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Breast Augmentation Orange County

Figure 1. Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.		Figure 2. Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.
Figure 3. The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.		Figure 4. After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.

Implant Choices

Many designs of implant are used. They all consist of a silicone bag containing a fluid. The outside of the silicone bag or envelope is sometimes textured. The first fluid used to fill implants was silicone gel, followed by saline (salt water). Newer implants filled with soybean oil and a starch derivative are unlikely to gain F.D.A. acceptance. (Soybean oil implants were withdrawn in Britain because of concerns about their long term safety.) Saline implants with multiple compartments are currently in trials, but their long term reliability will not be known for many years.

Conventional saline implants are available for all patients, and silicone gel implants have been re-released for use in most patients (you must be 22 years old to receive silicone gel implants for cosmetic reasons). Silicone gel implants have been continuously improved since their introduction over 40 years ago. The bag is stronger and the gel thicker, making current implants much safer than older implants.

Preventing Implant "Hardening" (Capsular Contracture)

When any foreign material is placed in the body, scar tissue forms a capsule around it. Usually this normal reaction is not a problem. Sometimes, for reasons that are not entirely clear, this capsule becomes thicker. It contracts around the implant, forcing the implant into a hard round ball.

This spoils the shape and consistency of the breast. A tight capsule can also cause discomfort. Usually the breast must be re-opened and the capsule surgically released, to make the breast soft again. The majority of patients who have capsule problems are still happy that they had a breast augmentation. Rarely does anyone want the implants removed.

The risk of developing a tight capsule is probably lower with a saline filled implant, or with a textured implant. Saline filled implants leak more easily than silicone gel, and if so the breast will rapidly return to its preoperative size. (The saline is harmlessly absorbed by the body.).

Textured implants were introduced more recently, so there is less long term experience with them. They are becoming increasingly popular because of the lower risk of a tight capsule.

Other Issues

Over two million women have undergone breast augmentation with silicone implants over the last twenty-five years and they are one of the safest surgically implanted devices in use. Breast feeding is rarely affected. There is also no good evidence of any increased risk of breast cancer or auto-immune disease.

Except in rare circumstances, breast augmentation will not delay a detection of a breast cancer. There is a slight loss of accuracy of screening mammograms. Be sure that the mammographer is used to imaging augmented breasts, as extra views are needed.

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