Dr. Neil Wells INC. MD, FRCSC

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Silicone vs Saline:

 

After 14 years of study, in late 2006 the Food and Drug Administration (FDA) declared silicone gel filled breast implants to be safe and effective. Plastic surgeons around the nation greeted the news with almost unanimous enthusiasm, welcoming the opportunity to offer their patients the choice between silicone and saline. In 2012, the FDA approved the fifth-generation Sientra® Silimed-brand implants – the original "gummy bears." These highly anticipated form-stable implants represent the latest improvement in the continual evolution of silicone implants.

 

If you’re planning a breast augmentation procedure in Beverly Hills or Los Angeles, breast implants play an important role in your final results. How do you decide which implant to choose? Here you can begin to learn more about your implant options.

 

Silicone Implant Background:

 

Breast implants with silicone filling were first manufactured in the early 1960s. Silicone’s popularity stems from two key advantages: it’s a material that is highly compatible with the body – finding uses in a variety of implantable medical devices such as artificial joints – and it creates breasts that have a very natural look and feel.

 

Silicone breast implants have been the subject of continued improvement and study over the years. The filling and shells have been modified again and again to upgrade both the safety and feel of the product. Nevertheless, in 1992 the FDA restricted use of silicone implants to just a small number of patients until further studies could be performed. The FDA declared silicone gel implants to be safe and effective and re-approved a new generation of silicone gel implants in November 2006. These are referred to as "fourth-generation" silicone implants.

 

Dr. Stevens and Dr. Spring have always believed in the safety of silicone implants. Noting that there was no direct evidence the implants caused problems and that the devices were never banned in other countries, the surgeons offered them to their eligible patients when possible. In addition, Dr. Stevens was chosen to participate in FDA-sanctioned patient trials of new, high-strength cohesive silicone gel implants also known as “gummy bear” implants.

Silicone Implants Today

 

FOURTH GENERATION GEL IMPLANTS

Worldwide, silicone gel has long been the preferred choice of women and physicians for the soft, natural look and feel that it imparts to enhanced breasts. Unlike saline, the cohesive silicone filling holds together if the shell should rupture, causing what the FDA terms a “silent rupture.” Though the material is not likely to migrate out of the breast pocket, the FDA advocates women have periodic MRI tests to ensure their implants remain intact.

Fourth generation silicone gel implants are available from 2 manufacturers: Mentor and Allergan. The products come in a variety of shapes, sizes and profiles, giving you and your surgeon the choices you need to create the perfect breast for you.

 

FIFTH GENERATION GEL IMPLANTS

The FDA approved Sientra implants are filled with a high-strength, form-stable silicone gel that is the most cohesive ever available. The manufacturer reports that these fifth-generation implants have a 3 year rupture rate of 2% to 2.5%. Since the gummy bears don’t wrinkle or fold, and since wrinkles and folds contribute to shell failure, these implants will likely prove to have a longevity advantage.

 

A study published by Dr. Stevens found that these implants have a complication profile comparable to fourth generation silicone implants, with a lower rate of capsular contracture. Future studies will likely show that gummy bear implant ruptures, when they do occur, don’t lead to silicone migration. In demonstrations, these implants are cut in half, then squeezed, and the gel retains its shape much like a gummy bear would.

 

Dr. Stevens is one of only a handful of plastic surgeons in the country involved in the studies of fifth generation silicone gel devices popularly known as “gummy bear implants.” He has been heavily involved in the Sientra studies, and continues to participate in the clinical trials of the Mentor CPG’s, expected to receive FDA approval in 2013. As a participant in this study, Dr. Stevens has some options not available through other doctors. For the right candidates, these advanced silicone gel implants can offer important durability advantages while still looking and feeling like natural breast tissue. In addition, these implants can be chosen by women between the ages of 18 to 22 who are having their first augmentation, a group not currently eligible for the widely-available silicone implants. Also, through this study the surgeons are able to offer larger silicone implants than most other plastic surgeons, with implants up to 1,000 cc’s creating up to a DDD breast size.

 

Saline Implants

 

Saline implants were first manufactured in France in 1964 and appeared on the U.S. market in the 1970s. They gained FDA approval in 2000 and became the implant of choice when the silicone versions were restricted.

