Everything you need to know about breast implants
Posted by mandyf on July 17, 2012
Breast implants are a phenomena that appear to be here forever. Most women at some time at least think about whether implants may be for them regardless of whether they actually get them or not. Breast implants are not always about getting bigger as some women opt for very small implants to provide an extra boost, help attain the cleavage they never saw develop, or to correct symmetry problems.
Let’s face it, not all breasts are created equal and sometimes they just look a little off which can cause self esteem issues for some women. With that in mind, for any woman that is considering breast implants this is a quick guide to all the things you need to know before you make a decision. The advice here is not to tell you what to do as ultimately the decision is yours, but to help provide you with some guidance so that when you talk to your surgeon you know what questions to ask to help make the best choice.
For starters breast augmentation, like vaginal rejuvenation or any other enhancement procedure, is surgery and it is not to be taken lightly. Likewise implants are not forever. Very few women realize that the implants they are getting, especially if they are young, will need to be updated once, maybe even twice. So when you plan on getting your initial breast augmentation and are under the age of thirty for example, be ready to get at least one more in the future. According to Diana Zuckerman, Ph.D., and president of the National Research Center for Women and Families, very few women are ever aware of the following statistics:
A) Within one year of surgery there is a 1%-3% chance of an implant rupturing.
B) Within three years the odds of a rupture increases to 3%-5%, and about 17% of women have had a “redo” surgery due to some sort of dissatisfaction with the implants or other concern.
C) At five years there is a 7%-10% chance of a rupture, and about 23% of all women have had a second surgery to correct problems with contracure, size, or other problems.
D) By somewhere in the range of 13 to 15 years the average lifespan of an implant has been reached and the odds of a rupture are around 85%
The next thing to consider is you have four major choices to make once you have decided to get implants.
What is the right size? If you are looking to correct symmetry problems alone a smaller size is usually best. Implants can be as small as 90 cc’s and as big as 800 cc’s. The three main sizes most women opt for are 200 cc, 300 cc, and 400 cc. To help understand these sizes, a 200 cc implant is about the size of a lemon, 300 cc’s is about the size of an average orange, and 400 cc’s is about the size of a grapefruit. Something to consider when choosing size is you want to avoid going up more than two cup sizes. Surgeons cite a jump of more than two cup sizes is most common among women in their twenties who have not thought out that such an increase can be uncomfortable in numerous ways and unwieldy as well. They further state that 34% of women have a second procedure just to change sizes. Dr. Antell, a breast augmentation specialist, advises that nobody get implants that would increase the size of their breasts to a size larger than they would be at nine months pregnant.
The second choice to consider is how the implant will rest in the body, over or under the muscle? While either way can be done safely, there are significant differences. For a woman that is already a bit busty over the muscle is just fine because they already have a fair amount of breast tissue that can conceal the implant and look natural. For a small breasted woman there is less tissue to do this so the implant can look very obvious. To help diminish the fake look, placing the implant under the muscle makes the edges of it far less visible.
The third choice is whether to go with saline or silicone implants. In the U.S., silicone is the FDA approved choice for most all common cosmetic procedures, while silicone is approved for reconstructive procedures. With that said however silicone can be approved in some cases for an implant. Saline is considered the safest option because if it does rupture it is easy to fix comparatively speaking. Silicone implants that rupture or leak are a mess to clean up if the silicone escapes the capsule area which houses the implant.
The fourth choice is regarding the incision made to place the implants, and as few women realize there are four points of insertion which can be used.
The first option is the riskiest, most invasive, and most expensive which is through the bellybutton. The reason you have likely never heard of this option is because so few surgeons are willing to do it. It involves creating a tunnel from the bellybutton to the chest which the implants are then ferried through.The good thing is there is no scarring on the breast. The bad thing is it is very invasive and getting the implants to rest correctly is a huge challenge and all too often winds up resulting in uneven breasts.
The armpit incision is usually used for very small chested women with little breast tissue that have an insufficient breast crease to work with. Usually this procedure will cost a bit more and the results aren’t always the best there are enough times that the result is uneven breasts to make mention of it. The other problem is that if you need a redo, which you almost certainly will at some point, they are more difficult to perform than with the final two options.
The nipple incision insertion accounts for about 8% of all breast augmentation procedures although it is gaining in popularity. The good point is that it hides scarring very well around the areola. The bad thing is it can result in permanent loss of nipple sensation which is not a very attractive risk for most women. As the procedure is performed more however, surgeons are getting better at minimizing this risk.
The most common insertion which about 90% of women opt for is the crease insertion. This is an incision made at the base of the breast where it connects to the chest wall. The down side is the scar is visible. The good points however are that it allows for the best placement, it is the simplest of the four procedures, and it makes a redo very simple. Unlike the early days of the procedure the scar is usually barely noticeable these days.
So you know all of these questions to go over with your doctor now, and you know the benefits you are hoping to realize from your implants. Have you considered the things that can go wrong however? Sure people know about the potential for rupture and the possible loss of sensation about 14% of women cite five years after the procedure, but what about everything else?
Capsular contracture is when the scar tissue that forms around the implant constricts and pulls against the implant. This is what makes the breast feel hard and look misshapen. The worst of all is it is described anywhere from uncomfortable to painful. This can manifest anywhere from a couple months after the procedure to several years later.
A hematoma is possible which is a collection of blood inside the chest cavity that usually occurs within a day of the surgery. usually the body absorbs small hematomas, but a larger one may require a quick surgery to remove.
Other risks which are rare but possible are synmastia where the implants pull the skin away from the breastbone (most common when implants increase the breast by more than two cup sizes), an infection at the point of incision or in the pocket which the implant rests, and necrosis which is when the skin around the implant dies which can cause permanent scarring or deformity.
Now you know enough about breast implants to make your discussion with your potential surgeon the best possible. Ask questions and expect straight answers. Mull over what you have learned and formulate a soft working plan as to what you think benefits you the most, and as with any surgery take precautions and plan ahead just in case any complication does arise.