Eeny, Meeny, Miny, Whoa! - Making Your Breast Bet In Augmentation Implant Selection
For many women, the decision to have breast augmentation surgery is perhaps one of the easiest to make in the pre-operative planning process. In fact, Dr. Steven Porto often hears from his patients at the first post operative office visits that they wish they had taken the plunge and had breast augmentation years before. One of the most crucial steps prior to surgery is deciding between the many breast implant options available. Will they be silicone or saline? Mentor Brands Memory Gel Xtra or Allergan’s Natrelle “gummy bear” implants? And you thought picking out the perfect pair of shoes to wear with that date night dress was a tough choice! Luckily the Porto Cosmetic Surgery team take pride in assisting each patient in tailoring their breast augmentation procedure and implant choice to meet their unique needs and desired results. So, fret not in this cleavage conundrum and allow us to illuminate all things breast implant.
Silicone or Saline?
Let’s start with one of the most important, and at times debated, choices in implant selection: silicone vs. saline. Both silicone and saline offer natural looking breasts that are reported to be essentially identical from a safety standpoint. Silicone is a thick, cohesive gel material that mimics the look, shape, movement, and feel of natural breast tissue. Saline Implants are comprised of a silicone shell filled with a sterile salt water and comparatively have a less natural overall look and feel. Saline, which behaves much like water, can cause the implant to appear heavy, rippled, and droopy. Silicone implants have a set, pre-made fill volume while saline sizing is flexible and can be dialed exactly during surgery. Silicone implant sizing is discussed at a pre-operative appointment and a range of sizes are taken on the day of surgery. An intraoperative breast sizer is temporarily placed into the surgical pocket and filled to determine the ideal silicone implant sizing for each patient prior to its final placement. Silicone implants are a great choice for women with minimal breast tissue prior to surgery, unlike saline, due to their more natural appearance.
One primary distinction between silicone and saline implants lies in the potential for rupture along with the methods of diagnosing this rare but potential surgical complication. Saline implant ruptures are often immediately discernible as the deflation can be seen once the implant flattens and the saline solution is safely absorbed into the body. As saline filled implants behave much like liquid they are therefore more prone to deflating or popping than silicone implants. Although silicone has proven less prone to rupture they are, however, more difficult to diagnose should one occur. Referred to as a “silent rupture”, this silicone implant complication is not easily detected visually but by MRI imaging to confirm. Silicone, unable to be absorbed by the body naturally, has not been shown to cause long term health concerns in the event of an implant rupture. Some breast pain and asymmetry of the breasts are possible until the rupture can be repaired surgically.
Surgical Technique
Breast augmentation surgical techniques also go hand in hand with implant choice to provide patients with optimal post operative results. The vast majority Porto Cosmetic Surgery patients choose silicone implants placed under the chest muscles, also known as submuscular placement for the most natural look and feel. Implants can also be placed subglandular, or under the skin, but this placement has proven to be much less popular with surgeons and patients alike over the years. Surgical incision to place breast implants can also vary by implant type as well and may impact whether a patient chooses silicone or saline. Saline implants can be placed using a slightly smaller incision than that of a silicone implant. Silicone implants also have fewer options for types of incisions however can be done via the crease beneath the breast, also referred to as inframammary fold. This popular technique allows for the most natural placement of the implant while scarring the least. Dr. Porto’s most preferred incision technique is along the outer edge of the nipple (periareolar) and blends the scar along the natural pigmentation of the nipple. Two less commonly used incisions are via the underarms (transaxillary) and through the navel (umbilical).
Implant Brand
The two primary manufacturers of breast implants are Mentor, who offer silicone Memory Gel technology in a variety of sizes and profiles, and Allergan’s Natrelle “gummy bear” implants. No, we aren’t also running a candy shop here at Porto Cosmetic Surgery you did indeed read that correctly: Gummy Bear. These silicone implants by Allergan incorporate cross linked silicone particles to form a cohesive gel that closely mimics the shape and feel of a natural breast. It was given this sugary sweet nickname to demonstrate that the silicone gel within the implant would retain its shape if sliced in half, much like a gummy bear candy would. Mentor brand’s silicone and saline breast implants are both manufactured and sold in the U.S. and their Memory Gel silicone product line is a particular favorite of patients here at Porto Cosmetic Surgery. The Memory Gel line offers a natural feel and roundness with a variety of profile options available such as moderate, high, and most recently Boost offering the most outward projection in their product line to date.
Profile
Wait, what on earth is profile? Even more choices to make?! Don’t worry, its actually very simple and has all to do with the upper pole fullness of the breast. Upper pole fullness refers to how round and full the area above the areola, or nipple, appears, and the more the better when it comes to our favorite topic in breast surgery, cleavage of course! In regards to implant profiles, the higher the profile the more the implant projects within the upper pole. What’s that saying in the South? The higher the hair the closer to God? Well the higher the profile the bigger the upper pole projection.
Shape and Texture
Lastly, shapes and textures of implants can also play a role in which style is the right one for some patients. Overall the majority of breast augmentation surgeries performed utilize the tradition smooth, round style of implant. Shaped implants, which are taped at the top and more full at the bottom designed to mirror the shape of a natural breast are on the market. These can have a tendency to shift and require corrective surgery over time. Textured implants are made with a rough surface to adhere to the surrounding breast tissue to prevent implant shifting but have been recalled due to persistent postoperative complications.
The pros and cons of the variety of implants available to patients in modern day breast augmentation surgery has been performed, researched, and refined for decades and the benefits of each are now more discernible than ever before. So book your complimentary augmentation consultation with Dr. Porto today and discover your breast implant bestie.
