HOW TO CHOOSE THE RIGHT BREAST

IMPLANT

Choosing the right breast implants is not easy. Make sure that you understand the risks and benefits of

breast implant surgery, and discuss with your doctor

your expectations. We have created a list to help you make sure that all your questions are answered.

ANATOMY OF THE BREAST

› Anatomy of the breast - it is important that you understand the limitations that may exist due to characteristics of your own breast tissue. No woman has two breasts that match exactly, and therefore there will still be some asymmetry following augmentation surgery. The right implant is the one that will balance your goals with what your tissues will safely allow.

SILICONE X SALINE› Implants: Silicone x Saline – both silicone and saline

implants are FDA-approved for cosmetic use. Each type of implant has its own unique benefits and trade-offs:

− Siliconea) contains a safe, cohesive silicone gel

b) feels more like natural breast tissue

c) requires a slightly larger incision

d) more expensive than saline implants

− Saline a) contains a salt-water solution

b) feels firmer than silicone

c) higher risk of visible wrinkling and rippling

d) can use a smaller incision

e) lower price than silicone implants

LOCATION› Location: Subglandular vs. Submuscular – breast

implants can be placed either partially under the pectoralis muscle (submuscular or dual-plane) or over the muscle and under the breast tissue (subglandular).

− Subglandulara) not recommended for thin tissues

b) more visible and palpable implants

c) higher risk of capsular contracture

d) more difficult mammograms

− Submusculara) appropriate for thin tissues

b) less visible and palpable implants

c) lower risk of capsular contracture

d) easier mammograms

IMPLANT SIZE

› Implant Size – the best size for a given patient is determined primarily by the patient’s measurements and tissue characteristics. While your goals and desires are very important, it’s also important you understand that an implant which is too large for your tissues can create additional complications, including excessive skin stretch. A specific cup size cannot be guaranteed, as bra cup sizes are not standardized across manufacturers.

IMPLANT SHAPE AND TEXTURE

› Implant Shape – both silicone and saline implants are made in round and teardrop shapes.

a) Round implants - most often used in cosmetic breast surgeries.

b) Teardrop implants - provide additional fill to the upper portion of the breast and are most often used in reconstruction surgeries.

 › Implant Texture – the implant’s surface can be smooth or

textured.a) Smooth implants - move easily and feel soft.

b) Textured implants - have a slightly bumpy feel on the surface. Textured implants do not move as much within the breast pocket, but they are associated with a higher risk of visible wrinkling.

INCISIONS LOCATIONS

› Incision Locations – there are three commonly used incision locations: within the breast fold (infra-mammary), around the nipple

(peri-areolar) and under the arm (transaxillary).

a) Infra-mammary – affords the best visualization of your tissues

and is well-concealed; lower risk of difficulty breast feeding.

b) Peri-areolar – also well-concealed, but it may be associated with

a higher risk of infection and of difficulty breast feeding.

c) Transaxillary- incision is within the armpit; may be visible in

some types of clothing; there is a risk of injuring important nerves

and vessels in the arm; very difficult to place larger silicone

implants through this incision.

RISKS AND ADDITIONAL PROCEDURES

› Risks - as with any other surgery, breast augmentation carries risks and benefits. Some of the risks associated with breast augmentation include:

• Rupture

• Capsular contracture

• Scarring

• Asymmetry

• Wrinkling

• Implant displacement

• Change in nipple and breast sensation

• Infection

• Possible breastfeeding difficulty

› Additional Procedures - in some cases implants alone may not be sufficient to address all of your concerns, such as sagging or extra skin. A breast lift is sometimes recommended at the time of breast augmentation.

BOARD CERTIFICATION

› Board Certification – make sure your doctor is board certified by the American Board of Plastic Surgery – board certified plastic surgeons complete a minimum of 5 years of surgical training following medical school, including a plastic surgery residency. State laws permit any licensed physician to call him- or herself a “plastic” or “cosmetic” surgeon, even if he or she has not been trained as a plastic surgeon or has had no surgical training at all – be sure to select your doctor carefully.

INDUSTRY RESOURCES

For more information about breast implants:

Additional sources of information about the use and safety of saline and silicone breast implants can be found online at the following sites:

Nina S. Naidu, MD, FACS: http://www.naiduplasticsurgery.com

Natrelle: http://www.natrelle.com

Breast Implant Follow-Up Studies (BIFS): http://www.bifs.us

Breast Implant Answers: http://www.breastimplantanswers.com

American Society of Plastic Surgeons: http://www.plasticsurgery.org

Food and Drug Administration: http://www.fda.gov/cdrh/breastimplants

Institute of Medicine Report on the Safety of Silicone Implants: http://www.nap.edu/catalog/9618.html

1021 Park Avenue, New York, NY 10028(212) 452-1230

www.naiduplasticsurgery.com

NINA S NAIDU, MD. FACS

PLASTIC AND RECONSTRUCTIVE SURGERY