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. 

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.    

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. 

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.  

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.

Breast Lift and Different Degrees of Ptosis (Sagging)

Because of the different degrees of breast sagging, plastic surgeons are using various types of mastopexy or what is more commonly referred to as breast lift.  In this way, they can address the problem using the shortest incisions possible.

Most doctors categorize breast sagging in three types: ptosis, empty sac syndrome, and pseudoptosis.

* Ptosis

This is the only condition that warrants breast lift surgery.  This happens when the breasts droop far enough that the nipple is at the same level or has even sagged below the breast crease.  Usually, this is often associated with the lack of volume in the upper poles and cleavage that the bosoms appear elongated.

Ptosis comes in three categories: mild ptosis in which the nipple has dropped to the level of the breast fold; moderate ptosis in which the nipple has dropped beyond the level of breast crease; and advanced ptosis in which the nipple is pointing toward the floor.

Advanced ptosis is often treated with full mastopexy, which is also known as an inverted-T or anchor lift due to the shape of its incisions.  Plastic surgeons create an excision that starts at the base of areola and travels to the breast crease, and then cut out a crescent-shaped amount of skin along the breast crease.

Full mastopexy also involves repositioning the areola complex so it sits in a more youthful position.

On the other hand, mild and moderate ptosis can be corrected with less invasive forms of mastopexy.  For those who need the least amount of correction, the Benelli or donut breast lift is often enough to address the sagging by simply making an incision around the areola complex.

But for those who need a little more correction, the lollipop breast lift or vertical mastopexy is a good option.  This technique involves an incision around the areola and another one that travels to the nipple down to the breast crease, resulting to a lollipop-shaped scar.

* Empty Sac Syndrome

This condition can be treated with breast augmentation surgery alone since the areola and nipple have not yet fallen at the same level or beyond the breast crease.  Implants are enough restore the lost volume associated with aging and pregnancy.

* Pseudoptosis

This condition, like the empty sac syndrome, is best suited for breast augmentation rather than breast lift.  Women with pseudoptosis have breasts that have fullness below the nipple but the upper portion appears somewhat “deflated.”

Liposuction for Breast Reduction

Liposuction surgery is often used to remove the fats in the abdominal area, however, what many people don’t know is that the procedure can also serve as a replacement for traditional breast reduction.  When given to the right patient, it can reduce the size of female breasts by more than 50 percent.

In many cases, liposuction can also have a slight to moderate lifting effect because it can remove the weight of the excess fats.

Compared to the traditional breast reduction in which the excess fats, glandular tissue, and skin are removed, liposuction is less invasive; in fact, most patients can resume to most of their daily activities two to three days after the procedure.

But perhaps the most notable advantage of liposuction over traditional breast reduction surgery is that the risk of scar is almost eliminated.  This is possible because plastic surgeons only use a few small round incisions where they insert a pen-like device that suctions out the fats.

Some women achieve better results than others after breast reduction via liposuction, especially those whose breast enlargement is primarily caused by excess fats rather than tissue.  Many doctors have noticed that patients who have passed through their menopause tend to have more glandular fats than teenagers, making them a great candidate for this procedure.

However, younger women may also enjoy the benefits of breast reduction via liposuction as long as the excess fat is one of the contributing factors of their breast enlargement.  To determine the amount of glandular fats, most doctors require their patients to undergo mammogram.

But still, not all women with exceedingly large breasts are a good candidate for liposuction.  Those with macromastia—a condition in which the breasts are extremely big due to abnormal development of the glandular tissue—will likely need the excision-based breast reduction surgery.

Thin women with excessively large breasts often have more glandular tissue and little fats, making them a bad candidate for liposuction.  For these patients, only the excision-based breast reduction can provide them good results.

After liposuction, the result is a smaller version of the breasts; however, patients should remember that the procedure cannot change the shape of the bosom. 

In many cases, it can also create a slight to moderate lifting effect because the weight of the excess fats is remove, though patients should remember that the final result also depends on the elasticity of their breast’s suspensory ligaments.

Because there is only minimal trauma to the glands and nerve, there is little chance that breast reduction via liposuction will affect breastfeeding.

What Is the Most Ideal Age to Have Breast Augmentation Surgery?

Breast augmentation is one of the most sought-after cosmetic surgeries not just in the US but also in many countries.  In fact, it has been estimated that 5 to 10 million people have the procedure; they consisted of women who wanted to improve their appearance, post-cancer patients who had mastectomy, and transgender.