 

A key advantage of saline breast implants is the filling itself. Very similar to natural body fluids, saline is easily and harmlessly absorbed by the body should an implant rupture. And since the implant deflates, it’s easy to tell when a rupture has occurred and replacement is needed.

 

Saline implants are filled after placement into the breast pocket. This generally provides the patient with a slightly smaller incision and scar compared with pre-filled implants. In addition, because the implants can be filled with different amounts of saline once placed, our surgeons are able to precisely tailor the size of each implant in an effort to avoid breast asymmetry.

 

Disadvantages of saline implants are mainly cosmetic. Women are far more likely to report being unhappy with the way saline implants look, as they occasionally result in rippling and wrinkling. Some women believe this implant type does not feel like natural breast tissue, and occasionally patients complain of being able to hear “sloshing” of the solution inside the implant. A cosmetic as well as functional concern is increased saline implant deflation rates over time. Deflation requires surgical correction, though if deflation occurs, saline is harmlessly absorbed by the body and poses no health risk.

Saline implants also can be more difficult to use when a patient has limited tissue. Those who have had a mastectomy or who have very small breasts may find silicone gel implants to be a better choice.

 

Your Decision

 

Don’t feel dismayed by the wide range of implant choices available. The physicians at Marina Plastic Surgery Associates have the experience to help you decide which one is right for you. You can receive a free consultation when you request your appointment online and schedule during one of the convenient times they have set aside exclusively for Web visitors.

 

 

Size:

 

One of the decisions that seems to challenge the women of Beverly Hills and Los Angeles most about breast implants is, “How big should I go?” After making the decision to enhance their breasts through cosmetic surgery, many women fear they’ll look too big. Others dream of a voluptuous figure but don’t know if they can “supersize” and still look natural.

 

Dr. Stevens and Dr. Spring are just the right plastic surgeons to help you with this all-important decision. Read patient testimonials that often speak to just how effective they are in assisting their patients settle on the perfect size.

 

Do your homework, think about the profile you want to see in the mirror in a few weeks, and bring all your ideas with you to your consultation.

If you’re ready to meet with Dr. Stevens or Dr. Spring right now, you can receive a free consultation when you request your appointment online and schedule during one of the convenient times our surgeons have set aside exclusively for Web visitors.

 

Natural Look Through Surgical Technique

 

Once you understand your surgeon’s favored surgical technique, you’ll see how they go about creating natural-looking breasts for their patients regardless of size. Using an areolar incision or the fold incision allows them excellent access to the breast for making a pocket and maneuvering the implant into perfect position. They also favor implanting behind the pectoral muscle, ensuring the resized breast slopes gently and normally away from the chest wall.

 

Your Body, Your Choice

 

Your body and its attributes will influence what size breasts you choose. Many small-framed women decide to go no bigger than a C cup size to look like they could have been born with their new breasts. Skin tone is also a factor. Patients with very tight skin may not find large implants fit very well. The doctors are experienced in evaluating body and skin types and will help you understand how these factors may come into play for you.

What if your true desire is to “go big?” If this is the case, don’t hesitate for a moment to bring it up with your surgeon. After all, you’ve made the decision to have augmentation; you should have the breasts you want to have.

 

Since our surgeons’ surgical techniques are designed to create natural-looking breasts, many people can still choose large implants with beautiful results. What’s more, the surgeons are two of only 15 physicians in the U.S. who can offer some of their patients the opportunity to participate in FDA-sanctioned trials of high strength silicone gel breast implants commonly referred to as “gummy bear” implants. Filled with a cohesive gel that looks and feels like normal breast tissue, these particular implants can range up to DDD in size.

 

The Ins and Outs of Breast Implants

 

Relating the size of an implant to a new breast size for you can be tricky. Implant manufacturers describe the size (volume) of their products in cc’s, or cubic centimeters. That’s not a metric most of us use in our daily lives. And, let’s face it, bra cup sizes aren’t exactly standard. So telling your surgeon you want to be a “C” cup or a “D” cup is just the start of the discussion.

 

That’s why the staff at Marina Plastic Surgery Associates will advise you to bring photos along with you to your consultation. Showing your doctor what you want to look like and being ready for an open two-way conversation will make all the difference. But don’t worry if you don’t have any photos. Dr. Stevens and Dr. Spring have thousands of photos for you to look through in both offices.

