- What Is Breast Augmentation?
- Breast Augmentation Candidates
- Breast Implants
- Fat Transfer
- Preparing for Breast Augmentation
- Breast Augmentation Procedure
- Breast Augmentation Recovery
- Breast Augmentation Results
- The Lifespan of Breast Implants
- Breast Augmentation Scars
- Risks & Complications
- Cost of Breast Augmentation
- Choosing a Breast Augmentation Surgeon
- Natrelle Implant Warranty
- Additional Breast Augmentation FAQs
What Is Breast Augmentation?
Breast augmentation (augmentation mammoplasty) is a cosmetic surgical procedure designed to enhance the breasts’ size, shape, or symmetry. Sought by more and more women every day, it can result in a more flattering and better-proportioned figure, expand clothing options, and has the potential to enhance a woman’s confidence and self-esteem.
Advances in breast implant technology and the surgical techniques to place them have made breast enhancement a safe and popular procedure. This is why breast augmentation is one of the top cosmetic surgery procedures performed in the United States.
The decision to have an augmentation mammoplasty is very personal. Each woman’s choice is unique and is based on her individual needs, wishes, and expectations. A well-informed decision is critical since it may not be a one-time surgery. A consultation with plastic surgeon Dr. Miguel Delgado will provide the necessary information to arrive at a thoughtful and thoroughly researched decision.
|Procedure||What It Does||Surgery||Recovery||Results|
Increases the size of the breasts with implants
2 weeks, no heavy lifting and exercise 3-4 weeks
Elevates sagging breasts and nipples
7-10 days, no exercise for 4-6 weeks
*Results may vary.
Who Is a Candidate for Breast Augmentation?
Women who are 18–21 years of age are candidates for saline breast implants. Women who are 22 or older are eligible for either silicone or saline implants. The U.S. Food & Drug Administration (FDA) and the plastic surgery community have done extensive research proving silicone implants’ safety. Studies now support that silicone implants match saline implants in terms of safety.
There are many reasons or conditions to have breast enlargement. These are some of the more common:
- The breasts are too small, which is the most common reason.
- One of the breasts is significantly different from the other breast.
- The breasts have become smaller and lost elasticity, which is common after pregnancy, breastfeeding, and aging.
- Weight loss has changed the shape and size of the breasts.
- There is reluctance to wear a swimsuit or a tight-fitting garment.
Also, a woman must be emotionally mature and fully understand her motivations for wanting breast augmentation. Breast enhancement surgery should be a personal decision and not one based on another person’s desires. Expectations need to be realistic, understanding that the procedure will significantly improve the breasts, but not necessarily create perfection.
It is very common that some women have loose breast skin from pregnancy, weight loss, or genetics. In some cases, breast implants will fill out the breasts and solve this problem, but a breast lift may need to be included in other cases. Breast lifts modify the skin superior to the areola, restoring a more youthful placement to the nipple on the breast.
What Are My Options for Breast Implants?
There is no “perfect” breast implant, as all breast devices have their advantages and disadvantages. There are essentially two breast implants used today: saline-filled and silicone-filled. Both have a pliable outer shell, which is made of silicone. The contents within the cover are either saline (saltwater) or silicone gel. For saline implants, the silicone shell is filled with saline at the time of surgery.
The breast implant companies now offer various shapes and sizes to customize the fit for each woman’s body. Based on a woman’s anatomical dimensions, Dr. Delgado will advise an appropriate range of implant size and shape options.
Learn more about saline and silicone implants below.
Saline Breast Implants
Saline implants have been used for decades: they are safe and effective.
The advantages of saline breast implants are:
- If a leak does occur, the saline (saltwater) is safely absorbed.
- Saline breast implants are filled after insertion; therefore, more adjustments can be made for volume discrepancies.
- In general, smaller incisions can be used.
- Saline implants are less expensive.
The disadvantages of saline breast implants are:
- Saline implants are slightly firmer than silicone breast implants.
- There is a chance for mild rippling or “scalloping” (of the bottom edge of the implant).
- Saline implants are not ideal for thin women over the muscle due to more potential noticeable rippling.
Silicone Breast Implants
Silicone implants have been approved for general usage since November of 2006. The restriction is that a woman must be at least 22 years of age. Also, it is suggested by the FDA that a Magnetic Resonance Imaging (MRI) be done at the three-year mark after augmentation, and every two years after that, to rule out potential leakage. Dr. Delgado feels the patient should return for an exam at the three-year mark to determine if an MRI is warranted. If there are no complaints, and with a routine exam, then no test is needed. An individual approach should be customized for each patient.
