Get A More Natural Look & Feel with Breast Implants
Dr. Angelchik was certified by the American Board of Plastic Surgery (ABPS) in 1996 and successfully completed a rigorous recertification process in 2006 and 2016. He participates in the Maintenance of Certification program through the ABPS. He is a member in good standing of the American Society of Plastic Surgeons. He has also been named to Castle & Connolly’s Top Doctors in America every year since 1996.
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Implants are classified according to their filling, which are either silicone or saline. Both types of implants come in different shapes and sizes. Each has its advantages and drawbacks. The right type of implant for you depends on your aesthetic goals, your body and many other contributing factors. Dr. Angelchik can help you decide which implant is right for you during your consultation at our Phoenix office, and you can also see how the procedures are done in our 3-D surgery gallery.
Saline breast implants are a very popular choice in the United States. This may have to do with the fact that the Food and Drug Administration removed silicone breast implants from the market for a period of time. Saline breast implants have a silicone shell and are filled with saline, or sterile salt water, at the time of your breast augmentation procedure. They are filled to the correct size after they have been placed in the breast pocket created for your implant. Because the implant is deflated and then filled, the size of the incision is reduced and scarring is minimized.
The advantages of saline breast implants include:
- Saline implants have been FDA-approved since May 2000.
- The implants are filled by Dr. Angelchik which allows for size and volume precision.
- They require smaller incisions even for large breast enhancements— although, new technology allows for silicone implants to be done with small incisions as well.
- The saline solution is safely absorbed into your body if the implant ruptures, and your breast will appear deflated, alerting you to the rupture.
The disadvantages of saline implants include:
- Rippling may occur on the side or edge of the implant, which may be visible or felt in thin women or in women with minimal breast tissue.
- The consistency of the saline makes the implants feel different and makes them more obvious to the touch.
However, both of these issues can be reduced significantly by placing the implants behind the chest muscles (the subpectoral placement method).
Breast Augmentation – Saline vs. Silicone Implants Explained By Plastic Surgeon Dr. Paul Angelchik
Silicone breast implants come pre-filled from the manufacturer and contain a cohesive gel, which will stay within the implant in the event of a rupture. They are praised for their natural appearance and aesthetic superiority. The FDA may have removed silicone breast implants due to concerns over leaking silicone into the surrounding breast tissue, but today’s silicone breast implants are not the same as they used to be. When silicone breast implants were reintroduced in 2006, the FDA approved them for women who are at least 22 years old.
The advantages of silicone breast implants include:
- Silicone implants have been FDA-approved since 2006.
- They offer a more natural look and feel.
- They yield better results for thin women and women with little breast tissue.
- Silicone implants have a reduced risk of rippling.
- They are more difficult to detect than a saline implant when touched.
- Ruptures and leakage are less noticeable because the cohesive gel remains intact with a slow leak.
The disadvantages of silicone breast implants include:
- Silicone implants come pre-filled, which gives less control over size and volume.
- A ruptured silicone implant is not usually noticeable.
- The cohesive gel is not readily absorbed into the body in the event of a leak.
- FDA guidelines require regular breast MRIs to detect any rupture or leakage.
Implant size is one of the hardest breast enlargement questions to answer. Standard breast implants range in size from about 100-800 cubic centimeters (cc)— which converts to 3-27 fluid ounces (fl. oz.)— and go up in steps of about 25-50 cc (0.8–1.6 fl oz.). The American Society of Plastic Surgeons estimates that, on average, a woman will increase her breasts by one bra cup size for each 185 cc, but women differ. The actual volume of your implants is very flexible, so it’s important to decide on your preferences and goals. There are many factors to consider in deciding on the best size for your implants, which include:
- Desired look
- Current physique
- Activity level
- Long term considerations of larger implants such as skin stretch, back pain, and sagging
The following are a few different techniques you can try to decide the best size implants for you:
- Pictures are a good starting place for considering your desired results after breast enlargement, but they do have limitations. Remember that in many cases you simply cannot look like a particular model if your proportions are different. Pictures can be used to start your conversation with our plastic surgeon who can show you breast implant before and after pictures.
- The Rice Test. The rice test is a common method for estimating the best implant size for your breast enlargement. Simply fill two bags with rice and insert them in an appropriately-sized bra under your breasts. You can also use couscous, oatmeal, quinoa, or any other dry ingredient, but rice has the advantage of having an appropriate density. You can start with about 185 cc (slightly more than ¾ cup) for each bra cup size you want to go up. It’s best to wear the rice-filled bra all day. Try on clothes, and adjust the amount of rice up or down, depending on how it looks. If the rice pokes too much, try quinoa. If the baggie is uncomfortable, use stockings.
- Breast Implant Sizers. Dr. Angelchik will give you the opportunity to wear breast implant sizers to help you get a better idea of the look and feel your breasts will have after your procedure. He will discuss how different breast implant types— including using high profile or shaped implants— will affect the appearance of your breasts, and how surgical placement of the implants differs from merely placing them in the bra.
Women considering breast augmentation frequently have difficulty deciding on the breast size that will feel right for them. It’s important to remember that everyone is different, and what feels large for one woman might feel small to another. It’s ultimately your decision, but we want to help you make the most informed decision possible.
When you decide to undergo breast augmentation, one of the most important decisions you will need to make involves breast implant placement. Depending on your situation and the results you are looking for, each option comes with certain advantages and disadvantages.
The three main types of breast implant placement are:
Dr. Angelchik will discuss each placement option with you during your consultation and recommend the one he thinks best fits your needs.
