Overview
Patients who desire to improve the overall look of their breasts may consider breast augmentation surgery. During breast augmentation, silicone or saline implants are placed under the breast muscle, in most cases, to help you to achieve your specified volume and size. This is a common cosmetic surgical procedure and our doctors are extremely knowledgeable about the latest techniques used to create gorgeous results. For women who may not want an implant, a fat transfer may be considered. At Prima Center for Plastic Surgery in Duluth, our Atlanta-based cosmetic surgeons will work carefully with you to achieve your desired look.
Breast augmentation or breast enlargement is a surgery to enlarge the size and enhance the shape of a woman’s breast. Many women at all stages of their lives may consider a breast augmentation. For women between the ages of 19 and 34 breast augmentation is the number one plastic surgical procedure and this is certainly no surprise to us here at Prima Center for Plastic Surgery. Many young women have the same common goal when considering breast augmentation and that is to achieve a breast enhancement that is in proportion to the rest of their body and a natural appearing result. We now have many different sizes, types and shapes of implants which gives us the ability to tailor the implant choices to produce that natural, fuller, more beautiful result. An ideal result is one that complements each woman’s individual shape to ensure a beautiful outcome for years to come.
Pricing for breast augmentation will vary per patient since it's such a highly customized procedure.
Reviews
Saline vs Silicone vs Fat
Saline Breast Implants
Saline implants are FDA approved and are just one of a variety of implants that are available for breast augmentation. Saline implants are filled with a sterile saltwater solution, the key to getting a satisfactory result with a saline filled implant is having sufficient soft tissue to cove the water baggy feel of the implant. Many women can be good candidates for a saline filled implant. If a saline filled implant leaks the solution is safely absorbed by the body. Saline implants also cost less than the silicone type, but cost alone should not be the primary decision making factor. One of the disadvantages of saline implants is that in some cases, rippling can appear. This is especially something to consider for women who are thin and have low breast tissue. Those who opt for this type of implant must be at least 18 years old.
Saline-Filled Breast Implants?
Saline implants are FDA approved and are just one of a variety of implants that are available for breast augmentation. Saline implants are filled with a sterile saltwater solution, the key to getting a satisfactory result with a saline filled implant is having sufficient soft tissue to cove the water baggy feel of the implant. Many women can be good candidates for a saline filled implant. If a saline filled implant leaks the solution is safely absorbed by the body. Saline implants also cost less than the silicone type, but cost alone should not be the primary decision making factor. One of the disadvantages of saline implants is that in some cases, rippling can appear. This is especially something to consider for women who are thin and have low breast tissue. Those who opt for this type of implant must be at least 18 years old.
Right Choice For Me?
If you have sufficient soft tissue to cover the saline filled implant it may be a choice for you. During your consultation we will discuss the various types of implants currently available. There is certainly no one size fits all when it comes to implant selection with over 4,000 different types, styles and shaped now available.
Best Candidate?
Breast augmentation is most commonly performed on women between the ages of 19 and 35. There are many reasons that a woman may seek breast augmentation. Some women may have never developed the breast size and shape that they desired. For others, weight loss and/or pregnancy may have caused a decrease in volume that they hope to restore through surgery.
Silicone Breast Implants
Breast implants are now safer than ever. The latest generation implants are filled with a silicone that is more stable and cohesive making them less likely to leak even if they become completely ruptured. Silicone breast implants are very popular today and are highly recommended by our plastic surgeons at Prima Center for Plastic Surgery for patients who desire a natural look. Since the FDA validated their safety and efficacy, safety concerns surrounding these implants are today almost no different than that of saline. The silicone shell is prefilled a cohesive type of silicone gel and these implants are available in a variety of sizes, shapes and textures. Prior to 1999 silicone gel, which is a polymer of silicone, was less viscous that it is today. The standard round gel filled implants are now all filled with the newer 3rd generation of cohesive gel and the implant shell has also been improved. The new shells are composed of three shells, an inner and outer silicone rubber shell and an inner low bleed shell. We also have a wide variety of shaped implants and these implants have certainly revolutionized breast augmentation surgery. These implants, filled with 4th generation gel, are the true gummy bear implants. These implants come in a wide variety of styles, shapes and sizes to fit and complement almost any woman. Our plastic surgeons find that a shaped implant help to restore perkiness to a woman’s breast after pregnancies and breast feeding. Shaped implants can also be a good choice for that women who has small A cup breasts and desires a result that is more natural with increased lower pole projection and fullness. The biggest difference between a round implant and a shaped implant is that the breast shapes the round implant while an anatomic implant shapes the breast.