Silicone breast implants have evolved into a safer product as a result of two significant improvements. Today’s silicone breast implants have a much thicker outer shell, and they contain a much more cohesive gel than earlier versions. The latter means that the silicone contents are more substantial or dense than the more liquid versions of their predecessors. For example, if a modern silicone implant is cut with a pair of scissors and squeezed, the silicone material will go out and then retract back inward into the silicone shell.
The advantages of silicone breast implants are:
- They have a softer, more natural feel (the most significant advantage).
- There are no wrinkles or “scalloping” of the edges; therefore, they can easily be used on top of the muscle.
- As a general statement, women with saline breast implants, who then change over to silicone, prefer the silicone breast implants for their more natural feel.
The disadvantages of silicone breast implants are:
- A leak or rupture may occur unknowingly.
- Silicone implants are prefilled and, therefore, the size cannot be adjusted.
- An MRI may be required in the future.
- They are more expensive than saline implants.
- A longer incision may be required.
Form-Stable Gummy Bear Breast Implants
The new product on the market is the “Gummy Bear Implants.” The FDA has approved the three United States companies—Mentor, Allergan, and Sientra—to distribute these breast implants.
These implants’ goal is to replicate a real breast in making them form-stable, heavier at the bottom, and shaped like a teardrop. The implant is firmer, and this is what holds the shape. If the breast implant is cut in half, it will keep the exact shape without spilling out of the implant shell. These reasons are why this type of breast implant is commonly called a “gummy bear implant.”
As with all breast implants, they have advantages and disadvantages. The obvious benefit is that it mimics the natural breast’s shape, giving more volume at the breast’s bottom. Because of the firmer silicone composition of this implant, it results in less wrinkling. Some women want to have a firmer breast. There are textured implants to hold the orientation.
The disadvantage is the potential for implant rotation, which will cause the breast shape to distort. The incision needs to be larger to accommodate a firmer breast implant. Some women do not like the firmer consistency.
The bottom line is the form-stable breast implants give plastic surgeons and their patients another option when considering breast augmentation.
Can Fat Transfer Be Used as an Alternative to Breast Implants?
Natural breast enhancement can be a great alternative to breast implants. The technology has significantly advanced to increase fat cell survival and breast skin expansion. Dr. Delgado performs this advanced breast augmentation procedure by taking fat from one part of the body and transferring it into the breast. Breast enhancement with fat injections provides two different techniques, the liposuction from the abdomen or muffin top and breast enhancement.
The breast size can usually be increased by one cup size fat transfer to the breasts; however, the breast size can be much larger if the Brava® System is used. The Brava® System is a skin expansion device worn over the breast for about three weeks before treatment. The negative pressure of the device stretches the skin outward to accommodate more volume. The fat can then be injected into the expanded space.
The best candidates are women who desire a fuller breast and do not wish to have breast implants, as well as post-mastectomy patients and women who have had multiple complications with breast implants and prefer a more natural approach.
Dr. Delgado’s technique starts with harvesting the fat via liposuction from a location where ample tissue is available. It is then put through a purification technique known as the “Coleman Technique,” and injected into the breast to accomplish fullness. The process takes about three hours, and the recovery is approximately seven to ten days.
How Do I Prepare for Breast Augmentation?
A personal consultation is the first step for every patient considering breast augmentation surgery. The appointment can be scheduled at either Dr. Delgado’s San Francisco office or his Marin County office.
At this meeting, Dr. Delgado and the patient will discuss the patient’s concerns about her breasts’ appearance. The current anatomy of the chest and breasts will be assessed and contrasted to the patient’s goals. A physical examination will be done and the patient’s medical history reviewed to determine if it is a safe and appropriate option for her. If the patient is a good candidate, Dr. Delgado will explain:
- The pros and cons of saline implants versus silicone breast implants
- Various implant sizes and shapes
- Options for incision placement
- Implant placement (i.e., over or under the pectoralis muscle)
- Potential complications
The patient is provided with a booklet that supplies detailed pre- and post-operative instructions, including the use of medications prior to surgery. For example, it is required that aspirin and aspirin-containing products be discontinued—including those with anti-inflammatory effects—two weeks before and two weeks after surgery. These products harm the patient’s clotting ability. The pre-operative instructions include a complete list of medications that could pose hazards for the patient and should, therefore, be avoided. However, Tylenol (acetaminophen) can be safely taken during this time, but do not exceed one gram over four hours or four grams per day from all sources since this can cause liver damage.
