, patients should no longer be concerned with rejection and allergic reaction.

However, patients should always remember that fat grafting has its own limits.  For instance, the method is not applicable to those with limited amount of body fats; and it can only increase the breast one cup larger from its original size.

Another consideration to make is the result is somewhat unpredictable given the fact that some of the transferred fats will be reabsorbed by the body; and anything that remains a year after the procedure would likely be permanent.

One way to increase the survival rate of the fats is to purify them; this means the blood, connective tissue, and other impurities are removed.  With this method, about 60 to 80 percent of the transferred fats can survive in their new location.

But to further increase the survival rate of the fats, some doctors recommend using bra-like suction cones for three weeks prior to the procedure.  With this technique, they believe that the tension will create enough room for the grafted fats to flourish, although no extensive study can back up this claim.

After purifying the fats, they are carefully injected to the breasts; this process may take more than once to promote high survival rate of the fatty tissues.

Fat grafting that is used as a replacement for breast augmentation is like hitting two birds with one stone.  Not only the patients enjoy bigger and fuller bust, also the areas which have been liposuctioned such as abdomen and thighs will appear slimmer, resulting to a curvier body.

For three weeks, patients are usually required to wear a compression garment around the liposuctioned area; in this way, the skin will heal faster and closer to the body, thereby preventing sagging and improving the body’s contour.

Breast Enhancement Surgery

Nowadays, breast enhancement surgery comes in many forms including breast augmentation, mastopexy (raising the sagging bust), and reduction mammaplasty (decreasing its size).  And while each kind uses different techniques, their goal is the same: to improve the appearance of the bosom.

In 2011, breast augmentation was the most popular cosmetic surgery in the US, with about 307,000 procedures performed during the period.  Currently, the Food and Drug Administration has only approved saline and silicone breast implants for this surgery.

As its name suggests, breast augmentation is traditionally used to increase the bust, but with the introduction of new implant designs, it has become possible to use the procedure in creating a more prominent cleavage, and address certain types of breast deformity such as pigeon chest.

In some cases, breast implants are used to reconstruct the breasts after mastectomy or cancer surgery, although they can only be helpful if there is an ample amount of tissue left.  By using the devices, women can avoid unfavorable scarring associated with tissue-based breast reconstruction, and weakening of the donor site (e.g., buttocks, abdomen, back).

Another type of breast enhancement surgery is mastopexy in which the sagging breasts are raised to make them appear more appealing and youthful.  Contrary to popular belief, the procedure is not only popular among aging women but also on massive weight loss patients who often develop sagging, elongated breasts.

For some, mastopexy involves reducing the size of areola (pigmented part of skin surrounding the nipple) to complement the “perky” and youthful appearance of the breasts.  Doing this additional procedure does not necessarily mean more scars because doctors simply use the peri-areola incision.

While mastopexy can lift the sagging breasts, patients should take note that it cannot create volume especially in the upper and medial cleavage.  For this reason, many plastic surgeons suggest breast implants as a way to further enhance the appearance of the bosom, resulting to a prominent cleavage.

Brest reduction is another type of breast enhancement surgery, although women with medical problems caused by extremely large bust size will more likely see this as a reconstructive procedure.  If performed as a way to improve body function and address discomfort, insurance reimbursement is possible.

By contrast, breast reduction which is performed purely to enhance one’s appearance is not covered by insurance, as with any cosmetic surgeries.  In fact, most insurance companies require at least 300 grams of fats and tissue to be removed from each breast before the procedure is considered reconstructive. 

Are Sientra Breast Implants Better?

Just recently, the US Food and Drug Administration has approved a new brand of silicone breast implant; the device, which is made by California-based Sientra, can be used in breast reconstruction following cancer surgery, and cosmetic breast augmentation.

Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons, believes the FDA’s approval clearly shows the “reasonable safety of silicone breast implants, despite potential risks such as implant failure and hardening of the tissue or capsular contracture.”

“Any type of breast implant does not guaranty to last a lifetime, although modern designs can accommodate greater force and are quite resistant to the elements that are causing natural wear and tear,” Smaili said.

The plastic surgeon added that implant from Sientra is just like other brands already sold in the US market, thereby patients who will choose the new silicone implant are “technically choosing a technology that has been tried and tested for many years.”

“In fact, silicone breast implants have been subjected to the most rigorous, comprehensive clinical trials and surveys that would allow patients to make a good decision and understand the potential risks and limits of the devices,” he said.

Meanwhile, the plastic surgeon believes that Sientra breast implant is neither inferior nor superior to other brands manufactured by Mentor and Allergan, which used to be the only two companies allowed by the FDA to sell silicone and saline breast implants.

In 1992, silicone breast implants were banned in the US over concerns that they may increase the risk of cancer and many forms of systemic disease.  But in 2006, the FDA has lifted the moratorium based on facts that no study has proven the link between the devices and serious illnesses.

After the lifting of the 14-year ban, silicone breast implants are increasingly becoming more popular than saline implants because they provide a natural feel and look.  In addition, many doctors believe they are less likely to fail because the cohesive gel filling prevents wrinkling, a problem that can eventually lead to shell failure.

By contrast, saline implants—which are filled with a sterile mixture of salt and water—are relatively prone to “folds” that may rub each other, thereby increasing the risk of implant failure.

Over the past few years, breast augmentation via silicone and saline implants has been the most popular cosmetic surgery in the US.  In fact, about 307,180 procedures were conducted in 2011 alone. 

Botox for Faster Recovery After Breast Augmentation?

Breast augmentation surgery involves pain and discomfort during recovery.  However, plastic surgeons have come up with different techniques to shorten the healing time and reduce soreness and other postoperative symptoms.

