Indiana Plastic Surgery Blog

After an inquiry by the French Society of Plastic, Reconstructive and Aesthetic Plastic Surgeons (SOFCPRE) uncovered safety issues with Poly Implant Prostheses (PIP) breast implants, the British Association of Aesthetic Plastic Surgeons issued a guidance advising the estimated 50,000 British women who have the implants to seek corrective surgery if their implants are ruptured.  

According to the results of the SOFCPRE inquiry, PIP breast implants were found to contain an untested, unapproved silicone gel that has not undergone safety tests and also lacked an essential protective barrier, making them especially prone to rupture.

Breast implant ruptures are uncommon in the safe, FDA-approved breast implants used in the U.S., but breast augmentation patients should know how to detect a breast implant rupture, as well as the corrective surgery options that exist should implant malfunction or breast implant trauma occur.

In saline breast implants, ruptures are usually easy to detect because the implants deflate and noticeably lose volume.  In silicone breast implants, ruptures are not as obvious and require an MRI for detection.  When ruptured breast implants do not cause problems with breast appearance or health, occasionally women will choose to forego revision surgery, however most pursue corrective surgery. 

Options for corrective breast surgery include:

• Breast implant exchange (breast augmentation revision)
• Breast implant removal (breast explant surgery)
• Breast lift with implants or without implants

Many women who experience a rupture in one or both breast implants choose to exchange their implants for new ones via breast augmentation revision surgery, while other women choose to simply undergo breast explant surgery, or implant removal, and do not have their implants replaced.  

A breast lift with implants may also be performed to remove skin that has sagged with age since the initial breast augmentation, while a breast lift without implants may be performed to remove skin stretched by the breast implants if a patient decides not to have the implants replaced.

If you experience a rupture in your breast implants, remember there’s no need to panic, as ruptures in FDA-approved breast implants pose no immediate health risk.  Consult a board-certified plastic surgeon with considerable experience performing breast surgery for reassurance and help deciding which corrective surgery option is best for you.

Several different practices are offering breast augmentation in Northern Indiana, but not every one is equal. To get great aesthetic results and an experience that is positive overall, you need to do some investigative work beforehand.

If you are interested in breast augmentation, use this list as a general outline of things to investigate.

1. Does your surgeon have specific training in breast augmentation and the versatility required to offer you multiple options?

Because skills often overlap, you might find different types of surgeons offering the same procedure. Just remember that only plastic and cosmetic surgeons receive training for breast augmentation as a primary part of their residency. Being focused on surgery of the breast gives your plastic surgeon a better understanding of the various techniques and options available.

2. Who is providing anesthesia for your breast augmentation?

This is a really important part of surgery, because anesthesia can pose a significant risk in the wrong hands. The task of administering anesthesia requires an individual who is well trained, prepared for unexpected problems, and focused on safety.

3. Who will be with you before, during, and after your surgery?

It’s common for the surgeon’s staff to oversee much of the operation and guide the patient through the process. Doing so is vital to both the success of the surgery and to the overall experience. Read about the talented supporting staff we have at Indiana Plastic Surgery.

4. Does your surgeon have hospital privileges?

To obtain hospital privileges, your plastic surgeon must be able to prove and/or demonstrate a record of training for the procedures he or she intends to perform there.

5. Is the surgical facility certified and safe?

Breast augmentation can be performed in a hospital or outpatient surgery center. To receive proper certification, specific standards must be met. Ask us about our surgical facilities in Northwest Indiana.

Patients at our Indiana office often ask about breast feeding and breast implants – whether it is possible, and whether it is safe for their child.

Breast feeding is usually not disrupted by the presence of a breast implant, but in some cases (usually when the periareolar incision is used) it is indeed disrupted.  Choosing a surgical incision that avoids manipulation of the nipple can decrease this risk.  If breast feeding is likely in your future, you may want to investigate incision techniques such as the inframmary fold incision, transaxillary incision, or transumbilical breast augmentation method.

Although breast feeding is not necessarily compromised by sub-glandular (above the muscle) placement, some surgeons maintain that submuscular breast implant placement reduces the risk as well.

If you’re concerned about infant safety, you may want to reference a study published in the June 1998 issue of Plastic and Reconstructive surgery.  The study found no measurable risks to the infant, and found that women with silicone breast implants, and women without them, show comparable levels of silicone (silicon) in their breast milk.  It is not known what effect could occur if a small amount of silicone were to pass through to the infant.

