BREAST AUGMENTATION SURGERY WITH IMPLANTS IN MIAMI

There are many considerations in breast augmentation that will be discussed in your consultation. In the case of augmentation with implants, these include the type of implants, the shell of the implant, the shapes of the implants, the content of the implants, the anatomical locations where the implants are placed, the incisions required to place the implants, and the long-term consequences and potential drawbacks of having implants. In the following paragraph, you will encounter a summary.

There are many considerations in breast augmentation that will be discussed in your consultation. In the case of augmentation with implants, these include the type of implants, the shell of the implant, the shapes of the implants, the content of the implants, the anatomical locations where the implants are placed, the incisions required to place the implants, and the long-term consequences and potential drawbacks of having implants. In the following paragraph, you will encounter a summary.

The shell of breast implants is currently only made of medical-grade silicone. In the past, we had textured implants, but they were recently retired, and only smooth shells are now available in the United States. The only implant shape available in the United States is round. We used to have “teardrop” or “anatomical” implants, but these were recently discontinued. In terms of implant content, they can be filled with saline solution or silicone gel on the inside. Both have benefits and drawbacks. One of the main advantages of saline-filled implants is that if they rupture, the implant deflates, the breast becomes smaller, and the patient notices the difference almost immediately. In general, silicone-filled implants are preferred, especially in thin patients, given the breast appears more natural to palpation after surgery. Moreover, they can produce more upper pole fullness (“perkiness”) and potentially less implant edge visibility (“scalloping” or “rippling”). Silicone gel-filled implants have had several generations of improvements. We are currently in the 5th-6th generation.

Gel thickness is also known as “cohesivity.” There are different degrees of implant gel cohesivity, typically three: mildly cohesive, moderately cohesive, and highly cohesive. The last generations of implants have a gel filling that is more cohesive and less likely to bleed out if a shell rupture occurs. Their inside resembles the consistency of a “gummy bear.” This allows them to provide even more upper pole fullness, hold their shape better, and even further decrease the chances of the gel leaking out if the implant ruptures. There are a few more topics to cover about breast implants, including implant projection, which will be covered during the consultation with Dr. Rivera-Serrano.

In terms of the anatomical location of the implant, it depends on the initial size of the breast and the thickness of the breast fat under the skin. Most implants in the United States are placed partially under the muscle (also called “dual plane”). Dr. Rivera-Serrano sometimes also places the implants over the muscle (“subfascial” or “sub-glandular”) in selected patients. A dual plane can decrease the risk of capsular contracture, which is a fibrous capsule around the implant that becomes thicker with time. Of note, a capsule always forms around the implant, but most of the time is very soft, supple, and not noticeable.

In terms of the incisions to place the implant, in the United States, most implants are placed from an incision along the fold under the breast, which typically heals very well. This is currently the most favored incision. In some patients, the implants can be placed at the inferior border of the areola (pigmented area beneath the nipple) or through an axillary incision.

Most breasts are asymmetric. In practice, we rarely encounter symmetric breasts; hence we tell our patients that their breasts are more “siblings rather than twins.” Therefore, results may not lead to fully symmetric breasts, although the goal is to improve balance and proportions.  A personal consultation will determine what is best for you.

You want a better proportioned or more appealing figure and wish your clothes fit better. When pregnancy, weight loss, or aging has affected the size and shape of your breasts. You believe you might gain self-confidence or self-esteem from such a procedure. To restore symmetry if one of your breasts is smaller than the other (keeping in mind that everyone’s breasts are asymmetric to some degree).