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Breast Augmentation

Breast Augmentation - (Breast Implants) Manhattan, NY

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Overview

Breast augmentation is a cosmetic surgery that uses either a silicone or saline implant to increase the size and improve the shape of the breasts. This surgery offers women an opportunity to positively affect their body image and self-confidence. It can resolve clothing issues, such as the need to wear padded bras and helps solve problems with trying to fit into swimwear. The best candidates are women whose breasts have an attractive shape but are just smaller than desired. Women who have been pregnant and breast fed are good candidates for breast augmentation. The breasts typically appear deflated in these cases, but if the natural breast shape is still good, implants can offer a nice enhancement. These women, as well as women with almost no breast tissue typically aim for a more conservative approach. This is to avoid sag in a breast that has been nursed, as well as create a natural result for women with little native tissue. Almost all of our breast augmentation patients are extremely satisfied with their results. Dr. Dana Khuthaila, a plastic surgeon in New York City, has extensive experience in cosmetic breast surgery and takes pride in helping her patients select the best implant options for their surgical procedure.

Saline VS. Silicone

Both saline and silicone implants are approved by the Food & Drug Administration (FDA) for breast augmentation. Both are available in a wide variety of sizes and shapes, and both are available with either a rough or smooth surface texture. Both saline and silicone gel implants have the same outer shell made of solid silicone plastic.

Saline Breast Implants

The advantages of saline implants are that they do not contain silicone gel and do not require any special tests for long term monitoring. A disadvantage is they are sometimes easier to feel on the side and bottom of the breasts, most commonly in very thin women with scant amounts of breast tissue to begin with. They may also cause visible wrinkles in this same type of individual. Also, saline implants can deflate prematurely after only a few years in about 5%, a harmless but inconvenient event that requires implant replacement. The key advantage of silicone implants is that they feel more natural to the touch, sometimes being completely undetectable due to the nature of the filler material. Saline implants seem to have a better prospect for lasting beyond ten years compared to silicone implants. Clinical experience has shown that saline implants can last as long as twenty years or more with no change in the aesthetics or consistency of the breasts whereas silicone implants have more of a tendency to develop capsular contracture (breast hardening) or silent rupture as they age beyond 10 years.

Silicone Breast Implants

Silicone in all forms, from liquid to solid, is one of the most biologically inert substances known. The filler material used in silicone implants today is a cohesive gel that has a gel-like consistency compared to the viscous liquid form used in earlier generation implants often referred to as the "Gummy Bear Implant." Silicone implants usually require a slightly larger incision for insertion. The armpit incision option is generally not possible with silicone implants. Empty saline implants can be easily passed prior to inflation through the narrow channel that lies between this incision and the breast whereas prefilled silicone implants cannot.Silicone implants do not completely prevent wrinkles in very thin women with scant amounts of breast tissue. Sometimes they can also exhibit wrinkles, although the tendency is far less than with saline implants. Occasionally silicone implants can exhibit a conspicuous bump or knuckle due to an implant fold, something which does not occur with saline implants.

Product Information

Manufacturers

  • Saline: MENTOR® or Allergan (branded as Natrelle®)
  • Silicone:  Allergan (branded as Natrelle® Gel), Mentor (branded as MemoryGel®) and Sientra, known simply as Silicone Gel Breast Implants

Profiles

Breast implants are available in several profiles that determine how much forward projection they have. Implants with equivalent volumes will have a smaller diameter as the profile, or projection, increases. Most patients are best served with moderate (regular) profile implants. Patients that either have a narrow chest, a small breast base diameter (or both) and seek a maximum implant volume are good candidates for a moderate-plus (intermediate height) profile implant. Moderate-plus profile implants are filled tighter than moderate profile implants of the same volume and tend to wrinkle less as a result. They are therefore also a good choice in very thin patients with little breast tissue.

Shape

There are many implant shapes available today for both saline and silicone implants. These are grouped into two broad categories: round and shaped. The latter are also termed "anatomic" or "tear-drop" types. Shaped implants are commonly used in breast reconstruction after mastectomy, a quite different scenario. The vast majority of plastic surgeons today use round implants for aesthetic breast augmentation. Round implants in the upright position behave like shaped implants in that the filler material migrates to the bottom of the implant, leaving less at the top. While lying down the filler material is evenly distributed and resembles a natural breast shape in that position. A problem unique to shaped implants stems from their asymmetric shape. If they rotate inside the pocket both shape and symmetry can be adversely affected. Definitive correction requires surgery to exchange them for round implants if this occurs. Another drawback of shaped implants is that they can look unnatural when lying down because the volume is not distributed evenly. It is for these reasons that round implants are recommended as the best choice for breast augmentation.

Texture

Breast implants can have either a textured or smooth surface. Dr. Khuthaila mostly uses textured implants positioned in front of the muscle (subglandular) when there is enough breast tissue to cover the implant to achieve a more natural look and feel.

Implant Placement

  • Submammary (Subglandular):  Under the mammary gland, over the muscle      
  • Subfascial (Retrofacial):  Under the fascia of the muscle       
  • Dual Plane:  Along two planes/layers
  • Submuscular (Retromuscular):  Mostly under the muscle
  • Complete Submuscular (Full retromuscular):  Completely under the muscle

Incision Type

  • Inframammary:  The incision is made in the breast crease where the breast meets the torso
  • Periareolar:  The incision is made just under and along the areola
  • Transaxillary:  The incision is made in the armpit
  • Transumbilical:  The incision is made in the belly button

During/After Surgery

Breast augmentation is performed under general anesthesia in an accredited surgical facility and typically takes between 1-2 hours to complete. It is considered an outpatient procedure. After surgery, patients will need to rest for a couple of days, but will be encouraged to move around in order to promote circulation. As the skin adjusts to the new breast size, it is normal to feel tightness in the chest area. Patients may resume their normal exercise routines within 4-6 weeks. It typically takes around 6 months for the breasts to fall into their final position. The result is a softer, natural looking breast appearance.

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Recovery Time  
1-2 Weeks
Average Procedure Time  
1-2 Hours
Post-op Follow-up  
1 Week
Procedure Recovery Location  
Out-Patient
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Breast Augmentation FAQs

Is Silicone Safe?

Patients sometimes have concerns about the safety of silicone breast implants because of the attention they received in the media years ago. However, the FDA did approve their safety. In addition, no evidence has ever been found to link silicone breast implants to cancer, auto-immune deficiency disease, or any other illness. Ultimately, 62% of today’s breast augmentation patients choose silicone over saline. For reconstruction cases, they choose them 3 times more often. 

Breast Aug or Lift?

Breast augmentation will help with size, but it will not correct sagging. If you are happy with the shape and laxity of your breasts, then implants alone may meet your cosmetic goals. If sagging is what is most bothersome to you, then you may be considered for a breast lift. During your consult, we will determine if you are better suited for breast augmentation, a lift, or a combination of the two.

Risk of Rupture?

Modern engineering creates strong and durable implants. With proper care and regular check-ups, the risks for rupture are rare. If a saline implant does rupture, the solution will be absorbed by the body and the implant will deflate, becoming visibly noticeable. If a silicone implant ruptures, the cohesive gel will stay intact and will not leak into the body. An MRI will be necessary to detect a silicone defect. 

How Long do They Last?

Most implants will last about 10 to 15 years. Some can last even longer. If there is no rupture, leakage, deflation, or any other visible defects (such as rippling), then there is no need to change the implant or have any type of secondary surgery.  

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.