Breast Implants

Serving Wellesley & Sudbury Patients

• History of Breast Implants
• Saline vs. Silicone Breast Implants
• Breast Implant Size
• Other Breast Implant Choices
• Allow Us to Help

Undergoing breast augmentation surgery in Boston under the care of Dr. William E. LoVerme can be a positive, life-changing experience. Boston, Wellesley, Sudbury and MetroWest patients who have had the procedure often remark that they love their new figure and have greater self-confidence.

Nonetheless, the decision to undergo breast enhancement should not be taken lightly, as it is a serious surgical procedure and the results of the procedure are extremely long lasting.

There are several important decisions that must be made during the breast augmentation process, including what type, size, shape, texture and profile of breast implants to choose. To help you make an informed decision about which breast implants to choose, the team at Accurate Aesthetics offers the following information about your breast implant options.

History of Breast Implants

Breast implants have been used since the mid 1960s. Initially, the implants used were most often comprised of silicone gel. In the 1980s and ’90s, citizens started raising concerns about the safety of silicone breast implants, asserting that they cause autoimmune disease. In 1992, after much debate about whether silicone implants were safe (including the implementation of a voluntary moratorium on the distribution of silicone implants proposed by the FDA and agreed to by implant manufacturers), the FDA placed a moratorium on the use of silicone breast implants, except for women undergoing breast reconstruction surgery or for those who already had silicone implants and needed to replace them. Saline implants were still available on the market.

However, in 2006, after reviewing the findings of many clinical studies conducted to prove the safety of silicone breast implants and concluding that they do not cause autoimmune disease, the FDA lifted the ban on silicone breast implants, allowing them to be used in breast augmentation procedures for patients who are at least 22 years old. The FDA also approved the use of a newer style of silicone breast implants: highly cohesive, form-stable silicone implants, often referred to as “gummy bear” implants, due to the gummy-like consistency of the filling material.

Aside from the concern regarding a correlation between silicone implants and autoimmune disease, there was also a concern that silicone implants caused capsular contracture (a potentially painful condition in which scar tissue hardens around the implant, causing the breasts to feel hard). To prevent capsular contracture in patients with silicone implants, plastic surgeons started instructing these patients to massage the treatment area to keep any scar tissue as supple as possible. This worked well and led plastic surgeons to the realization that by placing the implants under the pectoralis (chest) muscle, the implants would in essence get massaged every time the arm was moved. Indeed, this did help minimize the incidence of capsular contracture, and is still a recommended treatment protocol.

Saline vs. Silicone Breast Implants

With postoperative massage and especially with submuscular placement, the chance of capsular contracture with first-generation silicone implants is greatly reduced. Also, the newest-generation silicone implants do not necessarily need to be placed beneath the chest muscle to reduce the risk of capsular contracture, thanks to their highly cohesive, form-stable filling material. In addition, silicone implants have been proven to be safe for use in breast augmentation surgery. However, some breast augmentation patients still opt for saline breast implants. Ultimately, the choice between saline and silicone implants is a personal one. To help you make this decision, here are some of the advantages and disadvantages of each type of implant.

Saline Implants

Saline implants are filled with a sterile saltwater solution that the body naturally absorbs in case of an implant leak or rupture. They are also slightly less expensive than silicone implants. Finally, because saline implants are filled after they are inserted, Dr. LoVerme can make small adjustments to the size of the implants during the operation

However, saline implants are more prone to folding, rippling or wrinkling within the implant pocket, and may be visible underneath the skin’s surface. For this reason, they are not necessarily the best option for women with thin skin or an insufficient amount of body fat to cover and support the implants properly.

Traditional Silicone Implants

Traditional silicone implants are filled with silicone gel. They are slightly more expensive than saline implants, but they more closely resemble the look and feel of natural breasts. They are also less prone to rippling within the implant pocket and to being visible underneath the skin’s surface.

The safety of silicone implants is shown by the fact that the body cannot absorb the filling material in case of a leak or rupture. Instead, the filling material stays intact either within or close to the implant pocket. This may make it more difficult to detect if there is a problem with the implant. For this reason, the FDA recommends that patients with silicone implants undergo a breast imaging exam every three years, starting the third year after the initial augmentation procedure.

