What is the breast implant?

The breast implant, or breast augmentation, is a kind of surgery that is got by women to make their breasts fuller and bigger. It is a procedure consisting of gel-like material implanted behind or in place of the breast. It can be done for constructive purposes such as after mastectomy or for cosmetic reasons. Regardless of any reason behind it, the breast implant is categorized into two main types: silicone and saline breast implant.

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Saline and silicone breast implant

Two types of breast implants are saline and silicone implants.
The saline implant is a type in which the breasts are filled with silicone shells that are filled with sterile salt water called saline.
The saline implant is suitable for women up to 18 years old to have breast augmentations and for any age for reconstruction goals.
Prospering any of these complications, either to remove or replace the implants, may need additional surgery.
If a saline breast implant ruptures, the implant will flatten and causes the affected breast to change in size and shape. Your body will absorb the leaking saline solution with risk, but you may need surgery to remove the silicone shell. A new implant can probably be inserted at the same breast if you want.

If a silicone breast implant ruptures, you probably will not notice right away or over, since any free silicone remains trapped in fibrous tissues. This type of rupture is known as a silent rupture.
Leaking silicone gel does not cause health problems such as reproductive problems, rheumatoid arthritis or cancer, but it might eventually lead to breast pain, changes in contour or shape of the breast or breast thickening.
If silicone gel leaks, your doctor will probably recommend surgical implant removal. A new Implant can be inserted at the same time if you want it.

Breast implant
breast implant

What is the gummy breast implant?

The gummy bear breast implant is a type of silicone implant made of more viscous silicone gel and is slightly firmer to touch than the older traditional silicone implant. It is called gummy bear because its texture is solid similar to that of the gummy bear. It can maintain its form even outside the shell.
Though this type of implant has existed approximately for three decades its use has been revolutionized in the last 5 years in the United States. But why? Because the applied silicon has a greater amount of crosslinking which means that the beast filling with it has a better shape. It does not ripple or wrinkle as much as possible. So, the volume of your breasts increases without it wrinkles or folds. If the implant is to break, your beasts will maintain its shape and the gel will not leak to your body.
The last aspect is very significant because when the implants are broken, the gel leakage can present a complication and additional surgery will be required.

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Breast implant procedure

Breast implant procedure

Breast implant procedure includes the flowing steps:

Medication is used to make you feel comfortable during the surgical procedure. Different options include anesthesia and intravenous relief. Your surgeon will decide on the best choice.

Incisions are made in invisible areas to minimize visible scarring. You and your plastic surgeon will talk about the appropriate incision area options for the desired outcome. These options include:
The fold under the breast ( inframammary fold), along the areolar edge( periareolar incision) and in the armpit( axillary incision). A belly-bottom approach has a higher complication rate.

Incisions are not the same. They vary based on the degree of enlargement desired, type of implant, your particular anatomy and you and your doctor’s preference.

After making the incision the doctor inserts a breast implant into the pocket either under the pectoral muscle or directly behind the breast tissue, over the pectoral muscle. The first one is called submuscular placement and the second one is called submammary placement.

The surgeon closes the incisions with layered sutures in the breast tissue and closes the skin with sutures, surgical tape or skin adhesive.
As time goes on the incision lines fade. The scare quality depends on various things such as exposure of your body to nicotine, your genetics and your exposure to infection.

You will see the result of the breast implant right after the incisions are closed. The larger and fuller breast is visible. However, the final results may take a few weeks to be observed completely as the swelling subsides and your skin stretches. Incision lines may take a long time, even a couple of years, to fade.

Choosing the breast implant shape

Teardrop shape

Teardrop implants are widely believed to be the most anatomic breast implant. Those who seek a more subtle and natural look consider it as the anatomical one due to its unique shape that is fuller at the bottom and gradually tapers towards the top and closely resembles the natural breast shape. It is recommended for patients with little breast tissue who will not get a natural look with a round implant.
Teardrop breast implant improves the natural breast line and does not need any post-surgery massage. However, sometimes doctors discourage patients from choosing this type because when it rotates the breast becomes unnaturally distorted and requires the patient.