Subpectoral placement involves placing the breast implant either partially or completely underneath your chest muscles (pectoralis major). Patients who undergo this type of breast implant placement are less likely to experience sagging and rippling, as the muscles provide additional support and coverage for the implant.
Subpectoral placement comes with several other advantages including:
- Reduced risk of capsular contracture
- A more natural look and feel
- Less interference with a mammogram
Patients who desire very large implants should be aware that subpectoral placement can limit the size of the implant you will be able to use, and you may experience a longer recovery time. Despite these drawbacks, the many benefits of subpectoral placement make it the most common breast implant placement method at our Phoenix office.
For patients who prefer a lifted and more dramatic look, subglandular placement is a valuable option. During this type of placement, your breast implants will be inserted above the chest muscles, but still underneath your breast tissue. Subglandular placement allows for:
- A larger implant size
- More lift
- A shorter recovery time
However, patients should weigh some disadvantages against these benefits. Women who have less natural breast tissue might find their implants are more obvious and visible, and the chances of rippling are greater. The risk of capsular contracture also goes up dramatically compared to the subpectoral approach. Because of this, subglandular placement is rarely recommended.
The dual-plane approach is used most frequently for patients who have pseudoptosis (breast droop) or high breast creases, since it allows for greater control of the breast’s lower pole shape and filling. During dual-plane placement, breast implants are placed beneath the chest muscles in the upper pole of the breast and in the subglandular position in the lower pole of the breast.
Like subpectoral placement, the dual-plane method has the benefits of:
- Muscle coverage in the cleavage and upper pole areas
- Less risk of capsular contracture and rippling
- A more natural breast shape
Dr. Angelchik can recommend the best implants for you during a consultation at our Glendale office. To schedule a breast augmentation appointment, contact us by calling or filling out our online form.
Both saline and silicone breast implants are designed to be safe for your body. Saline implants are filled with a sterile salt water solution; if this solution leaks, your body can absorb it harmlessly. Meanwhile, silicone breast implants contain a cohesive gel that is meant to stay in place in the event of a rupture. If the silicone implant does leak, it will leak very slowly— so slowly that you might not notice any change in your breast size for several years. Because of this, the FDA recommends women with silicone breast implants have a breast MRI three years after the implants were placed and every two years into the future.
While most women do not react strongly— if at all— when a silicone implant has leaked, others can become sick. Always follow up on any abnormal symptoms with Dr. Angelchik and/or your primary care physician.
No single medical device has undergone more study than silicone breast implants. Because silicone is used in several life-saving devices— including heart valves, artificial joints and pacemakers— it has been extensively studied for decades.
After years of research, the Academy of Medicine concluded that there is no significant correlation between silicone implants and connective tissue disorders, which initially worried the FDA prior to 2006. Since then, silicone breast implants have become an increasingly popular option among patients.
Predicting how long any given breast implant might last is difficult. Generally, the FDA’s research has found that, after around ten years of having breast implants, a woman can expect at least one of them to rupture or leak.
Once ruptured, breast implants need to be removed and/or replaced. Because of this, you should anticipate needing additional surgery over your lifetime to address leaks and other potential complications. Like any medical device, breast implants become weaker and more worn over time.
Patients must be at least 18 years old to have saline breast implants placed and at least 22 years old to receive silicone breast implants. There are some exceptions such as asymmetric breast surgery and breast reconstruction.
While there is no upper age limit, older patients should be in excellent health and free of any major medical conditions prior to considering breast enhancement. Approval from your primary physician may be necessary.
Although the minimum age for saline breast implants is 18, women must be 22 years old or older to receive silicone breast implants. This is because the FDA has decided that women at the age of 22 are more likely to have experienced full and complete breast development. Silicone implants also require monitoring in order to detect leakage. The management of a leaking silicone implant has the potential to be more complicated than the management of a leaking saline implant.
Temporary loss of sensation in the nipples after breast augmentation surgery may occur in some patients, but permanent numbness is rare. Nipple sensitivity tends to be better preserved when breast implants are placed beneath the muscle (subpectoral placement) using certain incision types.
It is extremely rare for mold or fungus to grow inside of saline implants. On the rare occasions when this has been reported, the contamination was the result of other substances (such as dextrose) being allowed into the salt-water-based fill solution. Dr. Angelchik is very careful to only fill implants with a pure saline solution.
When a foreign object is placed inside your body, the body’s natural response is to form a fibrous lining of tissue around the object. In most cases, this pocket (or “capsule”) of tissue will remain open, allowing your implants to look and feel natural. Unfortunately, in some situations the capsule will close and tighten, squeezing the implant and distorting the appearance of your breast. This complication is termed a capsular contracture.
Saline implants typically come into less contact with your skin while being placed, meaning there is less of a chance they will be contaminated with bacteria, which can contribute to capsular contracture. Historically, capsular contracture occurs much less frequently with saline implants than with silicone implants. However, better shell technology in the latest generation of silicone implants has reduced the rate of capsular contracture to a comparable rate to that of saline implants in studies conducted up to 7 years post-operatively.
As a general rule of thumb, 150 cc typically account for an increase of one cup size. Your final cup size will vary depending on the shape of your breasts and even the bra’s manufacturer. When choosing breast implants, it’s best to decide based on the size that best suits your body’s proportions and the look you want to achieve, rather than trying to reach a goal cup size.
Breast implants most commonly range in size from 300-500 cc. The correct size of breast implant for you depends on your goals, your existing breast tissue, and your body’s proportions.
It is possible for breasts to sag slightly over time due to the natural aging process even with implants in place. However, breast implants last a lifetime for most patients.