The booklet also provides a list of vitamins and homeopathic preparations that promote healing and limit bruising, which a patient can opt to use before surgery.
Dr. Delgado understands and respects the courage it takes for a patient to come to him about changing something as personal as your body.”
How Is the Breast Augmentation Procedure Performed?
Dr. Delgado performs breast augmentation at Marin Cosmetic Surgery Center, a private surgery suite located in his Marin County office on the Sutter Marin County Community Hospital campus. This private surgical facility allows him to offer his patients personal, concierge medical care while providing the extra measure of safety and reassurance afforded by the surgery center’s contiguous location to the hospital.
Before general anesthesia is given, the breasts and chest demarcations are outlined using a surgical marking pen. The pre-operative markings act as a roadmap during surgery, allowing Dr. Delgado to make the appropriate adjustments for the gravitational changes that occur as a person moves from lying on the back (supine) to a sitting position, for example.
Breast implant surgery can be performed through one of four incisions. The two most common are the inframammary incision and the areola incision. The inframammary incision is made at the breast fold, whereas the areolar incision is made between the dark and light interface of the areola and breast skin. Of the two, Dr. Delgado prefers the inframammary incision, as it offers less risk of capsular contraction, areola irregularities over time, sensation issues, and internal breast tissue scarring. The other two techniques—employed far less frequently—are the transaxillary method involving an incision made through the underarm region, and the trans-umbilical breast augmentation (TUBA) approach involving an incision made through the belly button. The TUBA approach is challenging and turns a moderately difficult procedure into a much more complicated one. The TUBA approach utilizes saline breast implants only, and when breast implant revision surgery is required in the future, an incision on the breast will be required. Today, few plastic surgeons will augment breasts through the belly button. Because most patients will require more breast surgery in the future, a more direct approach is preferred.
Breast implants can be placed either on top of the pectoralis muscle, beneath it, or in a dual plane position. Dr. Delgado typically prefers placement of the breast implants below the pectoralis muscle. This position provides a more natural look—especially in the breasts’ superior margins—and better protection and support for the breast implant. That said, some women have loose skin from childbirth, weight loss, or genetic predisposition. In this situation, the implants are best placed partially below the muscle with more breast skin exposed at the bottom. This dual-plane technique ensures that the loose skin is fully stretched over the breasts. However, if the breasts’ skin is very loose (ptosis), mastopexy may give the best results in conjunction with breast enlargement.
Once the breast implants are in place during surgery, the operating table is adjusted so the patient is placed in an upright (sitting) position. This way, any necessary adjustments can be made to the breast implant placement—or in the case of saline breast implants, to size—before closure. A multiple-layer closure is then performed, and a soft support bra with front hook closure is placed.
Breast augmentation surgery is performed under general anesthesia. At Marin Cosmetic Surgery Center, only a physician who is board-certified in anesthesia administers general anesthesia. Additionally, the anesthesiologist calls the patient the evening before surgery to review her medical history, confirm last-minute instructions, and answer any questions she may have regarding the anesthesia.
What Is Recovery from Breast Augmentation Like?
The first few hours after breast augmentation surgery are spent in the recovery room. When the patient is fully alert, she will be able to go home with a friend’s or family member’s assistance. It is essential to sleep with the head and back elevated to reduce the swelling in the chest. Two days after surgery, the patient may remove the bra and any dressings to take a shower. The bra—and, if used, the compression band—should be put back on immediately after showering. There will be instructions given for suture care.
The discomfort after surgery is mild to moderate. The pain and discomfort are more noticeable if the patient has had the breast implants placed underneath the muscle. These patients will notice more tenderness and fullness around the chest region until the muscles stretch and adjust to the breast implants’ presence. This process takes a few days, and the prescription muscle relaxant is very helpful for this.
Regardless of the implants’ location, patients may choose to take pain medication to increase comfort levels during the first day or two. However, prescription pain medications are rarely needed by the third day after surgery. Occasionally, patients with a lower pain threshold may take pain medication for up to five days.
