Each year, hundreds of thousands of women undergo breast implant surgery, a plastic surgery procedure designed to improve the appearance of the breasts. Also called breast augmentation surgery, most women undergo the procedure to enlarge breasts that are naturally small, though some have it to correct disproportionate breasts or repair breast deformities.

Procedures that advertise using fat from liposuction and re-injecting it into the breast, also called fat grafts, are still considered surgical procedures, explains Dr. Doft. While it might be tempting to consider because it seems less invasive than a traditional boob job, the results are also harder to predict. Dr. Doft says: “Thirty to 50 percent of the fat will not survive. It is also not possible to know which fat will and will not survive, which may alter your results.”
As with any medical/surgical treatment, individual results may vary. Only a surgeon/physician can determine whether reconstruction or augmentation>is an appropriate course of treatment. The following are general adverse events associated with breast implant surgery: Device Rupture, Capsular contracture, Infection, Hematoma/Seroma, Pain, Reoperation, Implant removal, changes in Nipple and Breast Sensation, unsatisfactory results, breast-feeding complications. Other reported conditions are listed in the Product Insert Data Sheet (PIDS). See full list in the PIDS for the product information. These potential adverse events, including contraindications, warnings, and precautions need to be discussed with your doctor prior to surgery.

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.


Since experienced surgeons are aware of these issues with saline breast implants and their need for eventual replacement, they opt to place them under the chest muscle. The chest muscle works as an extra layer of tissue over the implant, which makes for a smoother transition from the chest wall to the implant. The finished product is a more seamless transition versus a more visible and abrupt change when the implant is not placed below the pectoral muscle. As for gel breast implants, they can also be safely placed below the pretorial muscle if that is a viable option for the patient since replacement and wrinkling is less common with this type of implant.
The first point is placed at a distance of about one centimeter from the outer corner of the eye. Then the patient is asked to squint, if wrinkles appear above or below the first mark, additional points are applied. There is a danger of too close to the introduction of the drug, which can cause it to hang over, so the expert’s experience should not cause doubts. It is worthwhile in advance to look at the document confirming the qualification of the doctor.
The U.S. Food and Drug Administration established the age ranges for women seeking breast implants; for breast reconstruction, silicone-gel filled implants and saline-filled implants were approved for women of all ages; for breast augmentation, saline implants were approved for women 18 years of age and older; silicone implants were approved for women 22 years of age and older.[120] Because each breast implant device entails different medical risks, the minimum age of the patient for saline breast implants is different from the minimum age of the patient for silicone breast implants—because of the filler leakage and silent shell-rupture risks; thus, periodic MRI screening examinations are the recommended post-operative, follow-up therapy for the patient.[121] In other countries, in Europe and Oceania, the national health ministries' breast implant policies do not endorse periodic MRI screening of asymptomatic patients, but suggest palpation proper—with or without an ultrasonic screening—to be sufficient post-operative therapy for most patients.
When it comes to determining the prominence and size to utilize for the breast augmentation, the first step is to determine what are your goals/desires for the end result. Once you have decided on what you would like the final result to look like, the surgeon will make recommendations and suggestions based on your body type and build as to what they know will be able to achieve your goal, or get you as close to them as safely possible. An individual may want a specific size, but the surgeon will be able to tell if that is a realistic option for that individual or not. For example, if the patient’s chest is small and the breast tissue is tight, it will not be recommended to use a large implant as it will not fit. This is why a surgeon with clinical experience is beneficial, because they will be able to help you understand and guide you towards the best implant for your body. It is not uncommon for patients to become focused on details such as the actual volume of CC’s, however, you need to keep in mind that there are many varying factors that have to be considered by the surgeon when recommending the best implant for your body so try not to get too caught up in those details and trust your surgeon.
The good news is that both types of implants are considered safe. The Food and Drug Administration (FDA) removed silicone implants from the consumer market in 1992 as a precautionary measure after conflicting reports of possible complications surfaced. Some of these complications required breast implant removal. However, silicone gel-filled breast implants were fully exonerated and reapproved in 2006. (Read more about implants and the FDA.)
Breast implants have gotten a bad reputation from the past and the fact that they had been known to rupture. The modern-day breast implants are very well made, and it’s almost impossible to cause them to rupture. This doesn’t mean that it can never happen, but it’s exceedingly rare. The rippling and wrinkling however, is a more difficult problem to address. This tends to me more common in the saline implants than with the silicone implants due to the filling. The saline implant is just water which is less dense then the silicone gel. The gel is denser and more closely resembles the actual breast tissue. Even when if the implant is placed below the muscle, it only covers about a half to two-thirds of the implant. Therefore, along the sides or underneath the implant you may see some wrinkling or rippling, however, depending on the size of implant used it may not even be noticeable. The larger the implant used the more visible any wrinkling or rippling could become. Typically, silicone implants are recommended because the risk of any wrinkling or rippling is lower and the implant feels more natural.
The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight, says Dr. Kolker. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects.
A breast lift, also known as a mastopexy, is most beneficial for women who have sagging breasts. This type of procedure reshapes and supports the breast tissue to achieve a more youthful figure. It also helps restore the shape and volume that may have been lost due to age, weight loss or breastfeeding. Because a breast lift repositions the location of the breasts, they can appear smaller. However, only excess skin is removed, not the actual breast tissue. Often with breast lifts, the nipple and areolas are repositioned and reduced in size to create a more natural look.
Your plastic surgeon will give you instructions on how to prevent these complications. If you have a high temperature, it’s a sign of an infection. If you monitor your temperature daily, you’ll be able to head off an infection in the early stages. Darkening of the skin is another red flag sign and your surgeon should be notified almost immediately. Vomiting, convulsions and loss of consciousness are signs that something needs to be checked medically – quickly.
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]
Traveling long distances or for long periods of time can be problematic after surgery. Generally, I do not recommend traveling longer than one hour for one week after surgery. When you do travel you must have help at all times with your baggage (do not lift more than five pounds for three weeks) and you must get out of your seat and walk for five minutes every hour. Remember, even small vibrations during travel can increase the amount of pain you experience. Finally, you will not have the same energy level as you did immediately before your surgery.
Breast reduction surgery, or reduction mammoplasty, can instantly and effectively reduce breast size through the removal of excess breast tissue. Breast reduction is a surgical procedure that involves the removal of excess skin, fat, and glandular tissue to reduce breast size, eliminating the negative issues associated with breasts that are larger than the patient desires.  Usually, the breast is lifted significantly and enlarged areolas are reduced.  The tissue removed can also be sent to a pathologist for breast cancer screening if the patient desires.

Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.
Round breast implants come in a wide array of sizes to accommodate women with different body types. They are also available with a moderate or high profile, which is the amount of projection of the breast profile from back to front. Most round implants have a smooth surface because they can rotate after placement without causing any change in appearance or distorting the breast shape. However, they are available with a textured surface as well.
From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[111]
Disclaimer: Please note, any information on this page is provided to you for educational and/or informational purposes only, and should not be construed as an endorsement of any particular procedure, product or treatment. This information is also not a substitute for medical advice, diagnosis, or treatment by a doctor or other qualified health care professional. For medical concerns, including decisions about any procedure, product or treatment, visitors should always consult with their doctor or other qualified health care professional.
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]
When a silicone breast implant ruptures it usually does not deflate, yet the filler gel does leak from it, which can migrate to the implant pocket; therefore, an intracapsular rupture (in-capsule leak) can become an extracapsular rupture (out-of-capsule leak), and each occurrence is resolved by explantation. Although the leaked silicone filler-gel can migrate from the chest tissues to elsewhere in the woman's body, most clinical complications are limited to the breast and armpit areas, usually manifested as granulomas (inflammatory nodules) and axillary lymphadenopathy (enlarged lymph glands in the armpit area).[41][42][43]
However, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.
“The biggest difference between the open and closed rhinoplasty is a small incision on the columella (bottom) of the nose,” says Dr. Kent V. Hasen, a Naples, Florida plastic surgeon, in a rhinoplasty Q&A. “This 6 mm incision allows the surgeon to peel the skin of the lower nose back to fully visualize the tip and dorsum of the nose. In the closed procedure, there is not as much visualization since the skin is not peeled back.”
From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[111]
All patients experience some pain in their breasts, chest and/or back after surgery. Most patients take only plain acetaminophen  (Tylenol) and Celebrex as prescribed for pain control. If you are unable to take Celebrex, acetaminophen  alone may be sufficient. Begin taking acetaminophen elixir (liquid) or tablets for pain as soon as possible after surgery.  If this is not sufficient to control your pain, begin taking any prescribed narcotic(Vicodin, Percocet, Darvocet, Tylenol  #3) pain pills as directed. If you did not receive a prescription for narcotic pain medication and you feel you need something  stronger for pain control, please contact us as directed below. Prescribed narcotic pain medications can make you sick to your stomach. Take them only after you have had something to eat. I recommend you take a dose of either  acetaminophen or narcotic pain medication before you go to bed the first night or evening after surgery. Set an  alarm clock to wake yourself up 4 hours after you go to bed. Take a second dose of the same pain medication then  resume your rest until morning.  Ice application during the first 24 hours after surgery will also reduce pain and swelling. Apply ice bags to  your breasts for 20 minutes at a time followed by 10 minutes of rest. In other words, apply ice to your  breasts for 20 minutes of every half an hour. When applying the ice bags make sure there is a small amount  of water in with the ice at all times. Your skin should feel cool to the touch. Do not use frozen gel packs.  It is not necessary to apply ice while you are sleeping at night.
According to Melissa Doft, MD, FACS, surgery will sometimes be covered when correcting severe asymmetry due to developmental deformity or reconstruction after mastectomy or lumpectomy. For breast reductions, Rady Rahban, MD, FACS, adds that insurance will sometimes pay if the breasts are so large they create symptoms of back pain, neck pain, or rashes under the breast or if surgery is otherwise medically necessary.

