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.

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.

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.”

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.