Patients have several options for choosing breast implants. This includes options regarding size and type of implants. Below are some guidelines to help patients better navigate this decision. Visit Dr. Thomassen at Thomassen Plastic Surgery in Fort Lauderdale to find out more information.
Choosing a Size
Breast implants are sized in cc or cubic centimeters. This is the same as milliliters. Plastic surgeons use this number when discussing breast implant size.
For a breast augmentation, a rough guideline when choosing an implant size is that every cup size increase requires an additional 100 cc (cubic centimeters) of volume. In other words, an A cup would require a 100 cc implant; a B cup would require a 200 cc implant; a C cup 300 cc and so on. Therefore if you start the process with an A cup and desire a C cup breast size, you would need a 200-300 cc implant.
There are helpful anatomical measurements that assist in selecting implant size. These are breast width, breast skin lower pole stretch, and anterior breast skin pull. By taking these measurements, plastic surgeons area able to estimate the optimal size of implants for a particular patient.
However, attempts to strictly use numbers do not always model reality. These guidelines are therefore assisted with breast implant sizing methods conducted in an office setting. A typical method involves using a thin brazier to hold sample implant sizes. A patient is then able to model different implant sizes. They are able to feel the weight of the devices and see the effects on their chest wall.
A combination of guidelines, anatomical measurements, and observations during a physical exam will help determine the optimal size for a patient.
Textured no more
Textured implants have fallen from favor. This is due to an association found between these implants and an extremely rare soft tissue lymphoma. This lymphoma is called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). These implants may still be available here or outside the United States. It is recommended for patients seeking an augmentation to select a smooth round implant for their surgeries.
Highly Cohesive Gel
Breast implants are made with a highly cohesive silicone gel inside a thick elastomer silicone shell. This cohesiveness means the gel will not leak out of the implant if the shell ruptures. It also means the implants are “form-stable” and will retain their shape once inside the body.
In early versions of implants, the gel was not as cohesive. Ruptured implants could leak silicone. This resulted in silicone granulomas in the axilla and soft tissues adjacent to the implant.
The drawbacks of a more cohesive silicone gel implant includes a stiffer feeling breast. However, this formulation keeps getting improved with newer generations of implants. The goal is to obtain the best combination of cohesiveness and feel.
Saline Implants have a Role
Saline implants may not be as sought after as their silicone counterparts. This is due to them not feeling as natural as silicone gel implants. However, they still are a good alternative for the right patient.
Saline implants are an excellent option for younger patients. These patients usually have plenty of breast tissue to fully cover the implant. Therefore the breasts will still feel soft with a saline implant.
Additional benefits of the saline implant is the lack of surveillance needed to detect an implant rupture. Patients with silicone implants are advised to undergo an ultrasound or other evaluation every 3-5 years. This helps ensure the implants are intact. Saline implants will deflate if ruptured, with the saline being absorbed in the body. Therefore no imaging is required.
Saline implants are also useful in patients with slight asymmetries. The fill volume of the implants can be tailored differently for each side.
They are also more cost effective.
Choosing a Profile
Implants come in different profiles or projections. Wider and less projecting implants are called moderate profile devices. Narrower and more projecting implants are termed high profile devices. Patients desiring a modest increase in size are better served with moderate profile devices. These devices are in the 200-275 cc range. For patients interested in more voluptuous augmentations, higher profile devices are recommended in the 300+ cc range.
Avoiding Capsular Contracture
All breast implants form a capsule around them once they are implanted. This is a thin layer of tissue that surrounds the implant. As long as the capsule remains thin, the implants will be remain soft. However, in a few cases, the capsule become thick and hard, resulting in a hard feeling breast. This condition is called capsular contracture. This condition may also cause the implant to migrate from its initial position. In severe capsules, the breasts may also become painful.
Several causes of capsular contracture have been hypothesized. These include contamination of the implant when placed in the body. Other causes are postoperative bleeding.
Multiple techniques have been developed to limit this complication. Some techniques include using funnels to place the implants through small incisions. This avoids touching the implant itself. Other methods involve antibiotic irrigation of the implant and cavity, systemic antibiotics, and meticulous hemostatic techniques. Additionally, meshes can be used to cover the implant and affect capsular formation. With the right combination of techniques, this complication can be averted.
Armed with this information, patients can make better decisions regarding their breast implants. Please visit us at Thomassen Plastic Surgery to help you make the right decision for you.
In Summary
When choosing breast implants, consider all these points and discuss them with your plastic surgeon. This will ensure an excellent result. You can obtain more information in the American Society of Plastic Surgery website.
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