Highly Cohesive Silicone Implants

The newest-generation implants are also silicone, but they are comprised of a more cohesive silicone filling material. Due to the gummy-like consistency of the filling material, these implants are often referred to by the public as “gummy bear” implants. Thanks to the advanced filling material, these implants are very unlikely to fold or move around within the implant pocket. Also, the filling material is form stable, meaning that it will maintain its form when the patient is reclining or even when cut in half.

These implants feel slightly firmer than the other options. However, they come in a variety of shapes and profiles, often making them a good option for women with very small breasts, those wanting a specific shape and some patients needing revision breast surgery or breast reconstruction for cancer.

Breast Implant Size

During your consultation, Dr. LoVerme will collaborate with you to help you decide what size your breast implants should be. The first step in determining your proper breast implant size is to have you review a series of photographs to identify the look you desire. It is helpful if you bring to your consultation photographs of breasts that you think look particularly nice and have a size you would desire. Special sizers (not just breast implant samples) are used for you to try on, to help determine the size you like. Dr. LoVerme will then measure your chest cage to establish an appropriate implant diameter. This is one of the most important factors in determining the specific implant for you.

Once Dr. LoVerme has helped you determine a size estimate, he will ask you to go home and fill two 1-quart Ziploc plastic bags with the corresponding amount of dry rice, which you will put inside a loose sports bra or halter top. This will help you get a better idea of how a certain size of breast implants will look on your unique frame.

The volume (size) of breast implants is measured in cubic centimeters (cc). One ounce of dry rice equals approximately 30 cc. Thus, a 300-cc implant equals about 10 ounces of dry rice.

At home, if you decide that a certain size is too small or too large, please complete this process again, using a different amount of rice. However, make sure that you adjust the size by at least 2 ounces at a time.

In general, when deciding on a breast implant size, we recommend that you:

• Take your body type into consideration. Thin women may not have an adequate amount of skin and body fat to cover and support large implants. If there is not an adequate amount of skin, fat and breast glandular tissue to cover the implants, they may be noticeable beneath the skin’s surface. Also, patients with narrow body frames should not choose extremely large breast implants that have a wide base, or the results may look disproportionate with the rest of the body.
• Bring Photos With You to Your Consultation. To ensure that you and your surgeon share a similar vision of what your implant size and final look should be, it is helpful to bring in pictures of women who have similar breasts as the ones you desire. Note: Choose photos of women who have a similar physique as yours.
• Avoid Relying Exclusively on Bra Cup Size. Although referring to a bra cup size can be helpful as a starting point in choosing an implant size, avoid using bra cup sizes as your only reference point. This is because what a certain bra manufacturer refers to as a C cup may be referred to as a B cup by a different manufacturer.

Other Breast Implant Choices

Besides the type of breast implant, you will also need to choose the shape, texture and profile of your implants.

• Shape. Breast implants are available in a round or shaped form. Round breast implants provide added fullness and cleavage throughout the upper breast pole. Shaped implants may be more anatomically correct (They are larger on the bottom than on the top, like a natural breast). Also, because shaped implants come in a wide variety of options, there is an appropriate implant shape for every patient, even those who need implants with extra height, projection or width.
• Texture. Every type of breast implant has a silicone outer shell. The shell can be smooth or textured. Smooth implants may move around within the implant pocket while textured implants become affixed to the overlying tissue. Anatomic, or teardrop-shaped, implants are always textured, so they attach to the tissue, stay in place and do not flip around. If a teardrop-shaped implant flips, causing the larger portion to move up top, the effect would be a highly unnatural breast appearance. Some people assert that because the textured implants can attach themselves to the overlying tissue, they help lower the risk of capsular contracture. However, more evidence is needed to support this claim.
• Profile. The smooth, round implants are available in different profiles, or projections. Consider a 12-ounce glass of water. The glass will hold the same amount of water whether it’s tall and thin or wide and short. The height of the glass is similar to the projection of the implant. A lower-profile implant is wider on the chest wall and provides more roundness at the side of the chest. A higher-profile implant provides a greater degree of forward (outward) projection from the chest wall.

Let Us Help

At Accurate Aesthetics, we understand that there are many choices to make in regard to your breast implants. Among the three breast implant manufacturers in the United States — Mentor, Allergan and Sientra — there are several combinations of size, shape, texture and profile to choose from. We will use our extensive breast enhancement expertise to help you make informed decisions about your breast implants that you will confident about.

To schedule a private consultation with Dr. LoVerme and learn more about your breast implant choices, contact Accurate Aesthetics by calling (877) 603-7874 toll-free today.