Breast implants are used to surgically increase the patient's breast size. In many cases, breast implant surgery is strictly a cosmetic procedure, but many breast cancer survivors often use breast implants as prosthetics to replace one or both breasts. Depending upon the needs of the patient, the surgeon may choose from a variety of breast implant materials and techniques to tailor the outcome to the individual.
Available implant types
There are two types of breast implants that are most commonly used: silicone and saline implants. Breast implants can vary in:
- shell surface
Some implants are made with a fixed volume, some are filled during breast implant surgery, and others allow for filler volume adjustment after breast implant surgery.
All the different types of breast implants are composed of a shell, filler, and a patch to cover the manufacturing hole. The shell of different types of breast implants can vary in surface and thickness. The filler in some different types of breast implants can be altered up to six months after surgical implantation in order to change the size of the implants as desired. The size or volume of different types of breast implants also varies considerably to allow a patient a variety of aesthetic options.
The different types of breast implants that are filled with silicone have been controversial for decades. Silicone filler breast implants have long been associated with serious health complications like connective tissue disorders, and local implant related complications like:
- capsular contracture
Because the different types of breast implants filled with silicone are thicker than those made of saline, a rupture may be silent and symptoms may not be noticeable, but it can potentially lead to significant health problems.
Because silicone had been proven dangerous, the FDA banned most different types of breast implants that used this material as filler in 1992. In April 2005, the FDA began to consider allowing silicone implants to be available on the market once again. Manufactures of these different types of breast implants argue that new silicone implants are safer and more durable than before.
Silicone breast implants are made up of a special gel-like substance that looks and feels more natural than saline implants or other alternatives, making them the preferred choice for breast augmentation and reconstruction procedures. Experts estimate that thousands of women in the United States will undergo revision surgery to replace their implants with silicone.
Saline filled breast implants have been the most popular implants on the market for some time. These different types of breast implants were considered safer because, in the event that they rupture, saline is considered less toxic than silicone. Saline implants are not free from complications, however. Like silicone, saline implants can:
- change shape
All different types of breast implants are associated with the risk of causing pain, infection, loss of sensation in the breast area, scarring, the inability to breastfeed and more.
Various saline breast implants are available, with sizes, shapes, and styles designed for a wide array of individual needs. Saline breast implants are surgically inserted either just under the breast tissue, or beneath the muscle; saline breast implants that are identically constructed will differ in appearance depending upon placement, and individuals receiving the saline breast implants should discuss the relative advantages of the two styles of placement.
How is the procedure performed
Breast implant surgery procedures can vary extensively based on the type and extent of surgery that is most appropriate for a particular individual. Prior to breast implant surgery a patient should have a clear idea as to the costs, risks, and benefits associated as well as what to expect during and after the surgery.
There are also four methods of breast implant surgery in terms of incision sites:
- transaxillary which is an incision in the armpit area
- periareolar with an incision made around the areola
- inframammary where an incision is made in the breast fold
- transumbilical where an incision is made in the belly button
Breast implants can also be placed under the muscle or under the glandular tissue. Each of these types of breast implant surgery has its own risks and benefits, so it is important to speak to a qualified surgeon to discover which one would be best for you.
During the first month or so after a breast implant surgery procedure many women will experience pain, swelling, bruising, tenderness, and nausea. A plastic surgeon will advise its patients of what to expect and how to care for themselves after breast implant surgery.
Breast implant surgery recovery
Recent advances in breast implant procedures enable the surgeon to operate with a minimal amount of scarring; many breast implants are now inserted through incisions hidden by the belly button or armpits. Recovery after a breast implant surgery varies by individual, but patients are usually able to return home immediately following their breast implant procedure.
The majority of patients will wear an elastic bandage to prevent shifting while the breast implants heal, and some patients experience soreness and stiffness for the first days to weeks following surgery. Any swelling or bruising should subside shortly, and the final results of the breast implant will appear around six months after the surgery.
Breast implant recovery is not a simple process. In most cases, the breasts that you see immediately after surgery are not indicative of the final results. It is not until after six to eight weeks of recovery that the breasts finally take a shape of their own. Recovery continues until each individual feels comfortable with her new breasts.
