Cosmetic and Plastic Surgery, Breast Procedures

Breast Implants: Your Options

by Dr. Diane Gibby • M.D., P.A., F.A.C.S

Breast Augmentation (augmentation mammoplasty) is a surgical procedure that enhances the size and shape of a woman's breast. Women may choose this procedure for several reasons: to enhance their body contour; to correct a reduction in breast size after pregnancy; to balance a difference in breast size; or as a reconstructive technique following breast surgery.

To increase breast size, saline or silicone implants may be used, although the use of silicone implants is under stricter guidelines issued by the FDA. Most saline-filled implants share some standard features, like a silicone rubber shell and a valve for filling with saline solution. However, breast implants do come in different shapes and sizes, as well as different textures.

The traditional implant is more likely to give a curve in the upper part of the breast resulting in a "rounder" appearance. Contoured or anatomical implants are tear-drop shaped. This gives a gentle curve or slope in the upper part of the breast; and fuller a appearance in the lower part, more like a natural breast.

Both types of implants will increase your breast size. Depending on the look you want to achieve, you may prefer one type of implant over the other.

Breast implants are also made with different outer materials and textures. The outer, pliable shell of an implant is thin, solid silicone, but its surface may be either smooth or textured. A textured surface is thought to help lessen the formation of scar tissue around the implant. A smooth-surfaced implant has a slightly softer shell, and is less likely to be felt through the skin and tissue around the implant.

Which type of implant you choose will also depend on your body shape, thickness of your skin and the size you desire. You and your physician will discuss what type of breast implant is best for you to achieve the result desired.

Another implant available today in the PIP, manufactured in France. This implant is touted as more natural looking than standard implants. In addition to the outer shell, what makes the PIP different from other implants available today is that they are prefilled by the manufacturer and therefore a fill valve is not necessary.

Other saline implants can be inserted into the breast partially filled and then filled with saline solution through a valve until the desired size is achieved . This limits the length of incision required for implant placement.

Manufacturers of the PIP implant state that the omission of a filling valve helps prevent the accompanying problems of valve failure, post surgery leakage, filling time delay, fill tube disconnection and under- or over-filling, thus giving optimal aesthetic results. While these implants have been available internationally for over 5 years, they have just recently been given FDA clearance in the United States. They will not be given full FDA approval until further studies have been completed.

The downside of the PIP implant it that a longer incision is required to insert this pre-filled implant and long term studies are not readily available on their rate of rupture and degree of scar tissue formation.

Any breast implant surgery does have the potential for complications. These risks include infection (requiring removal of the implant) and capsular contracture (scar tissue), which may develop around the implant, distorting the shape of the breast and potentially causing breast pain. The chance of rupture or deflation of implants is low, but does increase with the age of the implant. Any woman opting to proceed with breast implant surgery should understand revisional surgery might be necessary to treat potential problems associated with implants.

While women shouldn't let their breast size define them, it can make a difference in how they perceive themselves and can directly affect a woman's self-esteem. Having a breast augmentation is a very personal choice, and as with any cosmetic procedure, risks and benefits should be considered carefully before proceeding.

Diane Gibby, M.D., P.A., F.A.C.S Licensed in Texas, Dr. Diane Gibby is board-certified by the American Board of Plastic Surgery (ABPS) and the founder of The Women's Center for Cosmetic and Plastic Surgery. She is a member of the American Society of Plastic Surgeons (ASPS), American Society of Aesthetic Plastic Surgery (ASAPS), American Medical Association (AMA), Texas Society of Plastic Surgeons (TSPS), Dallas County Medical Society (DCMS) and the Board Certified Plastic and Cosmetic Surgeons of Dallas. She is also a Fellow in the American College of Surgeons (F.A.C.S.). Dr. Gibby's office is located at Medical City Dallas, Building C, Suite 820, (972) 566-6323. Individuals interested in brochures or names of qualified plastic surgeons in their area may call the American Society of Plastic and Reconstructive Surgeons at 1-800-635-0635.