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There are other ways a surgeon can be guided to the tumor, but these techniques are newer and not used in every facility.
Implant types Because there several choices to be made about the style of your implant, it is important to discuss your options with your surgeon. Two implant surface types are available to augmentation patients, smooth and textured. Textured implants have small bumps on their surface. These implants were developed in hopes of reducing the risk of contracture, a complication some women develop after augmentation.
Smooth implants have a smooth rather than bumpy surface. Many surgeons prefer smooth implants for their softer, more natural feel. Women have the choice of implants filled with cohesive silicone gel or with saline (salt water solution). Both types of fill have been used since the earliest days of breast implantation.
While there is no evidence that exposure to silicone can cause any disease in human beings, some women prefer to have their implants filled with saline. In the unlikely event of a rupture in the outer shell of the implant, saline, a completely bio absorbable salt water solution would be simply absorbed into the body and the implant would deflate.
Because of this, the FDA recommends a periodic MRI to confirm integrity of silicone filled implants. Most surgeons and patients agree that saline filled implants do not have the natural feel of silicone filled implants There are two shape options for implants, tear drop or round. Generally, round implants conform best to the natural shape of the breast and offer women favorable results.
Subglandular placement may offer women with sag in their breasts better results. Procedure types This procedure involves an incision in the fold underneath the breast and tends to allow the surgeon more direct control of implant positioning. About 70 to 80 percent of breast augmentations are performed using an inframammary fold procedure.
The same incision may also be used if complications arise or additional surgeries are needed. Inframammary fold augmentation works well for older patients or mothers, since age and pregnancy allows for a natural amount of sag in the breast. This natural sag allows for the surgical incision to be well hidden for most women.
During this procedure, an incision is made in the armpit, or axilla, and is used to insert an implant either above or below the muscle. Some surgeons will use an endoscope, which is a small, fiber-optic camera, to help them complete the surgery. About 10 percent of breast augmentations are done using a trans-axillary procedure.
A potential disadvantage of this approach is that getting symmetrical implant positioned is somewhat more difficult, and correction of post-operative problems will likely require additional incisions on the breast. Also, there is potential for thickened scars that are visible with sleeveless clothing, bathing suits or while arms are raised. In this procedure, an incision is made around the nipple-areolar complex and the scar tends to blend into the edge of the areola.
This is the preferred incision for women with very small breasts who do not have any fold under their breasts. This newer approach to augmentation uses an incision through the belly button. An endoscope, or small fiber-optic camera, is tunneled through the incision to a pocket under the breast. The implant is then inserted through this tunnel and inflated with saline.
Implants placed using TUBA have a slightly increased chance of damage. During placement, surgeons may possibly tunnel under one of the muscles. If there are any complications or additional surgeries needed, you may need an additional incision made closer to the breast. Lastly, manufacturers often do not honor an implant warranty if it is placed using TUBA.
Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body. Saline breast implants provide a uniform shape, firmness and feel, and are FDA-approved for augmentation in women age 18 or older.
Silicone breast implants are FDA-approved for augmentation in women age 22 or older. Gummy bear breast implants, Form-stable implants are sometimes referred to as because they maintain their shape even when the implant shell is broken. The consistency of the silicone gel inside the implant is thicker than traditional silicone gel implants.
Shaped gummy bear breast implants have more projection at the bottom and are tapered towards the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast that requires a separate procedure to correct. Placement of gummy bear implants requires a slightly longer incision in the skin.
Higher profile options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place. Smooth breast implants are the softest feeling. They can move with the breast implant pocket, which may give more natural movement. Smooth implants may have some palpable or visible rippling under the skin.
Implant manufacturers occasionally introduce new styles and types of breast implants, so there may be additional options available. Whether you choose saline or silicone implants, it is important for you to monitor your breast implants and follow-up with your plastic surgeon for appropriate checkups.
There are many different reconstruction techniques available. Your healthcare team can talk to you about the options that may be right for you, but it's in your best interest to do your own research, too. If you know someone else who had reconstruction, you might find it helpful to talk to her about her decision process, her doctors, and her satisfaction with the results.
“Just like we have vanilla and chocolate, there are two ‘flavors’ of reconstruction: implants and flaps. That’s it. Implant reconstruction is easier on the front end: an easier surgery, easier to recover from, easier to understand. Flaps are more difficult to perform, more time-consuming, and a longer recovery. But on the back end, things flip.
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