Breast augmentation has become a very popular procedure with variety of techniques and different types of implants with which it’s performed. Breasts implants are prosthesis used to change the size shape of women’s breast. The type of breast implant depends upon the filler material used in the breast implant device (called the outer shell of the implant). Breast implants are used for reconstructive surgery, enhancing shape and size of breasts and mammoplasty.
Usually, it is a personal choice to choose either silicone or saline breast implants, while consulting with their consulting surgeon. While undergoing breast augmentation, there are several important characteristics to consider when choosing the type of device to be inserted. Among other things, one considerable characteristic is the feel of the implant, as it is generally desired to be as close to natural breast tissue as possible. The softness of breast implant is also of great importance, and you should also consider the need for follow up visits and secondary surgery as well.
Two types of breast implants are widely used during these procedures, Silicone breast implants and saline breast implants.
Silicone breast implants consist of breast shaped silicone outer shell with thick jelly like silicone fluid filled inside. Silicone breast implants are best at mimicking the breast tissue and comes in various sizes and shapes to give the desired breast shape to the client undergoing breast augmentation
The other type of implant is saline breast implants. In this article, we will go through all the aspect of Saline breast implants. Let us start.
What about Saline Breast Implants?
Well, saline breast implants also has outer silicone gel, just like silicone breast implant, but differ in the filler material that is the outer shell is filled with saline rather than silicone. They are inserted under the chest wall muscles and are filled with saline once the implant is in place.
Shapes of Saline Breast Implants
· Round Shape
Round breast implants are a popular choice and are generally suitable for most women. These implants give more rounded appearance to the upper breast. The final appearance of breast is round, full and proportioned. Since these are perfectly rounded if they tend to rotate once inside the body, their rotation cannot produce the deformity of breast shape. They are usually ideal for women who loose upper breast volume due to breastfeeding or weight loss. Although most surgeons believe that once settled into the body they do assume a more natural shape that is fuller at the bottom.
· Tear Drop (Anatomical) Shape
Tear drop breast implants are more oval shaped implants that give breast a more natural look of being fuller at the bottom. They are used for breast reconstruction and in those women that have little breast tissue available. Tear drop implants have textured shells to ensure that the implant stays in its right anatomical position by bonding to the surrounding breast and doesn’t move, and thus breasts don’t look uneven.
Surface of the Implants
There are two types of breast implant surfaces available in saline breast implants. Smooth and textured, the kind of implant surface you choose depends upon number of factors such as what is your lifestyle? What breast volume are you starting with and what breast volume would you like to have?
· Smooth saline implants
Smooth saline implants are favored by many surgeons, because they have low palpability, which means that they cannot be felt in skinny women or women with less breast tissue, making them feel more natural. They also feel like women’s own breast tissue because they move inside breast pocket freely.
· Textured saline implants
Textured implants were introduced into the market in the hopes of reducing capsular contracture, of the implant pocket. Because the surface of the implant is textured, it was theorized that it will not allow consistent scar tissue to form and hence reducing the chances of capsular contracture. However, the textured shell saline implants had a higher deflation rate and quickly fell out of favor. The intention of textured surface implants was to promote adherence of implant to the normal breast tissue. The main objective to produce adherence is to fix the implant in its place, and to prevent position changes such as implant moving towards the outer side and bottoming out over time.
Size of the Implant
One of the most important things to consider during breast augmentation or reconstruction is the size of the breast implant. The implant you choose depends upon your desirable look. Choosing implant size is one of the most important and stressful experience, as the implant size determines the aesthetic for many years to come.
Choosing implant size is an important process and it is important to consider the type of shape and fullness you want and to consider the area of fullness you desire. One of the most common ways to determine the size of breast implant to choose is by trying out breast implant during consulting sessions and pre-operative appointments, as it will give you a rough idea of the amount of volume you desire and would prefer. The size of the implant you choose and how the chosen implant will look once its put under your breast depends on number of individual factors for example its depends on your breast width and breast tissue thickness as a bigger implant on thin breast tissue might cause rippling during physical activity.
It is also very important to adjust breast implant diameter to breast width, to give a more natural feel to the breast and to protect breast for years to come.
The surgeon will make recommendations regarding the implant size depending upon your anatomy and desired look but it is important to know that the ultimate decision in choosing the implant size has to be yours. Usually it is recommended to choose a size that looks natural to you and your anatomy.
The profile of the breast implant is actually meant to tell us how much will implant project away from the chest wall. There are three types of profiles to choose from i.e. small, moderate and high profile. Implants that are similar in volume to each other but differ in their base width might project differently from the chest wall. The narrower the base width of the implant, the greater the projection of that implant away from the chest wall.
