Picking the Ideal Implants For You

Before making an appointment with your plastic surgeon to discuss a breast augmentation, educate yourself on the three different types of implants, risks, complications, and what to expect during surgery. Picking breast implants is a decision that will have a lasting impact on your lifestyle and your confidence. Thoroughly researching breast implants before you see a surgeon will allow you to ask the right questions and make informed decisions which will lead to a better outcome physically, mentally, and emotionally. Visiting our Breast Implant Education Center is a great step to getting your breast implant surgery questions answered.

A Brief History of Breast Implants

Like many devices in the history of medicine, the road to developing the ideal implants for women has been rocky. Before modern-day implants, doctors were injecting women with a variety of materials including goat’s milk, ground rubber, and silk fabric. According to researchers Walter Peters and Victor Fornasier, paraffin injections and liquid silicone injections have been among the most popular choices from the 1890s up until modern implants began to be used in the 1960s. However, they caused many issues in unsuspecting patients ranging from painful lumps to death. Injections often traveled to other parts of the body such as the abdomen or armpits. One of the important facts to note in this history is the lack of regulation before the 1970s. In the US, Congress passed the Medical Device Amendment in 1976 which opened the door for regulators to ensure devices such as breast implants were tested and approved for safety before being placed on the market. To learn more about this history of breast implants read our post on the subject.

The Three Types of Modern Breast Implants

The breast implants you will encounter at your board-certified surgeon’s office are no longer injectables or hazardous substances but properly tested medical grade devices. Here is a brief overview of the three types of breast implants you should consider before your breast implant surgery.

    • Silicone Gel: the FDA approved silicone gel implants in 2006 after a lengthy testing and approval process. Silicone gel filled implants are comprised of a silicone shell filled with silicone gel. The gel inside is thick, sometimes giving these implants the nickname “gummy-bear” implants. Many women love the look and feel of these implants, and they have enjoyed popularity. However, a recent survey found that women do have concerns about the possibility of the implant rupturing without their knowledge, known as a “silent rupture.”  While the silicone gel implant is safe when intact, the FDA does recommend removing a ruptured silicone gel implant including the shell and any leaked silicone, so it does not become misshapen, cause discomfort, or migrate. However, the only way to detect a silent rupture is with an MRI, which is why the FDA also recommends women with silicone gel implants get an MRI at three years post-op, then every two years for the life of the implant.
    • Saline: saline breast implants have a silicone shell filled with sterilized salt water (saline).  These implants were the only implants approved by the FDA between 1992 and 2006. Women enjoy the peace of mind that comes with saline breast implants because the body naturally absorbs saline in the case of a rupture. There is no need for repeated MRIs as a rupture will be immediately evident, and nothing will migrate and need to be removed like silicone gel. However, because saline is less dense than breast tissue, these implants tend to look and feel unnatural and can cause ripples under the skin.
  • The IDEAL IMPLANT® Structured Breast Implant: the FDA approved the new technology found in the IDEAL IMPLANT after years of research, testing, and clinical trials. It was developed by a plastic surgeon to address the compromises women feel they have to make when choosing between saline implants and silicone gel implants for their breast implant surgery. The IDEAL IMPLANT is a saline filled implant with an outer silicone shell and a baffle structure inside that controls the flow of saline. The result is an implant that has structure and stability, fewer ripples, a natural look, a natural feel and peace of mind.

What Complications and Risks Should You Know About?

According to the FDA, the most common complications with breast augmentations are implant rupture, capsular contracture, reoperation, and removal. Reoperation and removal can occur due to a variety of reasons such as rupture or dissatisfaction with results. Removal may or may not be followed by replacement. It is important to note that breast augmentation is surgery and comes with the same risks and complications that occur with any other surgery. Your doctor can further explain risks and complications you should be aware of, including infection and problems with anesthesia. Different implant types and brands have their own statistics on the rate and risk of reoperation, removal, rupture, and capsular contracture. Choosing an implant with statistically lower risks means a decreased chance of complications that can lead to discomfort and removal. Read below for more information about implant rupture and capsular contracture, including important statistics.

Implant Rupture

An implant rupture is when the outer shell of an implant tears. With saline implants, this causes deflation as the saline flows out and is naturally absorbed by surrounding tissue. A rupture in a saline implant is immediately detectable because of total deflation. With the IDEAL IMPLANT® Structured Breast Implant, a rupture is still easily detectable, but the structured layers and two lumens inside mean the deflation will not be total. In silicone gel filled implants, the silicone gel may stay close to the tear or stick to the surrounding tissues. To remove ruptured implants the surgeon must remove the shell, and in the case of silicone gel implants, the surgeon must also remove any silicone gel stuck to the tissues. Removal surgery for silicone gel implants that have ruptured or had capsular contracture may include a capsulectomy, where the surgeon removes the thickened scar tissue surrounding the breast implant. To confirm a tear or hole in a silicone gel filled implant, your doctor will order an MRI. Some women with silicone gel implants may have had a tear or hole for several years without knowing it, which is why the FDA recommends regular MRIs for these women. The FDA recommends removal of all types of implants that have torn, even if the implant is not causing symptoms. See the table below for the rupture risk of some of the top silicone gel brands and the IDEAL IMPLANT® Structured Breast Implant.

