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Breast implant surgery is the least difficult of the aesthetic breast surgery procedures. Many patients report a shorter operative, as well as recuperative time, and physicians generally observe less stress and trauma to the body as a result of this procedure. Over 2 million women have chosen to have breast implants and have been very happy with the results.

Types of Breast Implants

Generally, Dr. Schusterman uses two types of breast implants, prefilled (with silicone or saline) and inflatable (for saline only).

1) Prefilled Breast Implants

A prefilled breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.

2) Inflatable Breast Implants

The main advantage of the inflatable saline implant is that being inserted non-inflated (empty) permits the smallest possible incision. After insertion, the implant is inflated with saline.

Incision Sites for Breast Implants

Dr. Schusterman will discuss with you the pros and cons for the incision site specifically suited for you. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

The common incision sites are:
1) Under the arm (axillary): This incision is less concealed than periareolar (2) and associated with less difficulty than the periareolar incision site when breastfeeding. Compared to the less complex inframammary incision (3), there is an increased chance of bleeding or bruising.
2) Around the nipple (periareolar): This incision is well concealed, but is associated with a higher likelihood of inability to successfully breastfeed, as compared to the other incision sites.
3) Within the fold under the breast (inframammary): This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breastfeeding. Compared to the less complex inframammary incision (3), there is an Increased chance of bleeding or bruising.
4) Umbilical or navel (transumbilical): This incision results in a single hidden scar (no breast scars) and no chance of causing difficulty with breastfeeding. Only inflatable implants are used in this procedure. Implants must be inserted entirely deflated and inflated only after they are in place. For more information, see Transumbilical Breast Augmentation (TUBA).

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

The Breast Implant Placement

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

1) The Submuscular Placement
The breast implant is placed behind the chest wall muscle (pectoral muscle). This placement feels and looks more “natural” because the implant is further away from the skin. It may require a longer surgery and recovery period, but typically results in less capsular contracture (scar tissue formation), and easier imaging of the breast with mammography.

2) The Subglandular Placement
A sub glandular placement for the breast implant behind the breast tissue offers shorter surgery, less pain and discomfort and briefer recovery, since muscles are left intact and only skin and fat are cut. Larger implants may also be used. This placement may result in more palpable implants, more capsular contracture, and more difficult imaging of the breast with mammography. Keep in mind that the only thing supporting the implant is the skin and breast tissue.

Dr. Schusterman will discuss with you the pros and cons of the two possible implant placement sites, and recommend the site that best meets your needs.

Also, you should be aware that breast implants don’t always last forever. They often require a future operation to remove and replace the original implant.

Any questions? Contact Dr. Schusterman

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