· Small Profile
Small profile implant is usually flat and wide, and has the least forward projection. These implants are better for women with wider chest.
· Moderate Profile
These are the universally flattering implant that project away from the chest more than the small profile implant but less than the high profile implants. These are flattering on women with narrow chest; they are probably the most natural looking implants that give volume and roundness along with appropriate projection.
· High Profile
High profile implants have a very pronounced projection from the chest. These are better for those who don’t want as much width to the chest. High profile implants are better for women who want fullness on the top of the breast and some breast lift. These are for petite women who have very narrow chest wall this create a prominent cleavage.
It is very important to remember that the profile that fits your body ideally would be suggested by a surgeon on the basis of your breast and body measurements. And that the profile is not some fixed distance away from your chest wall, but rather a ratio of these measurements.
Cost of Saline Implant
The cost of breast augmentation using a saline breast implants depends on number of factors, which are discussed in detail below:
1] The cost of the implant
Saline implants usually cost $1000 a pair, much cheaper than the silicone implants, since saline implants have essentially salt water in them and silicone implants contain cohesive silicone gel in them
2] The fees of the consulting surgeon
Different surgeons have different costs and packages to offer regarding breast augmentation using saline implants. This depends upon number of factors including surgeons experience and geographic location.
3] Where surgery is performed?
Breast augmentation is usually 1-3 hour procedure that is performed either in hospital or ambulatory service Centre or a surgeons own personal surgery suite, the choice of the venue will affect the cost of surgery.
4] Cost of recovery
Recovery from breast augmentation using saline implants depends upon number of factors and will determine the cost of recovery in terms of days missed from work, inhibition of strenuous physical activity and also driving, etc.
· Pain: usually the pain from the surgery is tolerated very well, when implants are placed above the muscle, the recovery from pain is quick, usually 2-3 post-operative days. But if the implant is placed below the muscles, usually you will need a week off work to recover from pain.
· Swelling: usually swelling after surgery takes about 3 months to subside completely, although 99% of swelling subsides in one month, the recovery time from swelling depends upon the amount of activity the person is performing on daily basis and the position of implant.
· Scars: scars from the surgery should usually be minimal when placed anatomically correctly and sutured properly, usually scars when taken care of properly, reach their baseline in 6 months.
· Exercise: usually clients undergoing breast augmentation are asked to refrain from any kind of aerobic activity with a lot of movement in the first two weeks, but usually at 6 weeks any kind of physical activity can be performed.
5] Cost of revision surgery
If you are clear about your goals and what aesthetics’ you want, chances are you’ll be happy with the results of breast augmentation for years to come, but sometimes due to some secondary complications like rupture of saline implant, or normal aging process of the breast you might need to have secondary surgery like replacement and breast lift in later years.
It is wise for anyone undergoing breast augmentation surgery to consider the fact that they might need secondary surgery in the future, so while undergoing initial breast augmentation surgery keep the cost of revision surgery in mind as well.
Pros and Cons of Saline Breast Implants
There are several advantages of saline breast implants.
- Their first advantage is that they are most cost effective than silicone breast implants usually costing $1000 a pair on average.
- The incision required for saline breast implants is usually smaller(2cm) than required for silicone breast implants(5cm) because they are inflated using normal saline once inside the body.
- Less chances of infection of scars since scars are smaller.
- Since saline breast implants are inflated inside the body, by using normal saline, the size is adjustable according to the aesthetics that are required, which is ideal for women with asymmetric breast. The saline implants also allow more volume choices depending upon the size of implant.
- One main advantage of saline breast implants over silicone is that there is no possibility of silent rupture, once the implant ruptures, the saline leaves the hard silicone outer shell and the size of the breast changes immediately, hence there is no need for follow up MRIs to detect silent rupture like that of silicone implants.
- When saline implant does rupture the saline escapes into the body, since saline is essentially salt water that is absorbed into the patient’s body and thus has no silent side effects on patient’s health.
- You can have breast augmentation using saline implants from 18 years onwards unlike saline implants that can be used for women 22 years and older.
- Saline implants need to be placed under the chest wall muscle because it looks more prominent and unnatural if put above the chest wall muscle, leading to longer recovery times.
- Saline implants don’t age very well, the weight of the saline implant causes them to drop, or stretch out the breast skin, or move to the sides, leading to need of breast lift and revision surgery later on.
- Saline breast implants tend to show more rippling then the silicone implant and are easier to feel than silicone implant, hence giving a less “natural” feel than silicone implants.
Safety Precautions and Instructions after Breast Implant Surgery
Following are the post-operative precautions you must follow instructions and safety habits
- In order to avoid infection in surgery scars it’s very important to take the prescribed antibiotics.