The recovery period is approximately two weeks in length. Once the bruising and tenderness are gone, the patient can return to normal activities. It is strongly recommended that patients avoid lifting anything of significant weight for at least two weeks following surgery. Most patients can drive a car and return to work and social activities within a week. However, strenuous exercise should be avoided for four to six weeks following surgery, as it can increase swelling and discomfort.
During this early post-operative period, the patient is ideally seen three days after her surgery. The patient will be instructed in breast massage techniques to soften and relax the breast implant pocket at this visit. Ultimately, this massage regimen’s conscientious practice daily can reduce the risk of encapsulation in the future.
About seven days after surgery, the sutures are removed. Subsequent appointments will be scheduled at two weeks, six weeks, and three months. For any of these post-operative appointments, the patient can be seen at either Dr. Delgado’s San Francisco office or his Marin County office.
What Breast Augmentation Results Can I Expect?
Breast enlargement is a way to enhance the breasts’ appearance and often improve the overall figure and body proportions. Breast augmentation can serve to boost a woman’s self-esteem and confidence. It is Dr. Delgado’s consultation style to invest significant time and effort preoperatively with a patient. In this way, he acquires sensitivity to a patient’s expectations and hopes, and works with her to devise the plan most likely to ensure she will be satisfied with her results. At the same time, he employs his expertise from years of study and practices with breast surgery to assure that the result will be aesthetically pleasing and appear very natural.
How Long Do Breast Implants Last?
Breast implants, whether saline or silicone, can last many years—but they will not last a lifetime. These are human-made devices that fatigue over time. Implant rupture can be due to the following:
- Breast capsular contracture
- Fatigue of the implant shell over time
- Trauma to the breast, such as a car accident
There are also many reasons why a woman would want implants replaced:
- Capsular contraction
- Breast asymmetry or undesirable shape
- Breast implants that are too large or small
- Breast changes as a result of pregnancy
- Unwanted breast implants for a variety of reasons
In general, breast implant revision surgery is a vital component for the maintenance required for breast implants.
Will I Have Noticeable Breast Augmentation Scars?
All surgery will require an incision, which results in a scar. The final breast augmentation scar is impacted by the surgical technique, the patients’ genetics, and the body’s natural ability to heal. Dr. Delgado prefers an infra-mammary incision for many reasons:
- There is reduced risk of capsular contraction.
- The areola and breast tissue remain in their natural state.
- This infra-mammary incision can be used for all future surgeries.
- The incision can be hidden in the breast fold in many cases.
Dr. Delgado uses meticulous wound closure and has a customized incision care program for an optimal outcome. The incision is generally easily concealed by a bra or bathing suit, and Dr. Delgado has very few, if any, issues with the final scar outcome.
What Are the Potential Risks & Complications of Breast Augmentation?
The most important concept to understand is that breast implant surgery is not a “one-time” procedure. Over a lifetime, implant revision surgery will be required for a variety of reasons. The most common reasons are capsular contracture, deflation or rupture of the breast implants, or post-pregnancy changes. Despite this, it is one of the most popular cosmetic surgery procedures, and patient satisfaction is extremely high.
Marin Cosmetic Surgery Center offers a highly trained plastic surgery team, including a board-certified anesthesiologist and experienced plastic surgery nurses and operating room technicians. This state-of-the-art surgical facility minimizes risk but does not eliminate the risks of this procedure. It is important to understand the risks, as well as benefits. Dr. Delgado and his staff, including the anesthesiologist, take time to explain the risks associated with this surgery carefully.
Capsular Contracture: The most common complication or adverse side effect of augmentation mammoplasty surgery is capsular contracture. During surgery, a pocket is created for the implant that is larger than the breast implant. During healing, a fibrous membrane called a capsule forms around the device. Under ideal circumstances, the pocket maintains its original dimensions, and the breast implant rests inside, remaining soft and natural. However, for reasons still largely unknown, the scar capsule shrinks or contracts in some women and squeezes the implant, resulting in various firmness degrees. This contraction can occur right after surgery or may not happen until many years later, and it may appear in one or both breasts. Current theories suggest that a very low-grade infection may trigger capsular contracture.
