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. 

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. 

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.    

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. 

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.

Which Is More Popular, Saline or Silicone Breast Implant?

Breast augmentation is either performed using saline- or silicone-filled breast implants, devices which not only increase the bust size but also regain the lost volume after childbirth.

In terms of popularity, silicone breast implants are almost outpacing the saline version.  This is not surprising because they provide a more natural result since they are filled with a cohesive gel that is designed to replicate the feel of breast tissue and fat.

The growing popularity of silicone breast implant can be attributed to the FDA’s decision to lift the ban in 2006 after several studies have suggested that there is no link between its use and cancer risk and systemic diseases.

Another reason why silicone implants are more popular than saline is that they are very ideal for women with little tissue and fat in their breasts.  And not surprising, a significant number of patients seeking breast augmentation have this anatomical feature.

On the other hand, saline implants can provide a natural appearance only if there is a moderate to significant amount of tissue and breast plastic surgeons can work with.

Meanwhile, a 2009 survey released by the American Society of Plastic surgeons revealed that 50 percent of breast augmentation patients had chosen silicone implants. 

Right after the lifting of the 16-year ban, silicone implant is gaining on saline version every year.  In 2007, 35 percent of breast implants used in surgery were silicone and they jumped by 47 percent a year after.

Difference Between Saline and Silicone Implants:

* Saline implants are filled with a sterile salt and water solution while the silicone version is filled with a cohesive silicone gel.

* Saline implants are prone to sloshing, which in turn results to higher risk of downward displacement than silicone with the same size.  For this reason, some doctors intentionally overfill the saline implants.

* Silicone implants need longer incision than the saline version, unless they come in a very small size.  By contrast, saline implants require a short surgical cut because they are placed empty inside the breast pocket before they are inflated with a sterile saltwater solution.

* Silicone implants can maintain their volume for years (except if there is a leak or implant failure) unlike the saline ones which have a natural deflation rate of 1 percent every year.

* For patients with a little amount of breast tissue, saline implants often result to unflattering, dome-shaped breasts while the silicone implants can provide a more natural result. 

However, saline and silicone implants provide almost the same aesthetic result for women with moderate to significant amount of breast tissue.

FAQs About Breast Implant Surgery

1.     Question: What kind of implants is used during breast augmentation?

Answer:  Currently, the US Food and Drug Administration only allows silicone- and saline-filled breast implants.  However, there is some speculation that the gummy bear implants (these are filled with a more cohesive type of silicone gel) which are under clinical trial, will be made available to the public in the next few years.

2.     Q:  Which can provide a more natural result?

A: Siliconeimplants are designed to mimic the feel of breast tissue, making them a more popular choice of women these days.

3.     Q:  Any benefits in choosing saline implants over silicone version?

A: Yes.  Patients are not required to undergo MRI screening, a test necessary for those with silicone implants because they are at risk of having silent leak (no visible manifestation that the shell has already ruptured),And in case of rupture, patients with saline implants can immediately see the problem because their breasts will become deflated within hours.

4.     Q:  What is capsular contracture?

A:  This happens when the scar tissue—which naturally forms around any implant—becomes extraordinarily dense that it ends up squeezing the implants.  Fortunately, there are many surgical techniques and post-operative treatments that can minimize the risk of capsular contracture.

5.     Q:  What is the difference between smooth and textured implants?

A:  Smooth implants have a balloon-like surface while textured implants have a rough, somewhat “grainy” exterior.

All teardrop-shaped (or anatomical) implants come in textured surface to prevent it from rotating inside the breast pocket, something which may lead to visible distortion.  On the other hand, round implants often come with smooth exterior because they can rotate without causing any problem.

However, some round implants have rough surface which is said to minimize the risk of capsular contracture.  But this claim has not yet been proven.

6.     Q:  Which can provide more natural breast contour, round or teardrop implants?

A:  Both implants can provide natural appearance as long as with the proper placement.  And contrary to popular belief, round implants do not automatically lead to a dome-shaped, unnatural-looking breast because their shape turn into a teardrop once inside the breast pocket (due to the pull of gravity).

      7.  Q:  How long do breast implants last?

A:  According to a study conducted by the Institute of Medicine, breast implants last an average of 16 years, although their lifespan still depends on many factors such as the patient’s lifestyle, certain features of the body, and type of implant used during the procedure.

Round Breast Implant and Its Benefits

In terms of shape, breast implants are available in two kinds: round and anatomical (or sometimes referred to as teardrop).  Patients should remember that the implant’s contour has a significant impact on the final result of their breast augmentation surgery.

To date, round implants are more commonly used than the anatomical versions because they come cheaper and are believed to last longer.  But still, the best option largely depends on the patients’ goals and expectations and certain features of the body.

However, anatomical implants are still popularly used on women who had mastectomy or cancer surgery, though plastic surgeons have started using them for cosmetic breast augmentation after realizing that they provide great aesthetic results.

