What is a breast implant?
Typically a breast implant consists of a silicone shell that’s filled with either silicone gel or cohesive silicone gel with shape-retaining memory. Not only are there choices in fillers, but the design of the shell that houses the gel can also vary. The surface may be textured or smooth. Your surgeon will discuss the benefits of the various breast implant options available and help you choose the best breast implants for you.
How are breast implants placed?
A breast implant is usually inserted either under the breast tissue or deeper under the large breast (pectoral) muscle on top of the ribcage. The incision for insertion is most often made in the fold of skin under the breast. Although it’s less common, the incision may be made around the areola (the area around the nipple) or in the armpit.
Are breast implants available in different shapes?
Yes. Breast implants are available in round and anatomical options. Anatomical breast implants are designed to reflect the shape of the breast. With its upper area gently sloping downward and outward, the shaped breast implant is more likely to match natural contours. Anatomical implants are also available in different heights and projection, so the implant can be selected to suit the breasts’ existing shape and each woman’s desires, whether they prefer discreet or more pronounced enlargement. The round breast implant will enhance breast size and may produce a more rounded appearance to the upper breast.
What size implant should be used?
You will probably want to choose a size that flatters your figure and gives you the natural look and feel you want. Most women want the firmer and fuller breasts they used to have or always wanted. You may also want to minimise the space between your breasts and find out how you can bring your breasts into proportion with the overall shape of your body. Discussing what you have in mind with your surgeon is important, so that he or she can take your expectations into account when the implant size and shape are selected.

For a natural look, you will probably want your new breasts to be in balance with your body as a whole. Breast width, height, and projection are all-important considerations. The width of your breast is what will determine the size of the space between the breasts (cleavage). Breast width also determines the outer curve of the breasts, a contour that is essential to the balance between breasts and hips.
What are the possible complications?
Possible complications specific to breast implants may include the following: implant rupture, capsular contracture, reoperation, implant removal, pain, changes in nipple and breast sensation, infection, scarring, asymmetry, wrinkling, implant displacement/migration, implant palpability/visibility, breast feeding complications, haematoma/seroma, implant extrusion, necrosis, delayed wound healing, breast tissue atrophy/chest wall deformity, calcium deposits, and lymphadenopathy.

You may also be dissatisfied with the way the implant feels or the appearance of surgical scars. The full extent of any complications should be clearly explained to you by your surgeon before the operation and of course careful assessment beforehand along with implant selection and placement will minimise the risk of these problems
How long will my implants last?
Breast implants are artificial devices which will gradually age and wear out and may eventually need to be removed or replaced. This should be considered after 10 to 20 years which is when the risk of problems may increase. In general, an implant may wear out over time or develop a microscopic fracture in the outer shell. How long the breast implant remains without complications depends on the type of implant inserted and the type of surgery you have had. The anatomical implants with high cohesive silicone are documented to have a low risk of rupture. It is important to remember that a breast implant, whatever it is filled with, is not necessarily in place for life and to remember that removal or replacement may be necessary.
When is a second operation necessary?
If a patient is unhappy with her result or if she experienced a complication, a second operation may be necessary. Talk to your doctor about his rate of revision and to find out more information about the need for a second surgery.
How long does breast enhancement surgery take?
Breast enhancement surgery usually lasts 1 to 2 hours, but it really depends on your surgeon’s technique, the location of the incision, and the placement of the breast implant. While your surgeon may discharge you after surgery, you should plan on an overnight stay after the procedure.
How much will it cost for me to have breast implants?
The cost of breast implant surgery will depend on your surgeon, where the operation is performed, and the type of implant you choose to have. Your surgeon will be happy to advise you on this.
Should I have regular mammograms?
All women in the age and risk groups for which mammograms are recommended should continue to have them. Women who have increased risk factors should follow a schedule based on their doctors’ recommendation. Regular mammograms are especially important as women grow older because most breast cancer occurs in women over 50.
Can breast implants cause cancer?
There is no medical evidence to date showing that women with breast implants are at increased risk of breast cancer. Following breast enhancement, you should continue to consult a physician to carry out normal checks to detect breast cancer.
What does cohesive mean?