Round shape implants

A round shape breast implant is oftentimes the most anatomically and even more so than teardrop shapes. It also assumes the anatomical teardrop shape. This shape responds to the gravity forces and mimics a natural breast closely. This is true especially when the woman lies down, since round implants, similar to the natural breast, fall more naturally to the side so that the anatomic implant shape. It has the added advantage of having less of a framework than the anatomic one, thus if it rotates, no change to the shape is visible.

Which one is better, saline or silicone breast implant?

Silicon seems to be a more advantageous way for breast augmentation, but more women prefer saline implants. Some different features of implants are:

During your consultation, you can try different sizes of both implant types. It is the best way to have an idea of how the real implant feels. Many patients prefer to choose silicon at this step because of its size. Most of the candidates like how silicone implants feel but you should know that saline implants won’t be like a water sack when placed in your body because the surrounding skin, fat, and muscle will add more volume to it. However, most of the patients think that the silicone implant feels better. Anyway, if you feel any problem with any type remember to contact your doctor immediately.

Though there is no major difference between saline and silicone implant silicone tends to show less rippling. Saline solution consistency is little and the implant shell may fold easily. However, silicone implants can have a significant visual difference

If the implants are placed under the muscles, this won’t happen. Experienced surgeons know how to prevent this problem. Both implants can cause this.

Raptures rarely happen and it generally happens with the saline breast implant. Because of cohesive nature silicone implant stays together and it can be detected only with an MRI. FDA determined that silicone implant risk to diseases or any medical problem is low.
Scares
One of the major differences between silicone and saline implant is scare. The saline implant has less scarring because it is inserted through a smaller incision and filled then with the solution. However, a silicone implant is inserted in full form.
If you are thinking of breast implant, assure that you have studied both implant type advantages and disadvantages first. Then consult with your surgeon in detail to make sure that your choice won’t make any problem to your health.

Breast implant replacement

Breast implants are not lifetime devices, so you may need to be replaced. Remember to see your plastic surgeon to be examined annually and evaluated implant integrity and breast health.
Naturally, your breasts will change over time due to aging, hormonal factors, weight fluctuation, and aging. When the breast’s appearance changes with time, some patients get breast lift or implant exchange service to restore a more youthful counter.

How about recovery time?

Breast implant recovery time differs from patient to patient. This is because everyone is different in terms of pain tolerance and the body’s natural recovery response. Additionally the type of implant, its size and placement can influence the recovery process.
Most patients can return to work and light activity after a week. Normal activities can resume in 2 weeks, however normal physical activity can resume in 4 weeks. The implant settles by 6 weeks and the final result is realized.

Who is a qualified surgeon to do breast implant?

If your surgeon has ABCS board he cannot attain certification from ABPS which assesses and certifies a surgeon’s ability to do plastic surgery to the highest standards. It just means that he/she has fewer years of surgical training. You should assure to closely assess his/ her qualification and background to be sure that he can make it according to peak standards.

Another important thing is that you should make sure the surgery center is accredited too. Board-certified plastic surgeons that work in accredited surgery centers have morality rates (>0.000017%) and lower rates of serious complications (>0.5%). These centers are verified by private organizations for having safety standards, the right equipment, and trained staff that monitor your condition and care for you. This especially is important if a complication or a life-threatening emergency happens.

DR Ali Asghar Salahi

Dr. Salahi performs hundreds of abdominal and thoracic surgeries, abdominal lipatomics, lipomatic abdominal surgery, thighs and arms, breast prosthesis and minimally invasive surgeries and is one of the top-ranked doctors in Tehran in cosmetic surgery. They specialize in cosmetic surgery.

