Breast Reconstruction

Among the more common cosmetic surgeries is breast augmentation. This can be done through multiple techniques. The standard techniques use implants filled with saline (salt water) or a silicone gel to increase the size and fullness of the which many women have lost as they age or never have had.

These procedures are done under general anesthesia. Your doctor will help you determine what surgery and what implants are best, as well as the location of the incision used. Following the surgery, you will need to take it easy for up to six weeks while your body recovers.

Types of Breast Augmentation

• Saline breast implants. The implants are filled with sterile saline (salt water). The advantage is that if they break, you will be able to diagnose the problem without any imaging, and the salt water will be absorbed by your body.
• Silicone breast implants. These implants are filled with a highly cohesive silicone gel, giving them a more natural feel and look. However, if they rupture, you will require some form of imaging, such as a mammogram, ultrasound or MRI to diagnose the problem. A rupture cannot be detected on physical exam alone. Both saline and silicone breast Implants carry a lifetime warranty against rupture, which means the manufacturer will provide the patient with a free implant and financial assistance to pay to have the ruptured implant removed and replaced.
• Structured saline breast implants. These are similar to standard saline implants, but they also have an internal structure designed to make them feel more natural.
• Form-stable highly cohesive breast implants. This is a type of silicone implant that is made of thicker silicone material, earning the nickname “gummy bear breast implants.” Even if the shell breaks, these implants are designed to keep their shape. The tradeoff is that they require a longer incision.
• Round breast implants. The shape is designed to give the breast a fuller appearance. If the implant rotates out of place, the breast’s appearance is usually not affected.
• Smooth breast implants. This is the softest, most common type of implant with the most natural appearance when the breast moves.
• Textured breast implants. The implant creates scar tissue that makes it less likely to move around unnaturally. With this type of implant, there is a rare complication known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). These are no longer available in the United States.

Breast implants are sturdy, but they are not designed to last forever. Typically 25% of women undergoing breast augmentation will have some type of revisionary breast procedure. The reasons for a revision include wanting to change the type or size of your implants or desiring breast lifting after pregnancy. Some women prefer smaller implants as they get older and some would like their breasts uplifted.

Revision may also be used to address complications, including bottoming out, where your implant drops lower on your chest while your nipple remains high. Another condition, capsular contracture, can occur when the natural protective capsule that forms around the implant becomes too dense. This can squeeze the implant and cause an unnatural appearance.

Having overly large breasts can be a burden for some women, leading to numerous chronic conditions, including back and neck pain, skin irritation (bra strap grooving) and rashes that will not go away. It can be difficult to enjoy an athletic, active lifestyle. Even shopping for clothes can be a challenge. There are also psychological considerations, with some women being embarrassed by the size of their breasts and the attention they draw.

Breast reduction will reshape your breasts, giving them a look in proportion to the rest of your body. The procedure is usually performed under general anesthesia. Your doctor will work with you to determine the best approach to your reduction, after which you will need up to six weeks of light activity while your body recovers.

A breast lift is used to change the general shape of your breasts. The procedure, also called a mastopexy, removes excess skin, repositions the nipples and reshapes the breast, eliminating sagging and downward-pointing nipples. While a breast lift won’t increase the size of your breasts, it will counter the effects that pregnancy, weight changes and gravity have on your body. It may also boost your self-image and self-confidence.

Your surgeon will help you determine the best approach to your procedure. Afterward, you will wear a support bra and need about six weeks to allow your body to recover.