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Breast Augmentation Surgery: What Should You Know?


Although cosmetic surgery overall was slightly decreased in the United States last year due to the economy, almost 10 million procedures were still performed, according to statistics released by the American Society for Aesthetic Plastic Surgery. The most popular surgical procedure was breast augmentation, or the placement of breast implants, with over 300,000 performed.

In recent news, the safety of breast implants has been spotlighted. Singer Amy Winehouse was briefly hospitalized over the weekend, reportedly after experiencing pain from the implants that she had placed in November of last year. According to People Magazine, she was soon released and is fine.

Officials in the UK have issued an alert this week to plastic surgeons after it was discovered that some breast implants manufactured in France by Poly Implant Prothese and sold worldwide since 2001 are twice as likely to explode as standard implants. These were made with an unapproved silicone gel that can cause severe infection if it were to leak into the natural breast tissue. Although it is unlikely for implants to break because the fluid is encapsulated in two layers, there is still a concern and women with the implants should return to their cosmetic surgeon to have them replaced.

If you are considering breast augmentation, carefully bear in mind the following factors.
First and foremost, while breast augmentation can help enhance both appearance and self-esteem, women seeking surgery should not expect to reach an “ideal” or “perfect” appearance. The best candidates for surgery are those who are looking for improvement, not perfection. It is important to remain realistic about the outcome of your body after breast implants.

Most women are appropriate for breast augmentation if they have small or under-developed breasts, an out of proportion figure (ie hips much larger than breasts), misshapen breasts due to pregnancy, weight loss or aging, or breasts that are of unequal size.

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Both silicon and saline breast implants are available in the United States. After rigorous scientific review, the FDA approved silicone gel-filled breast implants in November of 2006 when manufactured by one of two companies, Allergan (formerly Inamed Corp) and Mentor Corporation. Silicon breasts are considered softer, but saline implants are currently used more often because the fluid is considered safer if the implant should burst.

The methods for inserting and positioning implants depend upon the patient’s anatomy and doctor recommendations. Incisions can be made either under the armpit (transaxillary or axillary), around the areola (periareolar), or under the breast (Inframammary) to minimize visible scarring. A transumbilical approach is used less often, where the surgeon feeds the implant through the belly button to the chest using an endoscope.

Breast implants can either be placed directly under the breast tissue (subglandular) or beneath the pectoralis muscle (submuscular or subpectoral) in the chest. Submuscular usually requires a general anesthetic whereas the subglandular placement can be performed with IV sedation and local anesthetic.

Most women who have breast implants will experience no major complications. A recent Institute of Medicine review of silicone implants found that there is “no definitive evidence linking breast implants to cancer, neurological diseases, neurological problems or other systemic diseases.” However, breast implants are not without risk.

Capsular contracture may occur as a result of the buildup of scar tissue around the implant that can cause unnatural firmness. Deflation may also occur in about 5.8% of the implant models currently in use, according to a study by the University of Minnesota. Infection is rare and can usually be easily treated with antibiotics if it should occur.

An implant may interfere with the ability to find breast cancer during mammography. They may affect the ability to produce milk for breast feeding and may not prevent breasts from sagging after pregnancy.
According to the American Society of Plastic Surgeons, the average surgeon fee for breast augmentation surgery in the United States was $3406 in 2005. This does not include additional fees for the procedure, including anesthesia or medication.