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Breast Enlargement:
Saline Breast Implants

Breast augmentation is one of the most frequently performed plastic surgery procedure by Dr. Patterson. Millions of women worldwide, just like you, have chosen to enhance the shape of their breasts with implants. Each individual will have their own specific reasons for considering breast augmentation, but the underlying motivation is to look and feel better about their appearance.

Types of implants: A breast implant is a silicone shell filled with either silicone gel or a saltwater solution known as saline as discussed on this page or cohesive silicone gel. For more detailed information on cohesive silicone gel implants click here.

Saline implants vary in shell surface (i.e. smooth or textured), volume, shell thickness, profile, shape (round or anatomical), as well as expandable implants. Most saline implants are single lumen, and are filled at the time of surgery. There are prefilled saline implants, which are filled by the implant manufacturer.

The shell consists of a strong, silicone elastomer shell, and is filled with a sterile saline solution at the time of surgery. Should these implants rupture, the body will absorb the saline, much like drinking a glass of water. The sterile saline solution, used as the implant filler, should conform to the USP (United States Pharmacopeia) of Normal Physiological Saline (injection grade), which has a concentration of 0.15M and a pH of 7.2-7.4.

Details: Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Procedure:By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.

The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples.

Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.

Length: The surgery usually takes one to two hours to complete.

Anesthesia: Breast implant surgery is performed under general anaesthetic, i.e. you will be unconscious during the procedure, or local/regional anaesthetic, i.e. you will be awake. The type of anaesthetic will depend on the anaesthetist, the surgeon and you. All anaesthetics carry a risk and you should discuss these risks with the anaesthetist.

In/Outpatient: The surgeon may prefer to perform the operation in his office facility, or a hospital outpatient facility. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

Side-Effects / Risks: Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure. The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood. A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body.

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Recovery: You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.

Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

You should be able to return to work within a few days, depending on the level of activity required for your job.

Results:
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Frequently Asked Questions:

Q. How long will my implants last?

A. Breast implants may have a limited life span and may have to be removed and/or replaced. They will age and may wear out and rupture as a result of an injury such as a fall or knock. An implant may last for only a very short time or for many years. Recent studies indicate that the risk of experiencing problems with the breast implant is much greater 8 to 10 years after the surgery. Breast implants should not be considered lifetime devices.

Q. How do I know if my implants have ruptured?

A. If you have saline implants, your breast will immediately become smaller. You will notice this straight away. The saline from the implant will be absorbed by your body and it will eventually pass out of your body in your urine. If you have silicone implants, a mammogram or ultrasound may show you if your implant has ruptured. The silicone gel from your implant does not flow freely in your body and may be contained within the capsule around your implant or may travel to nearby breast and other tissues, sometimes resulting in a palpable lump. If your implant ruptures you will need to have an operation to have it removed.

Q. How can I check to see how much my implants may be leaking?

A. You can try having a mammogram or ultrasound but there is no guarantee that your leakage (e.g. a leak through a hole in the outer shell of the implant) will be picked up. Magnetic resonance imaging may also be able to detect silicone in body tissues. Your doctor should be able to advise you about these services.

Q. Should I have regular mammograms?

A. If you are over 50 years of age, it is recommended that you have a mammogram every two years for the early detection of breast cancer. If you have breast implants this procedure is safe if performed by a trained technician. In theory, the pressure applied by a mammography machine could damage the implant causing rupture or gel diffusion. However the risk of this is considered very small.

Q. Should I have my implants removed or replaced?

A. Your decision to leave your implants in place or to have them removed or replaced is a personal one. Only you, in consultation with your doctor or surgeon can make it, but you should weigh up all the benefits and risks. Doctors generally only recommend removal of implants if you are experiencing specific problems such as extreme capsular contracture, constant pain, infection that will not clear up, or rupture. Other factors to consider are how you feel about your implants, your health, your body image and your concerns about the long-term health effects of keeping your implants in.

Q. Is it safe for me to breast-feed?

A. Current information indicates that women with breast implants are able to breast-feed however there have not been many studies conducted on the effects of silicone on breast fed babies. There is no evidence that silicone from breast implants is present in breast milk, or whether if swallowed, silicone is absorbed by babies or passes through them. There is also no evidence that if silicone is absorbed it will cause illness in the child.