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Author: foreignhaus | Total views: 27 Comments: 0
Word Count: 1155 Date: Thu, 19 Mar 2009 7:49 AM

What Type and Size Breast Implant Should I Get?

If your envelope has been stretched by pregnancy, you'll need enough to fill the envelope adequately for the best result. If you've not been pregnant, a good rule of thumb is to think about enlarging the breast the amount it would enlarge during pregnancy, about a cup size.

If you want an especially large breast, you must accept the inevitable consequences of your decisions. The larger the implant and the thinner your tissues, the greater your risks of complications, additional surgery, visible implant edges, rippling, and possible shrinkage (atrophy) of your existing breast tissue. You need to consider what you want and balance that with what will happen to your tissues as you age, especially with a larger implant. Best choice? Ask your surgeon to enlarge your breast proportionate to your figure, filling the breast only enough to create an aesthetic result, not too large and don't ever discuss ccs.

You'll definitely be happier ten years or more later. Don't be too concerned when you hear many women say they want to be larger. They aren't thinking about the long-term consequences.

Do you prefer a smooth-surface implant? Why? Hopefully it isn't because smooth implants are cheaper. Don't make this choice believing that you'll be less able to feel the implant because it isn't so. Tissue coverage is the main issue that affects whether you can feel an implant.

The fact that a smooth-wall implant can move around more than a textured is a positive and a negative. The main worry is whether smooth implants really are as good at preventing capsular contracture and how the smooth wall implant may affect tissues long term.

Most surgeons believe that textured surface implants offer a decreased risk of capsular contracture (more so with silicone-gel filled implants compared to saline-filled implants).

With anatomic or shaped implants, a textured surface helps maintain optimal position of the implant. If you choose a smooth wall implant and subsequently develop a capsular contracture, will you look back and wonder, "What if I had chosen a textured surface implant?"

The main question is how to deal with the fill issues with current round, saline-filled implants. If you fill it to manufacturer's recommendations, the shell folds and risks visible rippling and shell failure. If you overfill, you currently are not assured in writing that the manufacturers will warranty the implant.

If you're choosing a round implant because a surgeon has told you that anatomic implants malposition, hopefully you asked exactly how many anatomic implants the surgeon had placed. The fact is that both round and anatomic implants can malposition, and published data suggest that the incidence of reoperations with properly used anatomic implants is less than one-half of 1 percent.

Looks more like a breast. More demanding of the surgeon. Offers better long-term control of upper-breast fill and breast shape. Best in first-time augmentations until a surgeon has plenty of experience, then okay for reoperations.

Fill volumes are defined differently by the manufacturer, depending on the specific type of shaped or anatomic implant. Remember that all anatomic implants are not the same. Some are full height and some are reduced height, and adequate fill to reduce risks of upper shell folding or collapse depends on the implant's passing the tilt test outside your body.

A better choice for any patient who, despite scientific evidence, has any concerns whatever about the safety or potentially higher capsular contracture rates with silicone gel filled implants.

The primary tradeoff of all saline filled implants is that they are likely to have a shorter shell life compared to silicone gel implants, and therefore potentially require more replacements during a patient's lifetime. Saline implants are also currently less expensive compared to silicone gel filled implants.

Silicone gel filled implants have been shown in FDA studies to have a longer shell life compared to saline implants. Form stable silicone gel filled implants have a substantially lower shell failure rate compared to conventional silicone gel filled implants. All silicone gel filled implants except form stable silicone gel implants have been shown in FDA PMA studies to have a higher rate of capsular contracture compared to saline implants.

These rates also relate to how a surgeon performs your surgery, the less trauma and bleeding, the faster the recovery and the lower the capsular contracture rate. Silicone gel filled implants are more expensive compared to saline implants, and form stable silicone gel implants are more expensive compared to conventional silicone gel filled implants.

Picking the Incision Location. Inframammary. The most commonly used incision in breast augmentation offers surgeons the greatest degree of control in the widest range of breast types and implant types and sizes. The standard by which all other incisions must be measured.

The only reason not to have an inframammary incision is you absolutely do not want a scar on the breast or you have a documented history of hypertrophic scarring from a surgical procedure.

Periareolar (around the areola). A good selection if you have a history of hypertrophic scarring or if you just prefer this location. The implant has more exposure to bacteria in breast tissue by this approach, but no scientific studies prove a higher risk of infection or capsular contracture. Nipple sensation is an issue. Nursing should not be an issue if the procedure is performed properly.

Axillary (in the armpit). The ideal location if your main goal is to get the scar off the breast. Much better control during surgery compared to the umbilical approach. The entire pocket can be created under direct vision by the surgeon using endoscopic instruments. This scar is not visible in over 90 percent of patients even with the arms raised.

Umbilical (around the belly button). Attractive to some surgeons from a marketing standpoint. You'll find that the vast majority of highly experienced surgeons feel this approach offers much less control compared to other approaches, unnecessarily traumatizes abdominal tissues, and requires that most, if not all, dissection of the implant pocket be performed bluntly and blindly.

The entire pocket is created by tearing tissue with an expander balloon and by forceful, manual movement of the inflated device or by using some other form of blunt dissector that tears tissues.

You'll have injury with discomfort and bruising in the upper abdomen that rarely, if ever, occur with procedures that assure less tissue trauma and bleeding, and in a few cases, you may develop deformities of the upper abdomen. You can't judge by pictures because many of the irregularities under the breast or in the abdomen aren't visible in standard pictures.

You get all of the benefits of the umbilical approach without the trade-offs and risks by selecting an axillary incision!

About the Author

Dave Stringham, the President of LookingYourBest.com writes about plastic surgery in Dallas, Texas and plastic surgery procedures like dallas breast implants, breast augmentation, face lift, rhinoplasty, liposuction, and tummy-tuck.