- For 2 weeks, sleep on you back.
- Avoid any strenuous activity for 2 weeks like jumping running etc.
- If the scars are under your arm pits, avoid raising your arm up for 2 weeks.
- Avoid putting water on your wounds for 2 weeks, if shower is needed try to dry the wounds properly.
- Keep you compression bra on until instructed by the surgeon to remove them.
Complications of Breast Implantation Using Saline Breast Implants
Here goes the list of complications that you should know beforehand because better safe than sorry.
· Deflation: saline implants can be deflated due to the leak in the outer shell of the implant which causes the saline fluid inside the implant to leak out. The leakage can happen abruptly or over the period of days or weeks, once the leakage happens, revision surgery is needed to either remove or replace the implant.
· Capsular contracture: capsular contracture happens more commonly in implants that are placed above the chest wall muscle and is associated more with the buildup of either whole blood (hematoma) or the water part of blood (seroma). Overtime the capsule that forms around the implant contracts, causing range of symptoms from pain (mild to severe) to distortion of implant shape and palpability or movement of implant, depending upon the range of symptoms, revision surgery might be needed.
· Pain: usually not a very common symptom in long term complications, but severe pain can be experienced long term due to inappropriate size or position of the implant.
· Infection: infection is a risk and possibility in any surgery, infection can happen right after the surgery for breast augmentation or weeks after, if there is infection of the implant, it is usually harder to treat than normal tissue infection, and in many instances the implant might need removal and revision surgery will be needed to replace the implant once the infection resolves.
· Breast feeding and lactation: the effects of rupture of the implant while the mother is breast feeding an infant is not known. However, surgery can have an effect on milk production or lactation if the incision is peri-areolar, or if the major nerves innervating breasts and milk ducts are cut during surgery, surgery may also effect the sensation of nipple areola area if nerves are damaged during surgery.
· Breast tissue atrophy or chest wall deformity: the pressure from implants might cause tissue necrosis and atrophy resulting in chest wall deformity once implants are removed.
· Deposition of calcium around implant: sometimes calcium is deposited around the implant which might mimic a breast disease during mammography, leading to additional testing and biopsy of the breast.
Saline Implant Leakage or Rupture Symptoms
Saline implants leak when the outer shell of the implant is damaged due to number of reasons, although saline leaking into the body is harmless as it is absorbed by the body and excreted into the urine, you would most likely need a corrective revision surgery.
Following are the symptoms of the saline implant leakage
- Pain in the affected breast
- Distortion of the shape and symmetry of the affected breast
- Hard nodules or knots
- Tenderness and redness
- Nausea vomiting and general discomfort
The diagnosis of rupture or leakage of saline implants is pretty straight forward, usually all that is needed is a clinical evaluation and CT/MRI is not necessary. Although leakage of saline through the implant shell poses no immediate threat to the patients’ health, leaking or ruptured implant should be removed as soon as possible and scar tissue should be dissected to avoid further harm to the breast pocket.
Questions To Ask the Surgeon
- How many breast augmentation surgeries do you perform each year?
- What is your training and experience?
- What are the risks of this surgery?
- Do I need to follow a specific plan before operation?
- Where would my surgery take place?
- Is the surgical venue fully equipped to handle complications during or after surgery?
- How long will my recovery period be?
- How will my lifestyle be altered during my recovery period?
Questions to Ask Yourself
- Can I afford the surgery and any other additional costs of complication that may arise?
- Why I am deciding to opt for breast augmentation?
- Am I emotionally and physically prepared to alter my appearance?
- Would I be able to adjust to the lifestyle during recovery period?
- Do I fully understand the procedure and the risks and complications associated with the surgery?
It is easy to be overwhelmed by the choices to be made while undergoing breast augmentation, from which type of implant to choose to the size and profile. Usually women who are not too thin and have sufficient breast tissue are good candidates for saline breast implants, also women who have asymmetric breast can benefit from saline breast implants for breast augmentation since their size can be adjusted so that both breast appear symmetrical. The incision is also smaller and the chances of adverse effects if the implant leaks are also close to none.
However, one should consider in detail the choices they have and the aesthetics they desire while undergoing breast augmentation surgery. Making an educated decision is extremely important. Any concerns and expectations that you might have must be addressed during consultation and pre-operative appointment. And finally your surgeon should be a guiding light helping you and counseling you through the challenging decisions regarding breast augmentation, lifestyle changes and follow up visits needed afterwards. All the best for the boob job!
Breast augmentation article references, these include Google books, FDA website, Harvard website, and answers from real cosmetic surgeons etc