Capsular contraction is not a health risk, but it can detract from the result’s quality and cause discomfort, pain, or distortion of the breast contour. In cases of minor contraction, surgery may not be required. However, patients of substantial contraction can be relieved only by surgical intervention. Early capsular contracture may be effectively treated with the asthma drug Singulair. Dr. Delgado has seen some success with its use with early capsule formation.
Leakage or Rupture: Saline breast implants deflate either through a leak in the fluid import valve or through a break in the outer shell. Breast implant deflation or rupture can occur immediately or progressively over a period of days. Since saltwater is naturally present in the body, the saline will be absorbed by the body safely, and ultimately voided. Deflated saline breast implants require additional surgery to remove and replace the implants.
If silicone breast implants have a leak or rupture, this is more difficult to identify. The silicone gel leakage stays within the breast pocket, whereas the saltwater from saline breast implants is absorbed, leaving a deflated breast pocket. Occasionally, the implant’s gel can escape the capsule (implant scar tissue), and irregularities can be felt around the implant’s outer shell. If this change is felt, it constitutes a problem that needs investigation. The FDA suggests that an MRI be done at three years, and then every two years after that, in hopes of detecting a silent leak. Silent leaks can occur spontaneously and are often undetectable to the patient or plastic surgeon. If an MRI or other test determines a silicone leak, the breast implant must be removed and replaced with a new breast implant.
Infection: Most infections resulting from surgery appear within a few days to two weeks after the operation. Generally, infections can be treated with antibiotics, but breast implants may need to be removed on rare occasions until the infection clears. All breast augmentation patients start oral antibiotics the night before surgery and continue to take these antibiotics for the week following the surgery as a prophylactic measure to avoid this complication. Also, the patient receives an intravenous version of this antibiotic administered by the anesthesiologist during surgery. A special triple antibiotic irrigation is used during the placement of the implants into the breast pockets. Whenever implants are involved, the surgeon and his staff ensure that no pathogens are introduced by not touching the breast implant.
A newer product on the market is the Keller Funnel, which the implant is placed into and squeezed through the funnel end. The Keller Funnel allows a “no-touch” technique. Other precautions include, but are not limited to, double sterile gloves worn by the surgeon and the scrub technician. The RN applies two different skin prep solutions instead of the standard three applications of one solution. As a result of the conscientious and skilled application of these special sterile techniques for implant surgeries, Marin Cosmetic Surgery Center boasts an exceptionally low incidence of infection since 2001.
Hematoma: A hematoma is a collection of blood around the breast implant pocket. If a hematoma occurs, it usually occurs soon after the surgical procedure, within the first twenty-four to forty-eight hours. Small hematomas are absorbed by the body and can be unnoticed, but large ones need to be drained surgically in the operating room.
Changes in Nipple and Breast Sensation: Feeling in the nipples and breasts can increase or decrease after breast implant surgery. Changes in feelings are usually temporary and return after swelling dissipates. On rare occasions, the sensation can be lost.
How Much Does Breast Augmentation Cost?
The cost of breast augmentation is approximately $7,500–$9,700, depending on saline or silicone implants. This fee includes the surgeon’s fee, anesthesiologist’s fee, operating room expenses, support personnel, and the actual cost of the implants. If needed, financing is available.
There are a few variables to pricing. The new “gummy bear” implants have three different degrees of firmness, and each has an additional cost. Also, the physician’s geographical location may increase the price, as will his or her expertise.
Breast implant revision surgery has a customized fee based on the specific case and complexity.
How Do I Choose a Breast Augmentation Surgeon?
How to select a breast augmentation expert is a critically important question. It is essential to maximize your likelihood of receiving excellent care, safety, and ethical treatment. A successful outcome with your first surgery sets up for continued success in the future. These are some critical points:
Board certification through the American Board of Plastic Surgery, the gold standard by which Plastic Surgeons are trained. This certification is a mandatory requirement. It does not guarantee that a board-certified surgeon will give you superior care, but certifies that he has undergone exceptional training.
What are patients saying about their breast augmentation experience? Patient reviews are now commonplace in our society, and we value their experience. However, everyone has a bad review here or there—but it is the doctors’ overall trend, which is essential. Also, it should be multiple reviews and on various platforms like Yelp and Realself, for example. You can also request to talk with patients who have had breast enhancement. Dr. Delgado offers this routinely.