Round Silicone Gel Implants
Today’s silicone gel implants are filled with soft, stable, and elastic gel that feels and moves like natural breast tissue. For many women, these cohesive gel implants are an excellent choice because they are closer to the feel of natural breast tissue. The implant manufacturers, Allergan, Mentor and Sientra design a variety of silicone gel breast implants which are available in multiple sizes, shapes, and projections.
Shaped Gel Implants
Shaped gel or “gummy bear" breast implants are the newest generation of implants. They have a more highly cohesive, sticky inner gel designed to have less wrinkling and rippling, with the potential of creating a more natural-looking shape. These devices were approved in 2013 by the FDA but have been available in Europe and the rest of the world for almost 20 years. They have a long track record for effectiveness and safety. These implant when used on the correct women can have many advantages over round gel and saline filled implants. At the time of your consultation we will discuss the advantages and disadvantages of all of the available implant shapes and styles. The Vectra 3D imaging systems allows us to view any of these implants on your body giving you the confidence that you are making the right choice when it comes to implant selection.
There are many reasons why a woman may select a Shaped Gel "gummy bear" breast implants over a round gel or saline filled device. The shaped implant may provide a more natural appearing breast with a more tapered appearance at the upper pole. Most women will agree that the gel filled implants whether round or shaped have a more natural feel.
Fat Transfer
For patients who desire fuller breasts but do not want an artificial implant to achieve this look, there is also an option known as a fat transfer. If you are interested in fat injections you must be evaluated by our plastic surgeons first to see if this is even an option for you to consider. In this procedure, our plastic surgeons will harvest fat from donor sites of the patient, such as the flanks, abdomen and thighs via liposuction. The fat collected will undergo a process of refinement and purification, and then gradually reinjected into the breasts with smaller syringes so the shape is evenly distributed. If you are interested in fat grafting for breast enhancement we will discuss this at the time of your consultation. Not all women are good candidates for this procedure.
Product Information
Manufacturers
There are several manufacturers approved by the FDA.
- Natrelle by Allergen – silicone and saline-based implants
- Mentor – silicone and saline-based implants
- Sientra – silicone-based implants
Profile and 3D Imaging
We utilize the Vectra 3D imaging system to help our patients with the difficult task of selecting a breat implant that is perfect for their size and shape. This 3D imaging has completely removed the guess work that goes into selecting that perfect breast size. Through a process of visual elimination we can select an implant that is based on your breast size and dimensions. Since breast implants come in a variety of different profiles these can be easily visualized in 3D. We spend a good deal of time picking an implant with the right base width and projection. Round smooth walled silicone implants are already pre-filled, the standard profiles come in low, moderate, high and extra high. Saline implants are filled with a filling tube at the time of surgery. Round saline filled implants come in the same profile shapes as round gel implants. Our plastic surgeons take care not to over expand or under expand a saline filled implant. There is a narrow range of implant fill that is recommended by the manufacturer.
Shape
The standard shape of a breast implant can either be rounded or an anatomic tear-dropped shape. Each shape serves a different aesthetic function as it pertains to the patient’s goals. Rounded implants produce a shapelier curve on the top portion of the breast. The teardrop implants are shaped to copy the natural appearance of the breast and can be preferred by many women. At the time of your consultation we will discuss all of your options when it comes to the type and style of implants. At the end of your consultation you will have a good understanding of the various choices that factor into your final result. Meeting and exceeding expectations is a priority.
Texture
Implants are made with either a smooth or a textured surfaces. In general, smooth implants cost less and are more common. The textured implants were initially conceived out of the idea that it reduces the chances of capsular contracture (the constriction of scar tissue around the implant) although there is no valid claim to this. The textured type is more common with the teardrop shape as the rough texture adheres to tissues helping the implant stay in place.
During/After Surgery
Breast augmentation is an outpatient procedure that generally last 1 to 1 ½ hours. It can be performed using general anesthesia either in our AAAASF accredited in office surgical facility or at the outpatient surgery department at Gwinnett Medical Center. We use only board certified M.D. anesthesiologists at our in office surgical center at Prima Center. Most implant are placed using a Keller funnel, this decreases the risk of implant contamination while being inserted.(see video) All activities should be limited for the first 48 hours after surgery. There will be bruising and swelling, and a compression support bra will also be worn to help in healing. It is normal to feel tightness around the chest area as the skin adjusts to the breast’s new shape. Most patients can resume normal activities within 7 days; exercise and activities that cause the breast to bounce up and down should be avoided for the first 4-6 weeks. It can take approximately 6 months for the breasts to look, feel and function normally in regards to softness, sensation and final placement. During your pre-operative examination we will discuss activity limitations in specific and we will answer any of your questions regarding exercise.