But nowadays, round implants are more preferred by many doctors because they have a lower risk of implant wrinkling since they often come in smooth surface, which cannot pull the tissue.  By contrast, teardrop implants are always available in textured exterior because they are not supposed to rotate inside the breast pocket.

The anatomical implant’s textured surface will prevent it to flip over, which if occurs can lead to visible distortion.  But studies have suggested that this particular design can lead to higher risk of visible rippling, especially for implants that have large “graininess.”

The risk of visible and palpable rippling is particularly a concern for women with limited fat and tissue on their breasts.  For this reason, most plastic surgeons do not recommend teardrop implants for patients with little tissue coverage.

While round implant has all its sides equal, it does not mean the result is always a dome-shaped breast that looks unnatural.  Contrary to popular belief, its shape can still lead to natural appearance with a proper implant placement.

In fact, round implants can turn into a teardrop shape if held on one side and left suspended.

Another advantage of round implant over teardrop is that it comes at a lower price.  In addition, several studies suggested that it often lasts longer particularly those with smooth surface.

Because round smooth implants do not pull the tissue, they are less likely to wrinkle—one of the factors that can weaken the implant shell.

Also, patients who will choose round implants can either use saline (salt and water solution) or silicone filler.  By contrast, anatomical implants are only filled with saline because a cohesive gel like the silicone cannot be used.

Currently, silicone-filled implants are more popular than saline version because they provide a more natural result; this is not surprising because silicone gel is designed to mimic the suppleness of the breast tissue.

                                                  

Thinking of Breast Augmentation Surgery?

Breast augmentation has been one of the most sought-after cosmetic procedures in 2010.  During this period alone, about 296,000 US patients had the surgery, with the number expected to grow in the next few years.

If you are thinking of having breast augmentation surgery, these are the most common questions of patients you may also have in mind:

·         Is the safety of breast implants monitored by the FDA?

Both saline and siliconebreast implants are considered safe both for breast augmentation and reconstruction following cancer surgery.  Currently, the FDA only allows Mentor and Allergan-Mentor to sell their products in the country.

·         What is the advantage of saline breast implants over the silicone version?

Saline implants require smaller incisions because they are only filled once they are inside the breast pocket.  Take note that no FDA-approved prefilled saline implants are sold in the US.  Another advantage is that you are no longer required to undergo regular MRI screening because there is no risk of “silent leak.”

·         Which is more popular nowadays, silicone or saline implants?

Most doctors believe that silicone implants are more popular these days because they can simulate the natural feel of tissue unlike the saline version which is typically described as like having a water-balloon inside the breast.

But because a leak may not have any manifestation (e.g., deflated-looking breasts), it is recommended that you undergo MRI screening at least every two years.

·         Is there any option other than saline and silicone implants?

A new breast implant called “gummy bear” implant is used in Europe, though it is not yet available in the US market, unless you will enroll in nationwide clinical trials to test the product’s effectiveness and safety.

Gummy bear implant uses the silicone gel that is more cohesive than the one used by the currently available silicone implant.

·         Do patients need revisions in the future?

Because breast implants are not guaranteed to last a lifetime, you will likely need revision breast augmentation at some point in your life.  This is because the devices are still subjected to the natural wear and tear which can lead to rupture and leak.

Bizarre Stories About Breast Implants

Just recently, a Florida woman made headlines after she was attacked by her ex-fiance’s new girlfriend.  While crime of passion is not uncommon, what makes the story bizarre is that she survived because her salinebreast implant prevented the pocket knife from piercing her heart and lungs.

If this story sounds weird, hold yourself from more bizarre news involving breast implants.

1.     Snake dies after biting a woman’s chest.

In 2011, a model from Israel was attempting a stupid act live on air: kiss a snake.  Unfortunately, the boa constrictor died after it bit her surgically-enhanced breast; reports showed the cause of death was silicone poisoning.

Surprisingly, the model did not suffer from any serious problem although she was rushed to the hospital right after the incident and was given an anti-tetanus shot.

2.     Politician raffles breast implants to raise funds for campaign.

In Venezuela, a politician raised money for his campaign by raffling off breast implants.  Gustavo Rojas defended his action and said that while people raffle televisions and other appliances, he decided to offer cosmetic surgery which he said was far more interesting.

“It is an interesting prize…I’m not showing disrespect to anyone,” Rojas said.  

3.     Woman survives gun attack because of her breast implants.

A Los Angeles woman was shot in the chest but survived when her breast implant stopped the bullet from reaching her heart.

When Lydia Carranza was brought to the hospital and underwent a CT scan, doctors were amazed to realize that the bullet fragments were millimeters away from reaching her heart and other vital organs.

Carranza was at her office when a co-worker’s husband fired at her and his wife.  The wife died during the shooting incident.