To date, many countries including the US require patients to be at least 18 years old before they can undergo breast implant surgery.  But take note that this age requirement generally applies if you will have the procedure solely for cosmetic purpose—e.g., you want to increase your bust size.

By contrast, age requirement is not important if you will have the procedure as a way to treat developmental abnormalities.

You have to remember that patients between 18 and 21 can only have saline implants which are filled with a sterile saltwater solution.  But when you reach the age of 22, you would be allowed to use silicone implants during your breast augmentation surgery.

The main reason why silicone implants require a higher age limit is because of the risk of rupture.  To prevent serious complications, you will be required to undergo MRI screening at least every two years.  By contrast, you will not need this if your implants are filled with saline, which in case of a leak, can be safely absorbed by your body, though your breasts will immediately appear somewhat “flat.”

While 18 years old can already have breast augmentation, many plastic surgeons believe that a woman should wait until she has reached her twenties because there is a likelihood that her breasts will further enlarge.

Imagine that if your breasts become larger after having plastic surgery, you may end up with a bust size bigger than what you really want.  While you can always have revisions to downsize your implants or even remove them without replacement, this means additional expenses and possibly more scarring.

If you decide to have breast augmentation in your teenage years, you will likely need revisions sooner than later.  Take note that breast implants are not designed to last a lifetime and are subjected to the natural wear and tear.

According to a data collected by the American Society of Plastic Surgeons, 65 percent of breast implant surgeries were performed on patients aged between 20 and 38, a clear indication that most women waited until their body has fully matured before they had the procedure.

Radio Station Gives Two Breast Augmentation Vouchers

A radio station in Chicago has recently given two breast augmentation vouchers each worth $7,000 for the winners of its contest “Breast Year Ever.”

Classic rock radio station WLUP “The Loop” held a contest requiring listeners to submit written reasons why they want to undergo breast augmentation surgery, and a photograph of their natural breasts.

One of the winners, Carrie, has shared her stories of why she desires to undergo the cosmetic plastic surgery.  Three years ago, the bank teller gave her husband her kidney, and as a way to thank her wife, the husband said he wants to “give her breast augmentation in return.”

The second winner, Alishia, is a cancer survivor who at a young age received radiation therapy to save her life; however, the treatment inhibited her to have normal breast development.

According to the radio station’s website, Alishia became a nurse as her way to heal others who are dealing with the same medical issues she had experienced during her struggle with cancer.

This is not the first time a radio station offers breast surgery vouchers to listeners.  Just recently, Calgary station Amp Radio also raffled off breast augmentation which was won by a transgender woman.

Also, a casino in Atlantic city offered jackpots in the form of cosmetic procedures including liposuction, cheek implants, and Botox injection.  The contest dubbed as the “Tuck and Lift Sweepstakes” raffled off $25,000 worth of plastic surgery and non-invasive procedures.

Meanwhile, some board-certified plastic surgeons are not happy with the growing trend of using cosmetic surgery vouchers as a prize for contest as it may mislead people to believe the procedure does not involve serious ramifications.

Dr. Tarick Smaili, one of the leading Los Angeles plastics urgeons, said that plastic surgery is a “serious decision to make and involves lengthy consultation between a doctor and his patient.”

“I always require lengthy consultation and physical examination before I proceed with a certain procedure to determine a patient’s qualification not just in terms of physical health but also emotional and psychological health.  Of course, I also consider my patient’s expectations and goals—whether these are achievable or not,” Smaili said.

50 Years After Silicone Breast Implants Were Introduced

It was in the early 1960s when Thomas Cronin and his team have developed the world’s first silicone breast implants.  The idea started when they noticed that plastic bags used by the blood banks have the same softness of a breast.

When Cronin attended a plastic surgery meeting, one of his colleagues told him about a new company which had a new product that can be made into solid and liquid form, with a variety of viscosity.  Another great thing about the device was the extreme compatibility with the human tissue.

The medical-grade silicone can be turned into a solid form which will serve as the shell, while the cohesive silicone gel will act as the filling.  This material then paved way for the invention of silicone-filled breast implant, one of the most commonly used devices in cosmetic plastic surgery to date.

After creating the first prototype of silicone breast implant, the device was implanted into a dog.  The trial worked okay and so Cronin and his colleagues started to look for a woman who would be interested to have the first breast augmentation surgery through the new device.

The plastic surgeons found a willing test subject: Timmy Lindsey.  Now she is 80 years old and working in a care home in Texas.