Before and After Photos
The breast augmentation before and after photo gallery will show many of the surgeon’s patients’ aesthetic outcomes. Each surgeon is an artist with varying degrees of aesthetic expression in their work. Some doctors, like Dr. Delgado, prefer a more natural appearance that fits the patient’s body. Other surgeons may desire a larger breast size that makes a more significant impression. If the doctor’s aesthetics agree to you by reviewing their photo gallery, this is a good sign. A few photos are not enough. Dr. Delgado shows hundreds of photos.
Communication and Trust
Communication and trust issues can not be overstated. Are you able to communicate your goals, and is your doctor listening to you? Do you trust that your physician and staff will be there to take care of you? You must have a very positive feeling about your surgeon and the team.
Breast augmentation should be performed in a hospital or an accredited operating facility, such as AAAASF. This accreditation will ensure that the facility meets the proper standards and ethical guidelines.
Natrelle® Implant Warranty
After your surgery, Dr. Delgado will give you a card with the type of implants, serial numbers, and date of surgery. This information will be provided to Allergan, Inc.—which is the breast implant company—on your behalf, and you must keep this card in a safe place. If you ever have an issue with your implants, you will need this information to activate your warranty.
Natrelle offers a very generous warranty on their implants. You can get detailed information on your type of implants’ warranty on their website by clicking here.
Natrelle offers the ConfidencePlus® saline warranty for their saline implants:
- Events covered include implant rupture/deflation and BIA-ALCL diagnosis that leads to surgical intervention and removal.
- In the event of an implant rupture or deflation: Lifetime implant replacement coverage for both affected and contralateral implants.
- In the event of BIA-ALCL diagnosis: Lifetime implant replacement coverage for both affected and contralateral implants. Up to $7,500 is also available to remove the breast implant(s) and associated scar tissue.
- For a reasonable fee of $200, within 45 days of implantation, the amount of out-of-pocket assistance would be $2,400 for a ruptured or deflated implant.
Natrelle® offers a ConfidencePlus® gel warranty for their silicone implant:
- Events covered include implant rupture/deflation, capsular contracture Baker Grade III/IV, late seroma, and BIA-ALCL diagnosis that leads to surgical intervention and removal. This is valid for cases on or after 1/1/2018.
- In the event of an implant rupture or deflation: Lifetime implant replacement coverage for both affected and contralateral implants along with out-of-pocket financial assistance for ten years up to $3,500.
- In the event of capsular contracture, Baker Grade III/IV: 10 years for both affected and contralateral implants and out-of-pocket financial assistance for two years up to $2,000 (breast augmentation patients only).
- In the event of late seroma: Implant replacement for both affected and contralateral textured implants for 20 years.
- In the event of BIA-ALCL diagnosis: Lifetime implant replacement coverage for both affected and contralateral implants. Out-of-pocket assistance includes up to $1,000 for diagnostic testing for textured implants and up to $7,500 towards the removal of the breast implant(s) and associated scar tissue.
- Your ConfidencePlus® gel warranty cannot be canceled or upgraded.
For more specific details, please go to Natrelle’s website or ask Dr. Delgado’s patient coordinator.
Additional Breast Augmentation FAQs
How do I know which breast implant size is right for me?
Most women want a breast size that is complementary to their build. Going too large can result in looking disproportionate or top-heavy. Going too small may leave you wishing you had chosen a larger size the first time.
Dr. Delgado’s patients find a useful tool in the rice test for finding the right implant size. Uncooked rice is placed in a nylon stocking and tied into a knot. A woman can test various size and weight dimensions by placing them in her bra with her breasts.
A cup of dry rice represents 250cc of volume. One may add to this volume in small increments to the desired size. One might try 1 cup, 1¼ cup, 1½ cup, 1¾ cups, etc. until the desired breast volume is achieved. Patients who have used this method have a high satisfaction rate with the implant size they ultimately chose. The implant company Mentor has developed a new tool. They have developed a system of shaped silicone implants to place in the bra. This is an excellent confirmation after the rice test is performed. Dr. Delgado offers this new breast-sizing tool to his patients.
There are three different diameters for the same volume implant: moderate, moderate plus, and high profile implants. Dr. Delgado will show you these various implant styles, explaining why one might be chosen over another and assist you with your final selection.
What type of breast implant should I choose?
There are essentially two implants used today—saline-filled and silicone-filled implants. Both implants have a pliable outer envelope or shell made of silicone, but the shell contents are either saline (saltwater) or silicone gel. Both implants are excellent but in different ways. Dr. Delgado tends to favor silicone implants because patients find they have a more natural feel and appearance.
