What to Know Before Surgery

Pre-Surgery Essentials, What to Know Before Surgery

For over a decade, breast augmentation surgery has been the most popular cosmetic procedure performed each year. In 2017 alone, over 300,000 breast augmentations were performed, and that number consistently continues to climb annually. Women who wish to enhance the size, shape or symmetry of their breasts may look to breast augmentation to address these concerns and restore proportion, balance and shapeliness to their breasts for years to come. Whatever your reasons for considering breast augmentation, Newport Plastic and Reconstructive Surgery is here to provide you with the need-to-know information to take into your initial consultation and help you determine if a breast augmentation is right for you.

Breast Augmentation Addresses Size, Not Sagging

There is often a common misconception that breast augmentation surgery can not only increase the size of your breasts, but also work to lift stretched, excess skin on the chest and raise breast tissue that has begun to droop. While breast augmentation can increase the breasts’ profile or their projection from the chest, the procedure does nothing to address lax skin or sagging tissue. In fact, any sagging present in your breasts prior to your augmentation may be exacerbated by the added volume of your chosen implants.

A breast lift, or mastopexy, is a cosmetic surgery designed to lift and restore the breasts’ shape to a more youthful and aesthetically-pleasing profile. During a breast lift, loose and excess skin is removed from the breasts and surrounding tissues are tightened to achieve a more attractive, lifted bustline. However, while a breast lift will effectively reshape and raise your breasts, no significant change in breast size or volume occurs as a result of a breast lift alone.

Similarly, breast augmentation on its own will not permanently prevent your breasts from sagging over time. For this reason, many patients at Newport Plastic and Reconstructive Surgery will choose to have a breast lift performed in conjunction with their breast augmentation, or after their breast augmentation, to both increase their breast size and keep the chest lifted for years to come.

Saline Versus Silicone Implants

Breast implants each consist of a soft, silicone outer shell. The contents that fill these shells can be broken into two basic categories: saline and silicone gel. While not discernibly different in appearance but sometimes varying in shape, these materials differ most significantly in the way they feel, the size and location of the incision requirements, and their overall cost.

Silicone implants are traditionally the most popular implant option and were used in 87 percent of breast augmentation procedures in 2017. However, these fillings each have their own advantages and drawbacks. The implant material you choose is based primarily on personal preference, but board-certified surgeon Dr. Seify can recommend which style, shape and texture will yield the best results for your individual goals.

Saline implants are composed of a sterile saltwater solution and tend to feel firmer to the touch than natural breast tissue and the alternative silicone materials. They are placed into the breast empty, which can allow for more custom adjustments in volume and symmetry during the procedure. Saline implants also have the added benefit that in the rare case of leakage or implant rupture, the solution can be safely and naturally absorbed by your body without any adverse side effects. While a leak or rupture in a saline implant will cause the breast to deflate almost immediately, this is ultimately beneficial, as you will know immediately when the implant needs to be replaced.

Silicone implants are prefilled with a gel substance and considered softer and more natural-feeling than saline implants. The smooth gel is less likely to display any rippling or wrinkling and is ideal for women without much existing breast tissue to work with. A disadvantage to silicone, however, is that they are capable of silent rupture, which is when leaks and ruptures are not immediately noticed due to no visible changes to the breasts’ shape.

Undetected leaks may lead to silicone migrating out of the implant pocket, though this is less likely with the new cohesive gel or “gummy bear” implants in which the consistency of the gel is much thicker and is less likely to migrate. The damaged implant will need to be removed, but the leaked silicone is inert, meaning it is safe and non-toxic. Again, any sort of leakage or rupture is a rare occurrence, and both silicone and saline implants have been extensively researched and tested for durability and safety.

In 2014, a new type of FDA-approved implant technology became available for breast augmentation— the Ideal Implant. The Ideal Implant gets its name by combining the best features of saline and silicone implants to both give women peace of mind in the safety of their implant material without compromising look and feel. While composed of saline, Ideal Implants are also internally structured, providing them with a natural look and feel similar to silicone without the risk of silent rupture. When choosing which implant is right for you, it’s important to discuss the benefits of each option with a board-certified surgeon to achieve the best overall outcome with your procedure.

Implant Placement Matters

It may surprise you to learn there are two different options for the placement of breast implants that play an essential role in the outcome of your procedure. The first option is referred to as sub-glandular, which creates a pocket for the implant directly beneath your existing breast tissue and above your pectoral muscle. Sub-glandular placement can be beneficial for providing a more dramatic breast profile with your implants, or more significant projection from your chest wall to accentuate the bust.

However, proper concealment of the breast implant can easily be compromised with this placement if the patient does not have a substantial amount of existing breast tissue. This can result in the outer edge of the implant or fill valve being visible from beneath the skin, or noticeable wrinkling or rippling in the implant’s texture.

The second option, known as sub-muscular or sub-pectoral, places a pocket directly between your pectoral muscle and chest wall. Sub-muscular placement is generally more ideal for women without a great deal of existing breast tissue, as the pectoral muscle provides better implant concealment by preventing visible edges or wrinkling. This placement is also thought to lessen the likelihood of developing capsular contracture— the most common complication of breast augmentation in which scar tissue gradually forms around the implant.

Breast Implants Will Need to Be Replaced

Many women are surprised to discover that their breast implants will at some point need to be replaced. While most implant devices will last up to 10 years or longer before requiring a replacement, annual check-ups and regular self-checks will be necessary to maintain the vitality of your implants. Women with silicone implants are advised to receive an MRI scan three years after surgery then every two years after that to inspect for silent ruptures. Women may also choose to replace their implants after significant weight fluctuations, pregnancy and breastfeeding or changes in personal preference.

Breast augmentation surgery isn’t a one-size-fits-all procedure, and with so many customizable options, it can be intimidating to know where to start. To learn more about what breast augmentation can do for you, Dr. Seify and the experienced staff at Newport Plastic and Reconstructive Surgery are ready to guide you every step of the way. Call our office today at 949-333-0305 to schedule your consultation.

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