Feel free to speak with Dr. Robinson or your OB/GYN if you still have questions and concerns about this topic.  Whether you plan to become pregnant or not, it is best to understand all of the possible breast augmentation risks before proceeding with surgery.

People often say that silicone breast implants look and feel more natural than saline implants, but that doesn’t necessarily mean that saline is an inferior implant.  It often comes down to a matter of patient comfort and preference.  When either implant is placed under the muscle, the breast assumes a look and feel that is quite natural.

The advantages of saline implants include adjustability and easier placement, since they come empty from the manufacturer and get filled during surgery.  Don’t choose an implant that is too large for your body.  Simply put – large implants increase the likelihood of an unnatural result.

If you want great results, consult with us about your desires and concerns before proceeding with breast augmentation.

Making a decision about breast implant size requires consideration of several factors:

1) The size you think you would like to be
2) The actual diameter of your breast (measured in your plastic surgeons office)
3) How you look with implant sizers placed in your bra at your consultation
4) The amount of skin laxity or sagging in your breasts

All of these things must be taken into account to give you the best possible look and fit.  Patients sometimes have unrealistic requests that will not fit them as an individual due to their breast anatomy or body type.

The rule of thumb is to have realistic expectations regarding the cup size you would like to achieve, but this requires that you understand breast augmentation surgery.  Make sure you and your board certified plastic surgeon have a thorough discussion, so you understand the procedure and the surgeon understands your wishes. Doing so will optimize your results and increase your level of satisfaction with the surgery.

It is common for patients who get breast augmentation to feel quite different after getting implants. Breast implants can bring new mental and physical feelings and change the way you experience life. Adjusting to these changes requires time.

After several months (sometimes sooner), almost all patients adjust to their implants and begin to accept them as a part of themselves. With time, breast implants will look more natural and become a part of you.

We tell our patients that “time is on their side.” While it is rare, patients that feel uncomfortable about their implants several months after the procedure can have them removed or changed.

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Why undergo breast augmentation surgery? A patient discusses her reasons for getting breast implants, saying “I wanted to look more feminine; I wanted to have cleavage.” Perhaps the most important point she touches on is about education: “I had fears to begin with, but my fears lessened the more information that I gathered.” Check out our breast page or the ASAPS site for more on breast augmentation.

The American Society for Aesthetic Plastic Surgery produced this educational video, and is devoted entirely to advancing the field of cosmetic plastic surgery through education and research.

Statistics from the American Society for Aesthetic Plastic Surgery reveal that for the first time, breast implants have surpassed liposuction in popularity.

The figures indicate that 355,671 breast augmentation surgeries were performed last year, compared to 341,144 liposuction procedures.

In a press release, ASPS President Alan Gold, MD comments that “for the first time in the twelve years these statistics have been collected, liposuction is a runner up in popularity to breast augmentation.”

Dr. Gold theorizes that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.”

Of the 10.2 million cosmetic procedures undergone in America in 2008, 92 percent were had by women.

Last year’s top 5 surgical procedures are as follows:

1. Breast Augmentation
2. Liposuction
3. Eyelid Surgery
4. Rhinoplasty
5. Abdominoplasty

Last year’s top five non-surgical procedures include:

1. Botox
2. Laser Hair Removal
3. Hyaluronic acid wrinkle fillers (Juvederm, Restylane)
4. Chemical Peel
5. Laser Skin Resurfacing

For many women seeking to enhance their physical appearance in Northwest Indiana, breast implants may be an option.  Up until recently women have only had the choice of using saline filled breast implants.  In November of 2007, the FDA approved silicone breast implants safe for use in the United States.  Silicone implants have the advantages of feeling more like a natural breast and weighing less than saline, which over time could possibly lessen the risk of ptosis.  The new silicone gel implants are also created with a thick gel that does not bleed in the event of a rupture.  There has been over 14 years of extensive testing on the safety of silicone gel implants, more than any other medical device or drug.  To learn more about your breast implant choices, contact Indiana Plastic Surgery today for your free consultation.Dr. David Robinson is board certified by the American Society of Plastic Surgeons and can help you make an informed decision on whether breast implants are right for you.