If you're considering breast augmentation with breast implants, the following information will provide you with a good introduction to the procedure. For more detailed information about how this procedure may help you, we recommend that you consult a plastic surgeon who is board certified or has completed a residency program that includes instruction in this procedure.

Types of implants

A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.

Because of concerns that there is insufficient information demonstrating the safety of silicone gel-filled breast implants, the Food and Drug Administration (FDA) has determined that new gel-filled implants, at the present time, should be available only to women participating in approved studies. Some women requiring replacement of the implants may also be eligible to participate in the study.

Saline-filled implants continue to be available to breast augmentation patients on an unrestricted basis, pending further FDA review. You should ask your doctor more about the specifics of the FDA decisions.

The type of incision can also categorize these implants.

1) In the breast fold: This hides the scar well should it thicken. It provides the easiest and safest approach for the surgeon and is the one most commonly used. An excellent surgeon should be able to do the surgery through an incision measuring exactly one inch.

2) Around the nipple: This is often a very thin scar; if not, it will be very visible. The biggest risk of employing this incision is loss of sensation in the nipple that can occur up to 50% of the time.

3) In the axilla: This is a popular means of access when the implant is put under the muscle, but it can also be used for over the muscle. One of the implications of a scar in this area is that if it thickens, raising your arm on the beach or in a low cut gown will be a dead giveaway that you have implants. This incision also makes proper placement of the implant very difficult. Unfortunately, it is not uncommon to see patients with implants that were placed too high on the chest because of this approach.

4) Through the navel: The surgery is performed through a long tube called an endoscope. While the scar may be imperceptible, it is nearly impossible to dissect a large enough pocket for placement of the implant in this manner. Therefore, the method used is creation of the space by blowing a dissecting balloon that tears open the area. This does not create a large enough pocket for the implant, so that its outline can be seen, producing a very unaesthetic appearance. If bleeding should occur, stopping it can be very difficult. Furthermore, because the implant can be abraded and weakened when pushed through the endoscope, the implant manufacturers will not guarantee their products in the event of leakage.

After the operation

Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support after breast augmentation surgery. You also may have drainage tubes coming out of the incision for several days, to help drain some of the excess fluid. It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.

Implant duration

Breast augmentation makes the breasts larger for the life of the implant. Remember, also that larger breasts sag faster than smaller breasts, and augmented breasts do this as well. It is possible that you may require surgery in later years to correct sagging if you choose to have large implants. Gravity unfortunately has no exceptions.