At the time, no one would have ever imagined that breast augmentation surgery would become one of the most popular cosmetic surgeries worldwide.  In fact, a 2010 survey conducted by the American Society of Plastic Surgeons showed that 296,000 procedures were performed in the US.

It has been estimated that 5 to 10 million women worldwide had breast augmentation surgery for cosmetic reasons, although a significant number also had it to reconstruct their breasts after mastectomy (or cancer surgery), and for transsexual people to transition from male to female.

While breast augmentation is popular in the US and UK, this is not the case in some countries which have their own standard of beauty.  For example, the procedure is not as popular in Brazil because most people there prefer large buttocks rather than big breasts.

Today, most women who seek for cosmetic breast augmentation are categorized into two groups: those with small breasts who want to increase their bust size, and those mothers who have deflated-looking bosoms which are caused by childbirth.

In the US and most European countries, breast augmentation for cosmetic reasons can only be conducted for patients aged 18 years and older.

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. 

Brazil Bans French-Made Breast Implants

Just recently, the American Society of Plastic Surgeons (ASPS) has released a statement saying the defective silicone breast implants made by PIP, a now bankrupt French company, did not reach the US.  This means that only patients who received breast augmentation outside the country are the ones who should only be concerned with the products.

But unfortunately, the ASPS said that about 80 percent of PIP breast implants were exported to other countries including UK, Chile, Spain, Germany, Colombia, Venezuela, Argentina, and Brazil.  For this reason, estimates suggest that 300,000 patients worldwide are affected by the substandard products.

Meanwhile, some reports show that PIP implants were sold by a Dutch-based company under the brand name “M” which was commonly used in Brazil.  And with the growing international scandal, the biggest country in Latin America has recently banned the defective products.

Aside from a nationwide ban, Brazil’s healthy ministry also said the government is willing to pay the medical costs for the removal of PIP breast implants.  This has also been the promise of French authority to the affected patients.

In fact, 39 women in Brazil have been entitled to receive implant removal surgery free of charge.

On the other hand, UK authority still insists that there is no reason to conduct a nationwide removal of PIP breast implants.  Such statement has appalled the public as some authorities directly said the government and clinics cannot foot the bill for about 40,000 patients with PIP implants, which are said to lack coating that prevents the gel filling from leaking out of the shell.

While Brazil is offering free implant removal surgery, the government said the coverage is only applicable for those with ruptured implants.  And without any symptoms, a patient should foot the bill if she is concerned with the potential complications associated with PIP’s products.

“We are not offering free preventive surgeries,” one government official said.

Currently, the health ministry has no idea on how many PIPbreast implants were imported and sold in Brazil.  However, it has discovered that in December last year alone, the country imported about 34,631 implants, with 24,534 of these were sold.

Substandard Breast Implants from France Did Not Reach the US—ASPS

About 30,000 women in France will receive surgery to remove the defective breast implants which are highly prone to rupture and leak, while approximately 50,000 patients in UK have these substandard devices which were manufactured by Poly Implant Prothese (PIP).

While the defective siliconebreast implants were exported to Brazil, UK, Chile, Argentina, Spain, Colombia, and Venezuela, the American Society of PlasticSurgeons (ASPS) said the products were never approved in the US.

In Germany and possibly elsewhere in Europe, the substandard PIP breast implants were sold under the brand name “M,” according to the ASPS website.  Meanwhile, about 80 percent of devices were exported outside France.

In a statement published on its web site, the ASPS said that “an American woman would need to have been implanted outside the United States in order to have received the implants that are now the subject of concern in France.”

According to earlier reports, about 50 clinics in UK have reported implant ruptures although the government said “there is no need to remove the products en masse.”

While the total number of British women with ruptured implants—which have been found to have a fragile shell—is still unknown, experts have estimated that about 1,000 patients could be affected.  However, this is just a conservative estimates assuming that implant failure rate is only 2 percent.

PIP’s cheap implants have been reported to be made of low-grade industrial silicone designed for mattress, making them “unfit for human use.”

Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the “quality of the silicone in PIP implants is not of medical grade, therefore, these are not fit to be implanted into humans.”

While there is a call for the UK government to “require women with the substandard devices to undergo implant removal” and “to shoulder the surgical expenses,” the spokesman for private medical clinics said that it would be “irresponsible” to remove all the implants as clinics could not afford to pay all the related costs.

The spokesman added that their study has suggested that the rupture rate of PIP implants is “between 1 and 2 percent” which is described as “within the acceptable industry standard.”  However a separate study has shown that failure rate is approximately 7 percent.