4.     Woman survives a car crash thanks to her breast implants.

A 24-year-old Bulgarian woman survived a head-on collision when her 40DD breast implants absorbed most of the impact, preventing fatal injuries on her ribcage, lungs, heart, and other vital organs.

While she survived the accident, her silicone breast implants did not.  A police officer said the devices worked like airbags—they absorbed the impact and protected the victim’s ribcage.

5.     Woman accused of faking breast cancer to get implants.

Trista Joy Lathern from Texas lied about having breast cancer to raise $10,000 which has been used to pay her breast augmentation surgery.  She even shaved her head to look like she was terminally ill.

When authorities found out her scam, she was charged with theft by deception.

Can Breast Implants Lead to Stretch Marks?

As its name suggests, the primary aim of breast augmentation surgery is to increase the bust size using either saline or silicone implants.  In the US, only Allergan and Mentor are allowed by the Food and Drug Administration to sell these products to the market.

One of the most common concerns of patients considering breast augmentation is stretch mark, which happens when the skin tissue is stretched to its limit, resulting to purplish, reddish, or whitish stripes.  This often occurs after a significant weight gain/lose and pregnancy.

In some cases, breastimplants can cause stretch marks although a patient’s predisposition to have them depends on many factors including the implant size.  The rule of thumb is that the larger the device is, the higher the risk of developing the whitish or purplish stripes on the skin.

One effective way to lower the chance of having stretch marks after breast augmentation surgery is to use smaller implants.  Most plastic surgeons will likely agree that a 300 to 350 cubic centimeter (cc) range is a reasonable size.

By contrast, breast implants that come in 500cc size and above are often considered relatively large especially if these are going to be used on petite patients.

Aside from large breast implants, the age also seems to affect the likelihood of developing stretch marks.  According to some surveys, the problem is more common on younger women (those who are in their 20s and younger) than adult patients.

Plastic surgeons have also noticed that placing the implants on top of the muscle (subglandular technique) can increase the risk of stretch marks than positioning the devices below the muscle (submuscular technique).

Perhaps the reason why the subglandular implant placement increases the risk of stretch marks is that only the skin and tissue provide support to the weight of the device.  On the other hand, the submuscular technique offers more coverage and support to the implant, preventing the skin from stretching too much.

Also, most patients who developed stretch marks after breast augmentation have previously experienced the problem, although choosing a reasonable implant size and using the proper implant placement can reduce their risk.

By contrast, it is very unlikely for patients who have not experienced stretch marks to have the problem after breast augmentation surgery.

Fortunately, most patients who have developed stretch marks after breast augmentation reported that the purplish stripes turned white and became barely noticeable within three to four months. 

Breast Implants for Women with Active Lifestyle

Contrary to popular belief, female athletes and women who live an active lifestyle can have breast augmentation surgery.  However, certain factors must be considered to achieve the best result possible and minimize the risk of complications.

In general, athletic women—especially those who are thin—should use small implants or those from 300 to 350 cubic centimeters range.  By using the right size, their body will not be hindered from certain movements.

The problem with large breastimplants is that they interfere with the patients’ movement, which is a concern of athletes and women who lead an active lifestyle.  Also, these may result to the “heavy top” and unnatural look.

Another consideration to make is that active women often have less amount of fats in their breasts.  This simply means that they are more prone to visible and palpable rippling than women with thicker glandular tissues and fats.

To reduce the risk of wrinkling and rippling, thin athletic women are advised to choose small implants that can provide them a B to C cup bust size after their surgery.  Nonetheless, the exact size also depends on other factors including breast base measurements, chest width, waistline, and other pertinent anatomical features.

Aside from using smaller breast implants, another technique to minimize the risk of wrinkling is to place the devices under the pec muscle rather than in front of it.  In this way, not only the skin and tissue will cover the implant shell but also the muscle.

Another advantage of submuscular implant placement is that it can prevent or postpone ptosis (or sagging) because the muscle provides a strong support.  By contrast, the subglandular placement—a technique in which the device is positioned above the muscle—is believed to increase the risk of sagging and wrinkling particularly on women with limited glandular tissue and fat.

Despite the advantages of submuscular implant placement, one tradeoff is the longer recovery and more pain and discomfort.  But when everything heals, most patients will regain their normal muscle contraction, although in rare occasion some women will have distortion of the lower inner region of the breasts as the pec muscle is flexed.

Fortunately, the problem is relatively uncommon; in fact, some body-builders have submuscular breast implant placement. 

As mentioned earlier, most athletic women have little glandular fats.  For this reason, most plastic surgeons would likely recommend smooth round implants rather than textured tear drop implants which have a rough surface.

Smooth implants can lessen the risk of visible wrinkling especially if there is a little amount of breast tissue and fats to work with.  By contrast, textured implants are not recommended for thin patients because of the risk of rippling.