July 16, 2008 – 10:50 am
Before reviewing this information, it is worth describing the silicone gel implant and explaining the differences between a silicone gel-filled and a saline-filled breast implant, which is an alternative to the silicone gel implant. The outer shell of both silicone and saline implants is made of a solid silicone material. Solid silicone is widely used in implantable medical devices. In contrast, silicone gel implants are filled with silicone gel, which is a semi-solid. Saline-filled implants are filled with the same kind of salt water that is used in I.V. fluids.
Surface of the Breast Implant
The surface of a breast implant may be smooth or textured (multiple fine bumps on the surface). There is some evidence that textured implants have a lower incidence of tight scar formation around them. However, because a textured implant adheres to the surrounding tissue, it may cause visible rippling (wrinkling) in the skin. This can occur if there is not adequate soft tissue between the implant and the skin’s surface on top of it to prevent wrinkling of the implant from being transferred to wrinkling in the skin. A textured implant generally requires a larger incision due to the increased difficulty of sliding the implant through the surgical opening.
Breast Implant Position
Implants may be placed either beneath the breast tissue or on top of the pectoralis muscle (subglandular) or partially beneath the pectoralis major muscle (submuscular). There are advantages and disadvantages of each placement. Generally, placement of an implant beneath the muscle gives an extra layer of muscle coverage and may give less interference with mammographic examination of the breasts. Placement of the implant on top of the muscle in a patient with adequate breast soft tissue to cover the implant may be carried out under local anesthesia, if desired. Generally, this placement has less postoperative discomfort and a quicker return to activities. Placement beneath the pectoralis muscle usually requires more anesthetic and higher costs.
Breast Implant Incisions
A silicone gel implant is commonly inserted through an incision in the inframammary fold (crease under the breast) or just above it. This incision may vary from 3-6 cm in length. An implant may also be inserted through an incision around the pink portion of the nipple/areola complex (a peri- areolar incision). This incision is hidden to some extent by the color change at the edge of the areola. The incision at or above the inframammary fold is often hidden by the slight droop of the breast and is not seen unless an observer is looking up under the breast. Implants can also be inserted through an incision in the armpit (axilla) but this is more
difficult. There is some evidence that more difficult insertions may cause damage to the implant.
Breast Implant Prostheses
A prosthesis is used to enlarge the size of a woman’s breasts (known as breast augmentation, breast enlargement, mammoplasty enlargement, augmentation mammoplasty or the common slang term boob job) for cosmetic reasons; to reconstruct the breast (e.g. after a mastectomy; or to correct genetic deformities), or as an aspect of male-to-female sex reassignment surgery. According to the American Society of Plastic Surgeons, breast augmentation is the most commonly performed cosmetic surgical procedure in the United States. In 2006, 329,000 breast augmentation procedures were performed in the U.S. Read this medical information article »
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