Round breast implants come in a wide array of sizes to accommodate women with different body types. They are also available with a moderate or high profile, which is the amount of projection of the breast profile from back to front. Most round implants have a smooth surface because they can rotate after placement without causing any change in appearance or distorting the breast shape. However, they are available with a textured surface as well.
The simple answer to the risk of losing sensation in the breast and nipple is that your chances of this are very low, somewhere between 1-2%. The incision is made in an area that doesn’t have any sensory nerves as a precautionary measure to minimize any potential risk to loss of sensation. Furthermore, the breast tissue itself is not cut. It is moved aside so that a space can be created for the implant, and then the implant is placed in the newly created opening. There have been some cases where sensation has been increased with the nipple and areola due to the implant pushing them forward.
Periareolar: a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola's circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola's border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars. 

Periareolar: a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola's circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola's border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars.
Thoroughly research surgeons who meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that the surgeon has experience in the type of surgery you’re wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon’s approach.

Since the mid-1990s, the fifth generation of silicone-gel breast implant is made of a high-strength, highly cohesive silicone gel that mostly eliminates the occurrences of filler leakage (“silicone gel bleed”) and of the migration of the silicone filler from the implant pocket to elsewhere in the woman's body. These implants are commonly referred to as "gummy bear breast implants" for their firm, pliant consistency, which is similar to gummy candies. The studies Experience with Anatomical Soft Cohesive Silicone gel Prosthesis in Cosmetic and Reconstructive Breast Implant Surgery (2004) and Cohesive Silicone gel Breast Implants in Aesthetic and Reconstructive Breast Surgery (2005) reported low incidence-rates of capsular contracture and of device-shell rupture; and greater rates of improved medical-safety and technical-efficacy than that of early generation breast implant devices.[94][95][96]


One of the biggest factors affecting the total cost is if you need to have a second surgery. Because your nose swells during the operation, the surgeon may get a false impression of the final shape of your nose. As the swelling goes down, it may become apparent that a second surgery is necessary to achieve the look you want. Approximately 15 percent of rhinoplasty surgeries require a second surgery.
They are essentially very similar procedures. The difference is in the amount of breast tissue removed. In a breast lift procedure, the nipple areolar complex is lift to a better position on the breast, and some breast tissue is removed and the breast envelope tightened. In a breast reduction, the nipple areolar complex is also lifted, but much more breast tissue is removed. 
Stay still but pay attention - If you are afraid of needles, don't make yourself writhe with discomfort by thinking about them. Set your mind on something random, like monkeys juggling pineapples. The Botox will be over before you know it. Stay still but pay attention and follow your doctor's instructions. He/she will tell you to smile, relax, frown, etc. during the injection process.
Post-operative patient surveys about mental health and quality-of-life, reported improved physical health, physical appearance, social life, self-confidence, self-esteem, and satisfactory sexual functioning. Furthermore, the women reported long-term satisfaction with their breast implant outcomes; some despite having suffered medical complications that required surgical revision, either corrective or aesthetic. Likewise, in Denmark, 8 per cent of breast augmentation patients had a pre-operative history of psychiatric hospitalization.[3][4][5][6][7][8][9][10][11]
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. 

Many patients have concerns that after getting breast implants it may result in less accurate testing for breast cancer, but this is not something they need to worry about. This is a very valid concern but having implants will not make your mammograms less effective. As the rate of women with breast implants has increased, so has the knowledge of the radiologists and technicians, and they have become very adept at performing mammograms on women with implants. During the test and the test films produced, the implants will not obscure or hide any suspicious lesions or growths, but rather appear as a fain shadow. Any experienced radiologist will not have difficulty in viewing and/or diagnosing any suspicious lesions or detecting any breast cancer in a patient that has implants.


Since experienced surgeons are aware of these issues with saline breast implants and their need for eventual replacement, they opt to place them under the chest muscle. The chest muscle works as an extra layer of tissue over the implant, which makes for a smoother transition from the chest wall to the implant. The finished product is a more seamless transition versus a more visible and abrupt change when the implant is not placed below the pectoral muscle. As for gel breast implants, they can also be safely placed below the pretorial muscle if that is a viable option for the patient since replacement and wrinkling is less common with this type of implant.
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