PIP, which filed for bankruptcy two years ago, has been warned by US Food and Drug Administration in 2000 that its implants were substandard as the company failed to follow “good manufacturing practices.”

Breast Surgery Improves Post-Cancer Patients’ Emotional Well-Being

Reconstructive breast surgery is an important part of recovery after battling with breast cancer.  This procedure is performed beyond cosmetic reason as breasts have always been associated with womanhood and sexuality; for this reason, diseases and invasive surgeries that result to deformities can have a huge impact to a patient’s emotional health.

Meanwhile, breast reconstruction is either performed via breast implants and/or tissue-based method. 

According to a 2011 study published in Cancer, the official journal of the American Cancer Society, women who have undergone breast reconstruction in which the tissue was grafted from the abdomen have experienced significant gains in social, sexual, and psychological well-being.

The researchers believe their findings can help women suffering from breast cancer to decide if reconstructive plastic surgery can be a part of their recovery.

The study, which involved 51 women who had free MS-TRAM or DIEP flap reconstruction (tissue grafted from the abdomen to create a breast mound), shows the positive emotional impact of reconstructive breast surgery on post-cancer patients.  However, one downside is that majority have experienced muscle weakness in the abdominal area.

Some patients may have reconstructive plastic surgery right after their mastectomy, a procedure that completely or partially removes the breasts.  However, others have to wait for a couple of months to make sure that their body has already fully recovered from the trauma caused by the initial surgery.

If there is a significant deformity, most plastic surgeons recommend tissue-based grafting in which they use a patient’s own tissue from the abdomen to create a breast mound.  Meanwhile, the buttocks and back can also serve as a donor site to form new breast/s.

On the other hand, breast implant surgery may be enough for some patients especially if the initial surgery has left them with enough amount of breast tissue.  This technique often leads to less scarring than if the tissue-based method is used, although it is not recommended for those who are left with little or no tissue.

One downside of implant surgery is that the breast which is not treated may “age” at a different pace than the one with the implant, resulting to asymmetrical look.  For this reason, some patients may be recommended to have breast lift or other surgeries that can create a balance appearance.

Contrary to popular belief, breast implants do not pose a significant risk to post-cancer patients.  First and foremost, there is a very little chance of cancer recurrence on the breasts that have already been treated with mastectomy.

Woman Tries to Have the Largest Breast Implants in the World

In an attempt to make history, Sheyla Hershey, 31, had undergone 30 breast surgeries to make her bust the biggest in the world through implants.  But just recently, she was forced to undergo an emergency procedure to remove her 38KKK cup size implants due to bad reaction and unusual pain during her recovery. 

However, what is more surprising is that she is still determined to hold the record for having the largest breast implant size in the world.  In fact, she was reported to have traveled to Mexico in order to receive a new operation to “reinflate” her breasts, even without her husband’s knowledge.

In an interview with the Daily Mail, Hershey was quoted saying that she felt “deformed without her breasts.” 

“I feel like I lost my leg,” she added.

Hershey regained her previous 38MMM cup size with a procedure that injected saline solution inside her breast implants.  Her husband only thought that she was going to Mexico in order to reconstruct her bust.

With the result of her new operation, she said she was happy and “felt whole again.”  Meanwhile, some experts believe she was suffering from body dysmorphic disorder, a type of mental illness in which the sufferers are extremely conscious to their body image and preoccupied with their slight or imaginary defects of their physical features.

According to previous reports, Hershey is also suffering from bipolar disorder.

Dr. Tarick Smaili, one of the leading plastic surgeons in Los Angeles, said that breast implants are reasonably safe “as long as they come in sizes appropriate to the body-frame and amount of tissue and skin of patients.”

“A good and ethical plastic surgeon will not push the body’s limit by introducing breast implant size that is way too large for a patient.  Violating this principle will likely result to higher risk of implant visibility, unusually painful recovery, and other serious complications,” Smaili said.

Smaili said that he was also concerned with the significant scar tissue associated with having multiple breast surgeries, which are necessary if one is going to have inordinately large breast implants.

“Hershey is likely having multiple breast implant surgery to slowly stretch her tissue and skin, however, it is also possible that she is using tissue expanders, which are temporary implants injected with saline every couple of weeks, so her breast can house larger sizes”, the surgeon added.

Meanwhile, the US Food and Drug Administration does not impose any limit on breast implant size although US manufacturers Mentor and Allergan do not offer implants larger than 800cc.