Implant Placement
The two most common placements are on top of the chest muscle or under it. When the implant is placed under the muscle, a pocket is created within the pectoralis major muscle. A pocket is also created if it is placed in front of the muscle, but many surgeons do prefer the submuscular approach (behind the muscle). This helps to keep the implant in place for a longer period of time and takes into consideration factors such as implant size, weight, gravity, and time. Placing the implant behind the muscle also provides a natural look and provides the implant with the long-term support it needs to stay in position.
- Submuscular - Under the pectoralis muscle
- Subglandular - Under the gland of the breast
- Subfascial - Under the fascia of the pectoralis muscle
- Dual Plane - The implant is under the pectoral muscle up top and below the breast tissue on the bottom. What is actually meant by dual plane is that in addition to making the pocket in the submuscular location dissection is also performed above the muscle. This plane of dissection is taken up for several centimeters and it's purpose is to loosen the muscle from the overlying breast tissue. This technique can be useful for patients who have a slightly droopy breasts where the muscle would restrict the expansion of the overlying droopy breast tissue in an adequate fashion. There are other methods of expanding this loose breast tissue besides the dual plane technique that may be used as well.
- Split Muscle - The lower portion of the implant is placed subfascial and the upper portion of the implant is under the muscle. This is most common in an athletic woman who does not want the implant to move when they are exercising or working out.
When the implant is placed a pocket is created many factors such as implant size, weight, and gravity, will be considered when making this important decision. The ultimate goal is to create a natural looking breast and provide the implant with the long-term support it needs to stay in position.
Incision Type
There are several standard incision approaches for breast implants. The most common is known as an inframammary incision, which is an incision near the breast fold. Second, is an incision made under the areola, which is known as a periareolar incision. A third option is to place the incision within the armpit, known as a transaxillary approach. The position of the incision will vary from patient to patient and this is one of the many choices that we will make together. It is up to the patient’s desires and surgeon recommendation as to what approach is best to take.
Surgery Information
- Location: Prima Center in office accredited OR Suite or Outpatient Department of Gwinnett Medical Center.
- Vectra 3D Imaging: Available at Prima Center for Plastic Surgery, educational imaging system to assure accurate implant selection and sizing.
- Anesthesia: General Anesthesia is preferred - given by a Board Certified Anesthesiologist
- Implants: Silicone gel implants and saline filled implants are available in multiple configurations, shapes and volumes. Vectra 3D imaging is a extremely helpful when it comes to selecting the right implant for each individual. Prima Center for Plastic Surgery is the only plastic surgical practice in our area that offers the unique ability to see your after results before the surgery.
- Length of Surgery: One to Two Hours.
- Location of Incision: Peri-areolar, inframammary crease (beneath the breast) or trans-axillary (under arm).
- Warantee: All manufacturers offer a limited warrantee for the implants. Please check with the manufacturer for your specific warrantee terms and additional information.
We look forward to answering all of your questions and making sure you are an educated, confident patient when considering breast implant surgery.
Plan Your Procedure
- Recovery Time
- 1 week
- Average Procedure Time
- 1.5 hours
- Post-op Follow-up
- 5-7 days
- Procedure Recovery Location
- Out-Patient
Breast Augmentation FAQs
Related Procedures
Natural or Artificial?
This depends on the patient’s breast make up. Those who opt for implants may choose between saline or silicone as each has its own advantages. Generally, patients who have low breast tissue will benefit from silicone implants; otherwise, saline implants are recommended. For fat transfer, the advantage is that it poses less risk since there is no introduction of foreign material in the body. However, the results do not last long compared to artificial implants as fat can be reabsorbed by the body.
Silicone Risk?
Negative notions about silicone started back in the early 90s when there were cases of leakage and complications. With today’s advancements in engineering, the silicone-based shells are made durable and safe, and have been proven so by the FDA. Today, in fact, silicone is more preferred than saline since they last longer and feel more natural. The rates of reported complications have significantly decreased in the last decade.
Implant or Lift?
Breast augmentation is a cosmetic procedure designed to enlarge breasts while a breast lift is designed to tighten the loose skin of a droopy breast. Both resolve different breast issues. There are cases that the procedures are simultaneously done when it is agreed that a breast lift with augmentation is necessary.
Silicone Leakage?
Today’s silicone implants are strong, durable and safe. Technical advancements have come so far, that even if a silicone implant does rupture, the shell of the implant will keep the silicone gel encased and protected from entering the body. In a rare case that a silicone implant does rupture, an MRI will be needed to detect the rupture. This is the main reason why MRI checks are recommended 3 years after surgery and every 2 years succeeding the first MRI.
Implant Replacement?
Implants may last up to 15 years. As long as the implant shows no signs of damage or visible defects, such as breast rippling or a deformity, replacing them is not necessary. What’s necessary, however, is a periodic check of the implants to make sure that they are still intact.