Cohesion describes a gel's tendencies to stick together. All silicone gel-filled breast implants available today are filled with cohesive gel.
What is silicone?
Silicones are a family of chemical compounds. They are made from silicon, a naturally occurring element found in sand, quartz and rock. Next to oxygen, silicon is the most common element in the earth's crust and becomes silicone when it is combined with oxygen, carbon and hydrogen. Silicone can be processed into many forms including liquid, gel or a rubber-like elastomer. In its various forms silicone can be found in everyday items such as polishes, lotions, deodorants, soaps, processed foods, waterproof coatings and even chewing gum.
Are silicone gel-filled breast clinically tested and evaluated?
Yes. Silicone gel-filled breast implants are arguably the most studied medical devices evaluated through decades of research. Allergan devices for breast augmentation are supported by extensive preclinical testing, U.S. clinical studies, a European rupture prevalence study, peer-reviewed literature and 30 years of real-world experience in more than 60 countries.
What are the main concerns related to silicone gel-filled breast implants?
Breast implant rupture is considered to be one of the most common concerns for all breast implants. Breast implants are not considered to be lifetime devices nor are they expected to last forever. Some implants may rupture in the first year after being implanted or after several years. Rupture is an opening in the implant shell. Silicone implant ruptures may be silent (no symptoms) or symptomatic. Some factors associated with breast implant rupture include increasing age of the implant, trauma, compression during mammography and damage by surgical instruments.
Am I at risk if my silicone gel-filled breast implant ruptures?
Although there is no immediate danger to your health should you suspect that your breast implant may be ruptured or leaking, you should consult with your plastic surgeon and have the implant removed. Rupture of a silicone gel-filled breast implant is most often silent. Silent rupture is a rupture without symptoms and which is not apparent except through appropriate imaging techniques such as an MRI. This along with additional testing may be required to confirm rupture. Additionally, possible surgery to remove and replace your breast implant may be required.
How can it be determined if a silicone gel-filled breast implant has ruptured?
Breast implants rupture when the shell develops a tear or hole. Ruptures can occur at any time after implantation, but they are more likely to occur the longer the implant has been implanted. Silicone gel-filled breast implant ruptures are most often silent. (MRI examination is currently the best method to screen for silent rupture.) This means that most of the time, neither you nor your plastic surgeon will know if the implant has a tear or hole in the shell.
What are the effects of silicone gel-filled breast implants on pregnancy and breastfeeding?
Women with breast implants do not risk exposing their breastfed children to excessive amounts of silicone. A major concern about implants has been the possible adverse effects of silicone on breast-fed infants. It is important to note that much higher levels of silicon—from which silicone is derived—have been found in cows’ milk and commercially available infant formula than are found in the breast milk of women with implants. In fact, there is no evidence of elevated silicone levels in breast milk or any other substance that would be harmful to infants, nor are there any differences in silicone levels in the milk and blood of nursing mothers with implants and those without them. Although some mothers with implants may find it difficult to produce an adequate milk supply, the Institute of Medicine committee urges that all mothers try breastfeeding, because it is beneficial to babies and is not harmful to mothers. If your surgeon uses a periareolar surgical approach (an incision around the coloured portion surrounding the nipple), it may further increase the possibility of breastfeeding difficulties. Concerns have been raised about the possible harmful effects of silicone crossing the placenta to the developing fetus. The committee found no evidence of increased levels of disease or birth defects in children born to women with implants.
How will silicone gel-filled breast implants effect having mammograms?
Mammography can pose a problem for women with breast implants. Mammograms produce an image of the inside of a woman's breast by compressing the breast. This presents a risk of rupture to the scar around the implant or a rupture of the implant itself. However, the current recommendations for getting screening/preoperative mammograms are no different for women with breast implants than for those without implants. Mammography exams should be interpreted by radiologists experienced in the evaluation of women with breast implants. It is essential that you tell your mammography technologist before the procedure that you have a breast implant. You should request a diagnostic mammogram rather than a screening mammogram, because more pictures are taken with diagnostic mammography. The technologist can use special techniques to reduce the possibility of rupture and to get the best possible views of the breast tissue.
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