Ingenious Ways to Avoid Capsular Contracture After Breast Augmentation

The development of capsular contracture is one of the most common concerns of breast augmentation patients.  This complication, which happens at about a rate of 15 percent, occurs when the scar tissue around the implants becomes abnormally thick that it ends up squeezing the devices.

Despite the relatively high rate of occurrence, not all cases of capsular contracture need a revision surgery especially if there are no symptoms such as visible distortion and pain.  However, women who are experiencing severe discomfort and have developed ball- or coconut-shaped breasts will likely need another breast augmentation.

In the early stages of capsular contracture, the complication can be treated with non-surgical methods such as taking antibiotics and certain medicines, and performing breast massage.  For this reason, any unexpected changes in the breasts particularly hardness of the tissue should be immediately reported to a plastic surgeon.

But as the cliché goes, nothing is far better than to prevent capsular contracture than to treat its symptoms.  Fortunately, plastic surgeons nowadays have a deeper understanding of how this complication occurs. 

These are the six most ingenious ways to avoid or at least minimize the chance of capsular contracture from occurring:

1.     Avoid smoking well in advance of the procedure and during recovery.  Several studies have suggested that the nicotine’s ability to constrict the blood vessels not just inhibits proper oxygen delivery but also lead to higher risk of capsular contracture and gangrene.

In fact, smokers face great risks during and after surgery that plastic surgeons today will likely decline to conduct an operation unless they will quit the habit at least three weeks before and after surgery.

2.     Use of no-touch technique.  Also called as the Keller Funnel technique, it involves the use of a pouch (lubricated with a special solution) where the implants are placed.  The narrower end of the device is then squeezed in order to transfer the implant to the breast pocket without actually touching it.

With this technique, doctors can prevent contaminating the implants with staph bacteria present in the patient’s skin, which in turn lowers the risk of capsular contracture.

3.     Avoiding incision in the breast’s sub-muscular space.  This area is known to harbor bacteria, which is one of the most common causes of capsular contracture.

4.     Creating an oversized breast pocket.  With this technique, the scar tissue, which normally forms around the implants, will not put pressure or squeeze the breast implants in case it becomes thicker than it should be.

5.     Breast massage.  While not all plastic surgeons recommend postoperative breast massage, some experts say that it can minimize the risk of capsular contracture by preventing the scar tissue from becoming hard and thick.

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Corrective Breast Augmentation for High-Riding Breasts

Breast augmentation, as its name suggests, augments the organ highly associated with femininity and sensuality.  And with the advances in plastic surgery, today the procedure is reasonably safe to many women that it has been the most popular “medical enhancement” over the past couple of years.

But one consideration to make is the risk of capsular contracture, a condition in which the scar tissue that normally forms around the breast implants becomes too thick that it ends up compressing the devices.  In severe cases, it results to visible distortion and pain.

Visible distortion may be manifested by a ball- or coconut-shaped breast or a high-riding bust.  In order to treat this problem, a revision plastic surgery is performed by doctors in which they remove the thick scar tissue and replace the breast implants with new ones.

Many plastic surgeons recommend replacing the breast implants to avoid or at least minimize the risk of infection, believed to be one of the causes of capsular contracture.

During a revision surgery, doctors avoid contaminating the breast implants so they apply the no-touch technique in which they use a funnel with a special lubrication.  With this procedure, the implants are placed inside the pouch which is then squeezed to its narrower end to push the devices into the breast pocket.

This technique, which is also called as the Keller Funnel, not just reduces the risk of contamination but also minimizes the pressure applied to the breast implants so the durability of their outer shell is not compromised during the implantation process.

To further avoid the recurrence of capsular contracture and high-riding breasts, plastic surgeons position the implants behind the muscle rather than on top of it so there will be less contact with the tissue, which is believed to harbor bacteria.

But instead of removing the scar tissue and replacing the breast implants with new ones, some doctors prefer to release the scar capsule using an electrocautery device.  This approach is particularly ideal for patients with a small amount of tissue and fats in their breasts, predisposing them to higher risk of visible and/or palpable wrinkling.

Patients with a high-riding bust or other forms of visible distortion due to capsular contracture should take into consideration that not all breast augmentation surgeons are adept in revision breast implant surgery, which requires a more complex skill.

Just to be sure, a patient should choose a doctor who has an extensive experience in conducting revision breast augmentation.

 www.californiasurgicalinstitute.com