One possible way to shorten the recovery is Botox injection; plastic surgeons use this treatment “off-label” to encourage the pec muscle to relax and allow the high-riding breast implants to settle downward quicker.

“Off-label” means using a treatment or drug beyond its real purpose.  For instance, Botox has been approved by the US Food and Drug Administration to remove certain types of facial wrinkles and address muscle spasm, although some doctors use it to encourage the implants to settle quicker into their natural position. 

After breast augmentation surgery, it is normal for the implants to appear unusually high off the chest wall.  This appearance generally lasts two months, although some women have to wait for as long as four months, as it takes time for the implants to drop and settle to a more natural place.

By relaxing the chest muscle, advocates of Botox believe the treatment can also speed up the recovery of patients.  And because the muscle is partially paralyzed, they also claim that there is less spasm and pain.

Crampy spasm following breast implants surgery commonly lasts several weeks or even months for some patients.

However, patients should realize that not all doctors recommend Botox injection to shorten the recovery after breast augmentation.  This is because other postoperative procedures have also been proven effective in minimizing pain and discomfort, and encouraging quicker healing.

For instance, some doctors recommend breast massage with compression exercise which can lead to faster recovery and encourage the implants to settle more naturally.  But when doing the procedure, patients should do this carefully and should avoid pinching the shell as it may affect the stability of the device.

Real Housewives Star Admits Plastic Surgery

While most celebrities deny having plastic surgery even if the result is too drastic and blatant, Real Housewives star Brandi Glanville has no qualms admitting going under the knife to improve her appearance.  In fact, she even said that in a town where “everyone is perfect, it is important to look good.”

In a previous interview, Glanville, 39, said she had breast augmentation surgery, a procedure necessary to regain the volume loss associated with pregnancy, in addition to increase her bust size.  And aside from breast implants, the star also admitted having regular treatments of laser to address her skin problems including “adult acne” and Melasma, a condition in which the skin produces too much pigmentation.

The TV personality also admitted to be receiving weekly spray tan to maintain her skin’s glow without damaging it, in addition to Botox injection and fillers to fight the early signs of aging.

Because she grew up modeling, she said that she is extremely aware of her physical appearance and knows the areas which need some improvements.  Another reason for her penchant for plastic surgery is the fact that she is now back in the dating scene.

To Glanville’s detractors who called her “plastic,” she said that “everyone has the right to do anything that can make her feel good.”

The good thing about Glanville is that despite having several cosmetic procedures, both surgical and non-invasive in nature, she looks naturally beautiful.  This is probably due to her belief that “less is more” which is her approach in plastic surgery.

Her breast augmentation is a clear example of Glanville’s “less is more” approach in plastic surgery.  While many celebrities have chosen large breast implants that gave them the “heavy top” look, she opted for smaller ones that perfectly fit her slender frame, thereby the result is a very natural appearance.

Leading Los Angeles plastic surgeon Dr. Tarick Smaili, who did not treat Glanville, said he is noticing a shift to a “more natural appearance.”

“Celebrities nowadays are choosing smaller breast implants that will give them a more natural, sexy look.  For example, Kate Hudson and Victoria Beckham have been rumored to have had breast augmentation using smaller implants, while Dolly Parton and Denise Richards have downsized their implants,” Smaili said.

Aside from giving a natural appearance, the renowned plastic surgeon also cited other advantages of small- to medium-sized breast implants including faster recovery, lower risk of downward displacement and sagging, and less chance of developing stretch marks.

Rebecca Linares Breast Augmentation with Dr Smaili

Breast Asymmetry and Implant Surgery

To some degree, both breasts are usually different in size although it is very minute that no one would even notice.  However, some women have pronounced asymmetry that makes it hard for them to choose clothing that would hide this aesthetic problem.

One way to address a noticeable case of asymmetry is through breast implant surgery.  In this procedure, a plastic surgeon will use either a saline- or silicone-filled implant to augment the smaller breast, which in turn leads to balance.

However, breast implant surgery is only ideal for patients who have no problem increasing their bust size; on the other hand, women who think that their asymmetrical breasts are too large can opt for reduction mammaplasty in which the tissue and fat of the larger breast are excised to make it smaller.

The advantage of using implants over performing breast lift is that it is possible to use less and shorter incisions, thereby the risk of visible scarring is almost not a concern. 

While it is possible to make an incision in the underarm and within the navel’s rim during breast implant surgery, these incision sites are not ideal when dealing with existing breast deformity.  This is because doctors have to work far away from the breasts, making it more difficult to create a balance appearance.

When dealing with asymmetry, it has become sacrosanct to use the peri-areolar technique in which a U-shaped incision around the edge of areola (dark pigmented skin around the nipple) is made; or breast crease approach in which a hidden incision is made within the skin fold where the breasts and chest meet.

In some cases, breast implant is performed in conjunction with breast lift particularly if there is some obvious sagging in one or both breasts.

The implant surgery, with or without breast lift, usually requires one to two weeks off from work.  However, patients should always bear in mind that residual swelling and tenderness often takes several months before they completely subside.

To support the new contour, most patients are required to wear a surgical support bra for several weeks.  This special garment also encourages quick recovery, leads to better contour, and minimizes swelling.

For at least two to four weeks, patients should avoid heavy lifting, pushing, arm extension, and rigorous activities.  However, it does not mean that they should remain sedentary during the entire recovery as doing so can exacerbate the swelling and may prolong the healing time.

As soon as possible, patients should take a gentle, short walk every day to encourage quick recovery and minimize swelling.