Brand Name Rupture Risk for Primary Augmentation*
 

Allergan gel

Mentor gel

Sientra gel

IDEAL IMPLANT

7.4%

3.4%

5.4%

1.8%

*FDA Core clinical trial results for primary augmentation; 7-year for IDEAL IMPLANT and Allergan; 6-year for Mentor and Sientra since 7-year results not published.

Capsular Contracture

According to the FDA, capsular contracture is “the hardening of the breast area around the implant. It can occur in the tissue surrounding one or both implants. This hardening causes the tissue to tighten, which can be painful.” Capsular contracture can happen any time after your breast implant surgery. In many cases, your doctor will recommend removal and replacement. See the table below for the capsular contracture risk of some of the top silicone gel brands and the IDEAL IMPLANT® Structured Breast Implant.

Brand Name Capsular Contracture Risk for Primary Augmentation*
  

Allergan gel

Mentor gel

Sientra gel

IDEAL IMPLANT

16.2%

9.8%

10.0%

6.3%

*FDA Core clinical trial results for primary augmentation; 7-year for IDEAL IMPLANT and Allergan; 6-year for Mentor and Sientra since 7-year results not published.

To read more about implant types and common complications visit this post.

What Will Breast Implant Surgery Entail?

Before your surgery, gather information on what to expect before, during, and after the procedure. Knowing what will happen to your body will allow you to prepare mentally, physically, and emotionally, leading to a better outcome.

Before Surgery

Before your surgery, you will meet with a surgeon and choose the ideal implants for your body, desired results, and lifestyle. If you desire a natural look and natural feel, your doctor will most likely recommend the IDEAL IMPLANT® Structured Breast Implant, or a silicone gel filled implant. If you are concerned about the cost or hassle of repeated MRIs, or you feel uncomfortable with silicone gel, make sure your doctor offers the IDEAL IMPLANT so you can choose a saline-filled implant with a natural look and natural feel. Your surgeon should talk you through the procedure and answer any questions you have. If your surgeon ever makes you feel uncomfortable or refuses to answer important questions, consider looking for a new surgeon. For more information on finding the right surgeon read our post here.  

During Surgery

Breast implant surgery typically takes a few hours and, as long as there are no complications, you should be able to go home the same day. During the operation, you will be put under general anesthesia or IV sedation. Your surgeon will make one of the following incisions to place the breast implant:

    • Inframammary – under the breast fold
    • Transaxillary – under the arm
  • Periareolar – around the nipple

Silicone gel filled implants are pre-filled to a predetermined size. Saline implants are placed and then filled by the surgeon with the desired amount of saline. Because they are not pre-filled, the IDEAL IMPLANT, can fit through a smaller incision site. Your surgeon will place the implants either below the chest wall muscles (submuscular) or above them (subglandular). Your surgeon will then close the incision with tape, stitches, or glue.

Post-Op

Breast implant surgery typically does not require an overnight stay at the surgery center or hospital. Be sure you have a friend or family member available to bring you home, which should be an hour or so after surgery. Your breasts will be wrapped with gauze and a bandage or support bra. It is important to follow all your surgeon’s post-op instructions for the best possible outcome. Wear your support bra and rest for as long as your surgeon recommends, take any medication prescribed, and be aware of the signs of infection. Call your doctor immediately if you have any concerns, or visit the ER if you believe it is an emergency. After the first week, the worst of the pain should be gone, but swelling and soreness will remain for a few weeks. Following your surgeon’s instructions for limiting activities, exercising, and follow-up visits will ensure you end up with the ideal implants for years to come.

To learn more about what to expect from a breast augmentation visit this page.

How to Choose a Doctor

How do you know you’re choosing an experienced, compassionate surgeon who will help you through this process? Asking the right questions during your initial consultation will help you determine if a plastic surgeon is the right one for you. Your breast augmentation is a decision that will affect you physically, emotionally, and mentally for many years to come. Make sure you have a surgeon who listens to and responds to your questions and concerns. Keep in mind the following when interviewing a plastic surgeon.

    • Is your surgeon board-certified? Being certified by the American Board Of Plastic Surgery means your surgeon is kept to a higher standard of care and stays up to date with safe and effective methods of surgery. To learn more about the American Board Plastic Surgery visit their website.

For a checklist of questions, you should ask your surgeon, print this FDA Checklist.  

To find a board-certified surgeon in your area, visit the IDEAL IMPLANT plastic surgeon finder.

How Much Does Breast Implant Surgery Cost?

Breast implants vary based on the office you choose, the implant you choose, and your location. Because it is a cosmetic procedure insurance companies typically do not cover the surgery or any complications that may arise as a result of the operation. Despite this, many women feel like it is the best money they have spent because of the increased self-esteem they have. When calculating your costs don’t forget to add the following:

    • MRIs: if you choose a silicone gel implant the FDA recommends an MRI every two years to check for a “silent rupture”. Most insurance companies do not cover this procedure.
  • Rupture Risk, Capsular Contracture Risk: all breast implants are at risk of a rupture or causing capsular contracture, but some have a higher risk than others. Look at the statistics when choosing breast implants to make an educated decision. Don’t let your surgeon push you toward a specific implant if the risk factors make you concerned. Make sure you have money put aside in case you need a reoperation.

Your Life Beyond Breast Implant Surgery

Breast implants can give you more confidence and self-esteem, but getting them shouldn’t be a spur of the moment decision. When you educate yourself about the options, the risks, and what to expect you will be able to enjoy your new body for years to come. It all starts with picking the ideal implants for you. For more information about breast implants visit IDEAL IMPLANT today.