There are several different stages of the recovery process, each with many different side effects that may occur. Such side effects include:
- swelling and bruising
For most women, the full recovery from breast implant surgery usually takes a few months. Everyday activities can usually be resumed after two weeks. However, as with all surgeries, recovery time is different for each patient.
Breast Implant Size
The size of the breast implants used depends upon several factors, including the proportions of the patient, the breast implant shape, desired amount of cleavage and protrusion of the breast implant itself when viewed from the side. Most patients have found after surgery that breast implants tend not to appear as large as natural breasts, so the size of the breast implant may seem smaller than what you intended. On the other hand, ordering breast implants in a size that is too large could lead to serious complications after surgery. A competent plastic surgeon will not push the limits of your body by using an oversized breast implant, so you should talk various sizes over with your surgeon to determine the breast implant size that is right for your needs.
Because breast augmentation surgery is customized to fit a patient's desired appearance, there are a variety of sizes to choose from. Breast implants are measured in cubic centimeters with sizes ranging from 125 ccs to 1200 ccs. Breast implant sizes are not measured in cup size, as this will vary depending on the patient's original breast size. Additionally, because saline breast implant sizes are usually wider than natural breasts, many women will need to wear larger bras than they think are necessary.
The best implant size for a woman depends on a number of factors, including:
- bone and muscle structure
- desired result
Only the woman and her surgeon know what's right for her. However, depending on the width of a woman's chest and the strength and tightness of the muscle and skin, a saline breast implant size of 250 ccs to 450 ccs may be the greatest size that can be implanted underneath the chest muscles. If this size is exceeded, the breast implants may take on a spherical shape, that makes the aesthetics of the breast seem too unrealistic.
Reasons for Breast Implant Removal
The three most common reasons for breast implant removal are change of size and shape, implant leakage or rupture, and capsular contracture.
Sometimes, breast implant removal is necessary to treat problems that occur with the implants.
- deflation or rupture
- implant wrinkling
Other times it may be due to the body's reaction to the implants.
- diagnosis of breast cancer
- the formation of scar tissue that tightens around the implant
- necrosis, or the formation of dead tissue around the implant, which may prevent wound healing
- calcium deposits
Breast implant removal is done under either general anesthesia or local anesthesia combined with IV sedation. The procedure usually takes 30 minutes to an hour and takes place in an outpatient surgical center. Breast implant removal usually costs between $1,000 and $4,000.
Initial recovery from breast implant removal surgery is usually quick, with many patients returning to everyday activity within a few days and full activity within two to three weeks. Full recovery often takes a few months. For the first few days after breast implant removal, there may be mild discomfort, swelling and bruising. Some uncommon, but possible, complications include:
- loss of nipple sensation
- loose skin
Some women suffer from psychological distress after breast implant removal. The change in the body's shape affects some women as profoundly as a mastectomy affects others. It is normal to feel some sadness after witnessing such a drastic body transformation.
Breast implant costs
In 2007, the national average breast implant cost ranged between $3000 - $8000. However, the national breast implant cost averages generally do not include a number of costs associated with breast implant surgery. Breast implants cost more than this average when other factors are included in the estimated cost. Such factors include:
- pre-surgical consultation fees
- hospital fees
- anesthesia fees
- prescription drug fees
- post operative care
- other potential costs
The cost of breast implants can vary depending on:
- the individual nature of a patient's procedure
- what is covered in the costs
- what surgeon is performing the surgery
It is important to note that choosing a surgeon based on the cost is not likely to yield the highest level of satisfaction. It is much more important to seek the quality service of a board certified surgeon who keeps your best interest in mind throughout the entire process.
In general, health insurance companies do not cover breast implants cost. They will also not cover subsequent breast implants cost when re-operation is necessary, even for health purposes. In some cases an insurance company will change a person's coverage or drop coverage if they know that they have had breast implant surgery. If the breast implant surgery is for reconstructive purposes after a mastectomy, insurance companies are required to cover the procedure.