A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast mound for post–mastectomy breast reconstruction patients or to correct congenital defects and deformities of the chest wall. They are also used cosmetically to enhance or enlarge the appearance of the breast through breast augmentation surgery.
A woman wanting a reduction comes usually after having put up with the pain and in some cases embarrassment and hassle for years before she presents in front of surgeon. She experiences neck, back, shoulder pain, skin irritation and even infection, she feels self conscious and sick of breasts getting in the way of a normal life/shopping/exercising. 
In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group.[26] The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast implant patients, than among patients for other types of plastic surgery; the mortality rate differences were attributed to tobacco smoking.[27] The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.[28]

When compared to the results achieved with a silicone-gel breast implant, the saline implant can yield acceptable results, of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, accelerated lower breast pole stretch, and technical problems, such as the presence of the implant being noticeable to the eye and to the touch. The occurrence of such cosmetic problems is likelier in the case of the woman with very little breast tissue, and in the case of the woman who requires post-mastectomy breast reconstruction; thus, the silicone-gel implant is the technically superior prosthetic device for breast augmentation, and for breast reconstruction. In the case of the woman with much breast tissue, for whom sub-muscular emplacement is the recommended surgical approach, saline breast implants can produce an aesthetic result much like that afforded by silicone breast implants, albeit with greater implant palpability.[90]
Smooth breast implants are round in shape, come in many sizes and are available with different profiles, which is the amount of projection of the breast silhouette from the chest. The shells of smooth breast implants are slightly thinner than textured implants. Smooth implants are less likely to cause rippling of the implant shell and are less likely to rupture.
2000 European Union European Committee on Quality Assurance & Medical Devices in Plastic Surgery (EQUAM) "Additional medical studies have not demonstrated any association between silicone-gel filled breast implants and traditional auto-immune or connective tissue diseases, cancer, nor any other malignant disease. . . . EQUAM continues to believe that there is no scientific evidence that silicone allergy, silicone intoxication, atypical disease or a 'new silicone disease' exists."[34]
In some very rare cases, usually about 2 to 3 percent your immune system is not satisfied with simply forming a capsule, and the inflammation continues to the point where the capsule thickens and sometimes squeezes the implant and distorts it. This can sometimes be painful, and in those cases, it usually requires surgical intervention to either release the capsule or to possibly remove the implant.

In general, silicone-gel-filled implants are smoother, softer and feel more like natural breast tissue than their saline-filled counterparts. Silicone implants feel like a semisolid gel, while saline implants are often likened to water balloons. Silicone-gel implants are also less likely to wrinkle and ripple than saline breast implants. Wrinkling is actually considered one of the major disadvantages of saline implants. The thinner the woman and the less breast tissue she has, the more likely the saline implant's crinkles and wrinkles will be felt and even seen.


A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.
The shells of both saline and silicone gel breast implants are made of silicone elastomer (rubber), and the surface area is either smooth or textured. The main purpose of textured implants is to promote tissue adherence to the irregular surface and hold them into place. Therefore, a textured surface is used with contoured implants because they have a top and bottom, and rotation or movement distorts the breast shape. On the other hand, most round implants have a smooth surface because the breast shape is not affected if the implant rotates in the breast pocket.

When trying to determine the implant sized for your body, it can be a tricky question but also a very important question. This is the question that you and your surgeon will spend the most time discussing during your consultation. Breast size and Implant size is very subjective, since what you may consider attractive and desirable may be very different from what others consider attractive, but in the end the surgeon wants to do what is best for you and you will be pleased with. Now with that being said, it is important to remember that not all expectations can be met. This is why it is important to discuss this in detail so that the surgeon can give you feedback and recommendations that are proportional to your body frame. There are instances where patients want to go slightly over what would be considered proportional, and that is fine so long as it is safe for the patient. The operation is relatively similar regardless of the implant size, but it is crucial that you choose the implant size and the resulting breast size that will make you the happiest and attain your desired results. As stated earlier, there are certain limitations. For example, you may not have enough skin, or you may have a breast shape that precludes a very large implant. So, this is something that you and your surgeon can discuss, and they will be able to help guide you to the best decision for you and your desired results.
There are four general types of breast implants, defined by their filler material: saline solution, silicone gel, structured and composite filler. The saline implant has an elastomer silicone shell filled with sterile saline solution during surgery; the silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel; structured implants use nested elastomer silicone shells and two saline filled lumen; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, etc. Composite implants are typically not recommended for use anymore and, in fact, their use is banned in the United States and Europe due to associated health risks and complications.

"Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing," Dr. Naderi said. "There are reality show plastic surgeons who charge high fees, for example, based on their television exposure and publicity. Then, there are well-known plastic surgeons in the field who focus mainly on nose surgery and are true specialists."
For me, the main area of concern is my forehead, which I’m told by all the greatest in injectables, to be the most common for those under thirty. After too many holiday sunburns, and recognising that I speak with very expressive eyebrows, the fine faint lines horizontally across my forehead have become much more prominent. So, in the name of beauty journalism I decided to give botox a try, here's what I learnt...

In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[119] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[113]
Having a breast lift is similar to resetting the clock for sagging. Your breasts will still undergo natural changes due to the aging process, although with proper care you should not experience your previous level of sagging for many years. However, it is important to understand that certain life events, such as future pregnancy or weight fluctuations can negatively affect your results. If you are planning to have more children or you would like to lose weight, it is best to achieve these milestones before having a breast lift.
When talking about the price with your plastic surgeon, it’s important to know exactly what the cost covers. Is it just the surgeon’s fee? Or will it cover anesthesia, facility fees, implant cost, medical tests, pre- or post-op appointments, and medical supplies you’ll need during recovery? Do you need to purchase a specific bra for recovery or will they provide one?
So what is the ideal age for botox? ‘There is no recommended age’, Wallace says, and Victoria Spyrou, the injectables expert at EF MediSpa agrees, ‘The recommended age differs because everyone’s muscles present differently. If someone at the age of 21 has visible dynamic lines that are causing a problem, then I will treat that person, however, if another 21-year-old comes in without any visible lines – I would decline to treat them.’
For breast augmentation or breast enlargement procedure, our surgical specialists are able to custom design the look that each client desires in terms of the shape and size of the breast implants as well as the resulting, enhanced look. They also take into account the body structure of the client in order to further ensure that the client will be most pleased with the outcome of breast augmentation surgery. Dr. Ortega and our team of plastic surgeons provides a comprehensive, inclusive, procedural experience that begins with a personal, confidential consultation and continues through the client’s post-surgical period of convalescence.
When doing a consultation there are many factors that need to be considered before deciding on the course of action the Doctor will take. For instance, one of the most important decisions that need to be made before beginning a breast augmentation is determining the placement of the breast implant. Will it be placed above the pectoralis muscle or below it? There are many variables that are involved in this decision. In today’s technological world there is an abundance of information available to anyone who can use the internet. This can be beneficial if you are getting your information from verified and educated sources, but it can also be detrimental as there is an equal abundance of mis-information construed as facts. Even family and friends who offer their thoughts or advice can cause confusion and doubts if their information is not based on facts. The best thing you can do when starting your breast augmentation cosmetic surgery journey is to remember that there is always a choice, and consulting with a board certified and experienced plastic surgeon is the best way for you to be able to make an informed choice that you will be comfortable with.

Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
Drink only liquids for the first few hours after surgery. Advance slowly to small, light meals. If you experience  nausea or vomiting more than two times, please call me so I can prescribe something to reduce this.  Excessive vomiting and retching can result in bleeding beneath the breast and/or around the implant (if  breast enlargement was done) that will require more surgery.

The plastic surgical emplacement of breast implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), late hematoma (post-operative bleeding after 6 months or more),[21] seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the “bread loafing” of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants—capsular contracture and capsular rupture—are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 per cent of the patients. [22][23][24] Statistically, 20 per cent of women who underwent cosmetic implantation, and 50 per cent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark.[25]


The study Safety and Effectiveness of Mentor’s MemoryGel Implants at 6 Years (2009), which was a branch study of the U.S. FDA's core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation.[49] The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1 percent, or less, at the median 6-year device-age.[50] Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the ruptured breast implants are accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast implant ruptures.[51] Therefore, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter.[22] Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine MRI screening, and, in its stead, proposed that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.[52]
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