Breast augmentation is a surgical procedure that enhances breast size. Implants are placed under the breast gland or under the pectoralis muscle. Implants may be placed using a number of different surgical techniques – each of which leaves a different type of scar (axillary, inframammary, or periariolar). Each approach has advantages and disadvantages, and must match the patient’s goals.
Implant size is selected by the patient in consult with her plastic surgeon. Although any size of augmentation is theoretically possible, implants that are too large to be adequately supported by the patient’s tissues may lead to undesirable outcomes, including thinning of the skin, premature sagging of the breasts, and exposure of the implant. Because of this, the patient’s breast tissues dictate the maximum size of the augmentation.
Silicone implants have a number of advantages – they are lightweight and have a natural look and feel. The main disadvantage of silicone implants is the risk of “silent rupture.” All implants have a small chance of rupture over time, but silicone implants can rupture without causing physical signs. The FDA recommends that women with silicone implants have their implants imaged by MRI biennially; if a rupture is discovered, the implant should be replaced or removed. Silicone implants are FDA approved for patients 22 years and older.
Saline implants have different advantages than silicone – scars can be minimized, and there is no risk of “silent rupture.” If a saline implant ruptures, the breast size decreases, and the saline is safely absorbed by the body. The main disadvantage of saline implants is that they tend to have a firmer, more unnatural feel than silicone. Saline implants are FDA approved for patients 18 years and older.