 

Breast Implant Resources:

Websites for implant companies.

 

Augmentation Potential Risks & Complications: 

 

Thousands of women have breast enlargement surgery in Los Angeles each year. Most sail through the experience and suffer no more than temporary disruption of their usual routines for a short time.

 

As a surgical procedure, however, breast enlargement does pose potential complications and risks you should know about. Dr. Stevens or Dr. Spring will spend time discussing these with you during your breast enlargement surgery consultation in Southern California. You can receive a free consultation when you request your appointment online and schedule your visit during one of the select times our surgeons have set aside for Web visitors. You can also call us at 877.298.9915 in Marina Del Rey to learn more about breast augmentation.

 

Capsular Contracture

 

Occasionally patients experience an outcome that calls for additional surgery. The most talked about undesirable result is capsular contracture. All breasts form tissue “capsules” around implants; a small minority of these eventually contract and squeeze the implants. Most cases are mild and don’t require surgery, but in rare cases of distortion it’s necessary to have another procedure. Capsular contracture can sometimes be relieved by scoring the scar tissue, other times implants must be removed or replaced.

 

You’ll be glad to know that very few Marina Plastic Surgery patients experience capsular contracture. The surgeons invest in ongoing development of their technical skills, in research studies and in keeping up with the latest advances in the field to deliver the best possible outcomes for their patients.

 

Other Possible Complications

 

Dr. Stevens and Dr. Spring take every possible precaution to minimize risks associated with Los Angeles breast enlargement surgery, but you must be aware that complications are possible. Any surgery carries with it the risk of infection, and a very small percentage of breast enlargement patients develop a skin infection or an infection around an implant. These rare infections are treatable with antibiotics and very seldom require further surgery.

 

Seroma, a pocket of fluid around the implant, and hematoma, a collection of blood at or near the incision site, are two other possible breast augmentation complications. These two conditions most often resolve themselves as the body re-absorbs the fluid. Occasionally a large seroma or hematoma may need a surgical drain to remove the fluid and promote proper healing.

 

Scarring, Nipple Sensation and the Future

 

All surgeries leave scars, breast augmentation included. This is another topic you should discuss in consultation with your physician. Most women find their scars, which fade with time, completely acceptable. In some instances scarring is more extensive. Dr. Stevens and Dr. Spring can often improve the appearance of an overdeveloped scar in a minor office procedure. Very rarely a patient will decide on additional surgery.

 

A small number of women notice their nipples become more or less sensitive after breast augmentation in Los Angeles. Some report losing sensation altogether. Most of these conditions are temporary, but in very rare cases a loss of sensation is permanent.

 

Your implants should not interfere with mammograms or with your ability to breastfeed in the future. As you have routine breast cancer screenings, ensure you have a technician experienced in working with women who have had augmentation. And discuss any future childbearing plans with your doctor to hear about the potential impact of pregnancy on your breasts and implants.

 

Your Implants May Not Last a Lifetime

 

Before deciding to proceed with breast enlargement surgery in Southern California you must consider that it’s possible you’ll need additional surgery in the years to come. It’s not usual for saline-filled breast implants to rupture. Since the saline solution is easily absorbed by the body it poses no threat, however, the implant must be replaced.

 

Rarely, silicone gel implants can rupture, though the cohesive material most often holds together or, at very least, stays inside the tissue capsule surrounding the implant. The FDA recommends MRI scans to test for these “silent ruptures” periodically. If a silicone gel implant ruptures, it must also be replaced.

 

And, to keep your new breasts looking youthful and shapely, you may decide you need a breast lift in the future. In fact, you may want to consider adding a long-lasting lift to your new breasts via The Stevens Laser Bra at the same time you have your augmentation.

 

Your Consultation is Key

 

Dr. Stevens and Dr. Spring will take time during your consultation to review potential complications with you, including the very remote risks associated with any surgery such as infection and excessive bleeding. Be sure to bring a list of questions or concerns with you. Receive a free consultation when you request your appointment online and schedule your visit during one of the select times our surgeons have set aside for Web visitors. You can also call us at (877) 298-9915 in Marina Del Rey.

 

As you do your research and make decisions, you can feel confident in knowing you’re in great hands at Marina Plastic Surgery Associates. Each member of the board-certified, accredited staff is experienced, caring and focused on your results.