Breast Implants

Breasts mainly consist of milk ducts and glands enclosed in a thick layer of fatty tissue. The breasts overlie the muscles of the chest. Factors such as advancing age, pregnancy, and nursing may cause the breasts to lose their natural shape and firmness and droop or sag.

Breast implants may be surgically implanted below the breast tissue for cosmetic purposes to augment the shape and size of the breast. Breast implants are artificial shells made of elastic silicone filled with sterile saline or silicone gel.

Breast implants may also be used for breast reconstruction after mastectomy or loss of breast tissue secondary to trauma or injury. Sometimes it may also be used to rectify a birth defect. Breast implants can be placed either under or over the chest muscles.

Eligibility Criteria

Breast implant can be considered in women if the following criteria are met:

• At least 18 years old
• Should not have any active infection
• Should not be currently nursing or pregnant
• Should not have an existing malignant or pre-malignant cancer of the breast

Choices in Implants

• Size: Size of the breasts after surgery depends on the initial breast size before the surgery and the size of the implant chosen. Implant size is measured in grams. The plastic surgeon will help you in choosing the right sized implant.
• Shape: Breast implants are available in two shapes
  • Round Breast Implants: These breast implants are round in shape.
  • Shaped Breast Implants: These breast implants are tear drop shaped. These resemble the shape of a mature breast, gently sloping downwards.
• Profile: Profile refers to the outward projection of the implant. Breast implants are available in three profiles: low, moderate and high. Some companies also have an extra-high profile. High profile breast implants have maximum outward projection for a particular size and shape.
• Surface texture: Round shaped breast implants are available with both smooth and textured shell surfaces whereas shaped breast implants are available only with textured shell surface. Textured implants have a thicker shell and are generally firmer. They require a slightly larger incision than the smooth implants.
• Implant filler: The breast implants are either silicone gel filled or saline filled.
• Saline filled breast implants require a smaller incision for placement. These are filled with saline only after surgical placement of the implant. Filling during the surgery allows the surgeon to make minor adjustments to the volume. Saline implants are considered safer as only the filled saline will be released into the tissue in event of an implant rupture (a rare event). However, these implants look less natural as compared to silicone filled implants.
• Silicone gel filled implants have a more natural look and feel softer than the saline implants. Silicone gel filled implants are pre-filled and require a longer incision for implantation.
• The newer silicone implants have a thicker shell and thicker silicone gel which significantly reduces the risks of gel bleed and release of silicone gel should the implant rupture.
• Saline implants: In general, saline implants are slightly safer than silicone implants; however, they look rounder and feel slightly firmer than silicone breast implants. If they rupture, there is no risk and you would see the breast size decrease. It is very easy to replace them.
• Brazilian implants: These are similar to the textured silicone breast implants, but have another layer of foam bonded to the surface of them which gets degraded within a few months. The role of the foam is to reduce the risk of deforming scar tissue formation around the implant.

At Collins St Plastic Surgery we are experts in all types of breast implants (silicone, saline, polyurethane) and would discuss them fully with you, so that your implant is chosen based on your particular needs.

Complications and risks

Complications associated with breast implant surgery are specific to certain breast implants. These may include capsular contracture, pain, infection, calcium deposits in the tissue around the implant, haematoma, seroma, changes in nipple and breast sensation, necrosis around the implant, extrusion and deflation or rupture. Few patients may develop unpleasant cosmetic outcomes that include wrinkling, asymmetry, implant shifting, incorrect size, unanticipated shape, implant palpability, scar deformity, hypertrophic scarring or sloshing. Sometimes, an additional surgery may be required to treat the associated complications. Careful surgical planning and newer techniques are aimed at minimising these risks and complications.

Your plastic surgeon will help you decide the right implant depending on your preferences.