The popularity of breast implant surgery or breast augmentation rose 36 percent between 2000 and 2009, according to the American Society of Plastic Surgeons (ASPS). Women unhappy with the size or shape of their breasts may choose to get breast implants to provide them with the look they want and improve self-esteem. In the procedure's infancy, various materials served as implants, but the first modern-day silicone implant procedure occurred in 1962. This operation utilized a silicone envelope filled with silicone gel--the first implant to provide a natural shape and feel--popularizing the surgery.
Implant Choice
Saline breast implants contain varying amounts of sterile saltwater, which alters the shape, firmness and feel of the breast. The ASPS states that saline implants can leak, causing the implant to collapse, and the body to absorb the saline. Cohesive gel breast implants contain firm silicone gel, described as a "soft solid." If the implant tears or gets cut, it maintains its shape. According to Dr. William P. Adams Jr., leaks do not occur with cohesive gel implants, and there's less of a chance of capsular contracture--hardening of the skin around the implant.
Surgical Incisions
The ASPS reports that breast implant surgery uses small incisions to minimize visibility and scarring. Patients determine the incision type with a surgeon prior to the operation, choosing one of four sites: the transaxillary (armpit), periareolar (areolar), inframammary (crease) and transumbilical (navel). The society further notes that incision also depends on the degree of enlargement, personal anatomy and the type of implant used. The Canada Breast Augmentation (CBA) website reports that saline implants work with any method of incision, as they're inserted empty and then filled. Cohesive gel implants come prefilled, and surgeons usually insert them through an inframammary incision.
Placement and Insertion
The CBA lists two types of placements for breast implant surgery--subglandular placement and submuscular placement. In subglandular placement, the implant goes over the pectoralis muscle and under the breast tissue, leading to less post-surgical pain and quicker recovery time, as only skin and fat are cut. A submuscular placement puts the implant partially under the pectoralis muscle, cutting skin, fat and muscle, resulting in a longer, more painful recovery. Once the surgeon cuts the tissue, she creates a pocket known as the "capsule," which holds the implant. The surgeon then inserts the implant and sutures the incisions.
Post-Surgery and Recovery
The American Society of Plastic Surgeons indicates that post-surgery recovery usually takes 24 to 48 hours, with reduced activity suggested for a few days. Soreness and swelling lasts for about three to four weeks. Over time, the swelling will decrease and the incision scars will fade.
Considerations
All surgical procedures carry some risk, including complications from anesthesia, blood clots and infection. You should discuss the risks associated with breast implant surgery with your surgeon. Aside from unwanted scarring, the risks specifically associated with breast augmentation include temporary or permanent changes in nipple and breast sensation, according to the ASPS. Capsular contracture, firm scar tissue, could also form around the implant, giving the breast an unfavorable appearance, and the skin over the implant may wrinkle.
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