In 1991, the FDA began restricting the use of silicone breast implants based on safety concerns. This stemmed from claims that silicone breast implants could cause autoimmune diseases in some women. In November 2006, after extensive research, it was concluded that there was no scientific evidence to support this claim, and silicone breast implants were approved for general use (with certain restrictions, including that the patient has to be at least 22 years of age).
How does breast augmentation affect future breastfeeding?
Breast augmentation does not affect the ability to breastfeed. Dr. Delgado has had many augmentation patients who later breastfed successfully. When performed correctly, the surgical procedure does not damage nor alter the milk ducts. Not all women can breastfeed, regardless of whether or not they have implants.
Will nipple sensation be affected by breast augmentation?
While there may be a loss of sensitivity following breast surgery, it is almost always temporary. Typically, breast sensation returns after the swelling subsides and healing is complete. Nevertheless, there is still a remote possibility for sensory nerve injury to occur. Breast augmentation could result in some degree of permanent loss of sensation in the nipple-areola complex.
How will breast augmentation affect my annual mammogram?
Mammograms can be safely and effectively performed on women who have breast implants. Breast implants do not hide or mask breast cancer.
However, women with breast implants will need to have four extra pictures (two on each breast) in addition to the four standard images taken during a screening mammogram.
What is capsular contracture and how can it be prevented?
Capsular contraction is one of the most common complications of breast augmentation surgery. Capsular contraction is scar tissue that developments around the circumference of the breast implant. This scar tissue can squeeze the implant to varying degrees of tightness, causing pain and distortion of the breast. The cause of breast contracture is due to a low-grade infection that results in inflammation. The inflammation causes a cascade of reaction, which results in scar tissue.
How can capsular contraction be prevented? There is no formula to avoid breast capsular contraction. However, some things certainly help. We typically use the 14 point plan. This is a 14 step surgical plan that has been shown by scientific studies to provide the best way for a successful outcome with capsular contracture and infection. Dr. Delgado is very meticulous with this approach and provides this to each patient. Other techniques that are used are early breast massage, Vitamin E, and at times Singulair. Singulair, or Montelukast, is an asthma drug for children and has been effective in early capsular contraction cases. Dr.Delgado will use this drug on certain genetic types prone to scar formation, early scar formation, and breast revision surgery for capsular contraction. The use of an ADM, or acellular dermal matrix, has been shown to significantly reduce capsular contraction. This human skin matrix is used for recurrent capsular contraction.
What is BIA-ALCL and should I be worried about it?
Breast Implant-Associated Lymphoma (BIA-ALCL) is a non-Hodgkin’s lymphoma, a cancer of the immune system. It is not breast cancer. BIA-ALCL is mostly found in scar tissue and fluid near the implant. On rare occasions, it may spread throughout the body.
Successful treatment is the removal of the breast implant and surrounding scar tissue. On rare occasions, the treatment may include radiation therapy and chemotherapy.
The main symptoms of BIA-ALCL are swelling (which is usually from fluid), a mass, and pain in the breast. These symptoms may occur after wound healing or years after.
BIA-ALCL is shown to be associated with textured breast implants and not smooth-walled implants. It is not associated with the implant’s content—i.e., saline vs. silicone—but only the outer envelope. The FDA has requested certain implants to be voluntarily recalled.
If you have texture implants, you should consult your plastic surgeon. He or she will make a recommendation as to whether the implants should be replaced.
Is breast augmentation painful?
The discomfort after breast enlargement surgery is generally mild to moderate. Tenderness and soreness are more noticeable if you have had your implants placed underneath the pectoralis muscle. You may want pain medication for the first day or two after your breast enlargement surgery. By the third day, you probably will no longer need it. However, if you tend to have a lower pain threshold than most people, you may still want pain medication for as long as five days post-op.
Is breast augmentation safe?
As with any surgery, the risks of bleeding, infection, and adverse reactions related to anesthesia exist. Nevertheless, each year thousands of women undergo breast enlargement surgery and experience no complications at all. An experienced, fully certified, and licensed plastic surgery team reduces the frequency of complications. Marin Cosmetic Surgery Center operates with Dr. Delgado—a board-certified plastic surgeon—a board-certified anesthesiologist, registered nurses, and trained surgical technicians.