Breast Augmentation at Plastic & Hand

This year alone, more than 200,000 women will have breast augmentation surgery. Like them, you might want your breasts to be more proportional to your body or you might want to reshape and enlarge your breasts to reverse the effects of breastfeeding or aging. Or, you may be a candidate for reconstructive surgery after medical treatment.

There are many personal reasons to consider this surgery. While breast augmentation won’t change the essence of your life, it can enhance your self-confidence as well as your silhouette.

As with all cosmetic surgery, the more you know about breast augmentation, the happier you are likely to be with the result. Talk to your Plastic & Hand surgeon about your expectations and the options available to you.

Call us at 775-3446 to schedule a consult with one of our plastic surgeons. Questions? Click here to Ask Bonnie!


The difference between gel (silicone) and saline implants

All implants have a silicone rubber shell, and consist of three main components:

• the shell; the outside layer sometimes called the envelope or lumen
• the filler which is inserted into the shell
• the patch which covers the hole in the shell where the filler is inserted

During your consultation, we can help you determine which type of implant is best for you.

Saline implants are filled with a sterile saline (salt water) solution. They can be filled with varying amounts of saline to affect the shape, firmness and feel of the breast. In the unlikely event that the shell should leak, a saline implant will collapse and the saline will be absorbed and naturally released from the body.

Saline Implant 3-D Animation

Gel implants are filled with an elastic silicone gel which feels and moves much like natural breast tissue. In the unlikely event of a leak, a gel implant might not collapse; the gel may remain in the implant shell or may escape into the breast implant pocket.

Silicone Implant 3-D Animation

What breast augmentation surgery involves

At Plastic & Hand, an anesthesiologist from Spectrum Medical Group, the physician group that provides anesthesia at Maine Medical Center, will provide your anesthesia care. Your surgery will take place in our accredited outpatient surgery facility located on-site.

Your surgeon will make inconspicuous incisions to minimize visible scarring. Your surgeon will recommend an incision option based on the type of implant, degree of breast enlargement, your anatomy and your personal preference. These options include Inframammary (under the breast), Transaxillary (in the armpit) or Periareolar (under the nipple).

After making the incision, your surgeon will insert a breast implant into a pocket either under the pectoral muscle (submuscular placement) or over the pectoral muscle (submammary placement).

We will then close the incision with layered sutures and skin adhesive or surgical tape. The incision lines will fade over time.

Full recuperation may take up to a month, but it’s likely you can return to work in just one or two weeks.

Implants: under or over the muscle?

In thinner women with average to little breast tissue, submuscular (under-muscle) placement is generally the preferred choice. Placement under the muscle helps avoid the phony look of implants that show under the skin and can create a shelf appearance. With submuscular placement, implants look and feel more natural since they’re under the double covering of muscle and breast tissue. This method also reduces visible rippling.

Submammary (over-muscle) placement may be more suitable for women with mild to moderate sag and adequate pre-existing volume. In patients who have tubular breast deformities, a submammary implant will be necessary to address the anatomic constriction at the base of the breast.

Your plastic surgeon will advise you about which type of implant placement is most appropriate.

How long breast augmentation lasts

Breast augmentation lasts a long time, but is not necessarily permanent. Studies show that for saline implants there is a 10% deflation rate over 10 years. A deflated saline implant will need to be replaced. Gel (silicone) implants should be monitored periodically, and the FDA recommends MRI examination 3 years post implantation, as well as every 2 years after the initial MRI to look for “silent rupture.” Self-breast exams continue to be essential for all women, and annual mammography for age 40 and over is still recommended, as for all women.

Side effects

The usual risks and complications of breast augmentation are as in any surgical procedure: bleeding and infection. In addition, asymmetry is a potential pre- and post-operative problem. Women with naturally asymmetrical breasts will probably still remain asymmetrical, but often can be corrected with different-sized implants or a breast lift (mastopexy) at the same time as augmentation. One of the more vexing potential post-operative issues is hardening of the implant, related to thick scar formation around the implant itself. This condition known as “capsular contracture” may necessitate follow-up surgery, and is an infrequent occurrence.

Gel implants do not have any association with disease, as was once alleged. Years ago it was suggested that certain rheumatological diseases (rheumatoid arthritis, scleroderma, lupus, etc.) were related to gel (silicone) implants. However, studies completed over the last 15 years have definitively shown no such association. You will have an in-depth discussion with your surgeon regarding the pros and cons of any planned surgery such as breast augmentation.

Who should consider breast augmentation?

The best candidates for breast augmentation are healthy women who have realistic expectations and a thorough understanding of this procedure. An in-depth consultation at Plastic & Hand Surgical Associates will help you determine if breast augmentation is right for you.