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Breast implant risk and complications

  • Breast augmentation is a type of surgery and has some risk and complications like any other surgery. Some adverse outcomes and complications include:
    Breast pain, breast sensation and changes in nipple
  • Additional surgeries that may be done with or without device removal
  • Capsular contracture, scar tissue that figures around the implant and causes implant squeezes
  • Deflation and rupture
  • Anaplastic large cell lymphoma, a type of immune system cancer.
  • Connective tissue disease, breast cancer and reproductive problems
  • Scar tissue that falsifies breast implant (capsular contract)
  • Infection
  • Changes in nipple and breast sensation that are often temporary
  • Implant rupture or leakage

In general breast implants, the healing process is quite painful and the patients experience scarring and bruising for some time. Also, it is possible that your body rejects the implant and causes some medical problems. In some cases, it ruptures or leaks and causes damage to the body. Some implants such as the gummy bear implants that are expensive have less probability of breaking because of their cohesive nature. Loss of sensitivity that patients experience especially in the nipples and other breast areas can interfere in breastfeeding and some women’s intimidate life.

Breast implant risk and complications

Who is a good candidate for breast augmentation?

The breast implant is deeply a personal procedure, so you must do it for yourself, not for someone else. You may be a good candidate if:

  • You are physically healthy and you aren’t pregnant or breastfeeding
  • You have realistic expectations
  • Your breasts are fully developed
  • You are bothered by the feeling that your breasts are too small
  • You are dissatisfied with your breasts losing shape and volume after weight loss, pregnancy or with aging
  • You are dissatisfied with the upper part of your breast that appears “empty”
  • Your breasts are asymmetrical
  • One or both breasts have not developed normally or has an elongated shape
Breast implant price

Breast implant price

According to 2018 statistics from the American Society of Plastic Surgeons, the average cost of breast augmentation surgery is 3.854 dollars. But, this cost is only part of the total price. Anesthesia, operating room facilities and other related issues have additional expenses. To get the exact price information you need to consult your surgeon.The surgeon’s experience, the geographic office location, and the type of procedure will affect the final price.
Some plastic surgeons offer patients financing plans to breast implant, so do not forget to ask about it.
In general, these factors determine breast implant costs:

  • Anesthesia fees
  •  Hospital or surgical facility costs
  • Medical tests
  • Post-surgery garments
  • Prescriptions for medication
  • Surgeon’s fee
    Insurance plans usually do not cover a cosmetic breast implant, additional surgeries for related complications to revise the breast’s appearance. Remember to review your health insurance policy carefully before having the surgery.

Common questions

This implant requires major surgery which means swelling, bruising, pain and not so aesthetically visuals. You must be prepared if what you expect is not met within the first few months. Some patients report that their breasts look the way they wanted after 6 months.
Thus, it is important to consult your doctor about your expectations on size and other issues to know how they may differ from reality. Remember that the width of your breast bone, your skin elasticity, and frame of breast bone determine the size that will look more natural and will have the least amount of negative results.

It is important to consult your surgeon about their protocol. He/she may add correction/ complication surgery into his/her fee while. Keep in mind that even if your surgeon does his work well your surgery might not result in the perfect breasts. So, you may need to have additional surgery or surgeries which may have other complications.

“No” it is not one-time surgery. As you get older other surgeries may be needed due to aging, pregnancy, sagging, weight changes or complication. You may also decide to have them completely removed or enlarged in the future.

It is said that pregnancy does not influence breast implants more than regular breast tissue. It means that still, your breasts will become enlarged and swollen during pregnancy. However, there are conflicting opinions on whether women can breastfeed after getting the implant. Most doctors believe that this surgery does not affect breastfeeding. It is safe with zero health risks. But, there could be a decrease in milk expression and nipple sensation depending on the incision site and the removal of breast tissue. The doctor may make incisions in the breast fold or armpit instead of around the nipple to minimize these risks.

Breast implant, as explained above, can make your breasts fuller and more beautiful, but it does not mean that it is safe. According to statistics, 50 percent of those who have cosmetic breast implants experience some kind of complication such as hardening, infection, pain or the need for additional surgery.
Thus, you must consult with an experienced and committed surgeon before making any decision. Breast implants should not be at the expense of your health.