Preventing Breast Implant Rupture

While there is no guaranty that breast implants will last a lifetime, plastic surgeons have come up with different techniques to at least prolong the devices’ lifespan and lower the risk of implant rupture.

In the event of implant rupture, the only solution is a revision breast augmentation; this procedure may involve replacing the implants with new ones or removing them without any replacement.

Meanwhile, these are some of the basic rules which can help patients prevent or at least lower the risk of implant failure.

* Choosing silicone implants over the saline version

Currently available silicone breast implants are less likely to rupture than saline because they are not prone to sloshing and wrinkling which are known to affect the shell’s stability.  Another advantage is that the silicone gel does not evaporate (unlike the saline) which means the patients can maintain their breast volume unless in the event of rupture.

The latest version of silicone implants—which have a more cohesive silicone gel than the one currently used—is almost immune to implant failure.  However, these breast implants, called the gummy bear implants, are not yet approved in the US although these are already used in Europe and Canada.

* When using salinei mplants

Rippling, which can compromise the shell’s stability, can be prevented in saline implants by slightly overfilling them.  However, this should be carefully done because too much filler can cause abnormal pressure on the device.

On the other hand, underfilling saline implants only has negative results because it can cause creases, leading to weak areas in the shell.

* Avoiding high trauma to the breast

Modern breast implants are very strong although they are still subjected to the effects of physical force.  Impact from car collision, sports injuries, and accidental falls may compromise the shell’s stability or may even lead to rupture.

* Consider the implant placement

Some doctors say that submuscular implant placement (placing the device under the pec muscle) poses a slightly higher chance of shell damage than the subglandular technique (positioning the implants over the muscle).  A good compromise might be the subpectoral placement.

* Use of Keller Funnel technique

In this technique, plastic surgeons place the breastimplants in a cone-shaped device and then squeeze it so the implants are transferred into the breast pockets.  Doctors use less force in this method than if they push the devices using their fingers.

Traditional Breast Lift Surgery Vs Surgical Mesh

Traditional breastlift surgery is conducted by making incisions around the areola, across the breast crease, and vertically down from the nipple to the fold, thus allowing plastic surgeons to excise some of the loose skin and tighten the tissue.  However, one tradeoff a patient should remember is that while it can raise and reshape the bust for a period of time, it cannot stop the effects of gravity and skin laxity.

But recently, plastic surgeons from South Africa have developed a new technique called Internal Bra System which uses a “support” to prevent future sagging.  This method is now also used in Europe.

The new breast lift technique uses a mesh-like device called Breform which is similar to the one used in hernia repairs.  Meanwhile, plastic surgeons who developed the method said the material can take the strain off the scars and skin, preventing the breasts from sagging.

While Breform has not yet been approved in the US, experts believe that it will be introduced to the market within the next coming years.

Breform is a cone-shaped polyester mesh that is placed underneath the breast skin and is attached to the fascia using internal sutures.  The procedure is conducted under general anesthesia that puts a patient to sleep.

Plastic surgeons in Europe who are using Breform said the device is incorporated into the breasts over time, with the body naturally producing fibrous tissue holding the new structure in place.  With this technique, they believe the result is like a permanent support bra under the skin.

However, patients should remember that the new technique also involves the same incision sites used by the traditional breast lift surgery.  This means that the risk of scar and the length of recovery of these two methods are almost the same.

While Breform is approved in Europe, it has not been permitted by the US Food and Drug Administration, which is noted for its strict regulations on medical instruments.  And because the breast surgical mesh is quite new, there is no long-term study proving its effectiveness and safety.

Some US plastic surgeons are also concerned if the mesh-like device may affect the accuracy of screening tests for breast cancer or if it may lead to serious complications.

However, a four-year study involving 170 patients in Holland found no serious complications following the procedure.  The trial also revealed that breast X-ray examinations were still possible after the internal bra surgery.

Breast Implants with Lift for saggy boobs

Even small breasts can sag due to the natural effects of aging, weight fluctuations, and previous pregnancies.  Fortunately, plastic surgeons have come up with a new technique which combines the benefits of mastopexy (or breast lift) and breast augmentation in one operation.

The sagging of the breasts primarily happens when the amount of tissue decreases and the skin becomes lax.  Contrary to popular belief, breast augmentation surgery alone is less likely to provide a lifting effect especially if there is a severe case of ptosis (drooping).

Mastopexy with breasti mplants starts by making incisions to remove a small amount of skin, which in turn corrects the sagging appearance.  With this technique, less tissue is excised than if breast lift is performed alone; for this reason, patients will enjoy less scarring on their chest.

Because less skin is removed, plastic surgeons need shorter incisions to perform mastopexy-augmentation surgery.  In most cases, they use the crescent-shaped incision around the areola complex, although patients with severe breast ptosis may need the lollipop incision in which the surgical cut is made around the areola and vertically down the breast crease.

The good thing with mastopexy-augmentation is that most patients can get more cleavage, although they should bear in mind that the final result also depends on their chest width and rib cage.  For example, women with a concave chest are likely to enjoy more medial cleavage and upper pole fullness as the implants tend to settle toward the center.

On the other hand, patients with convex chest will achieve less cleavage because their implants will likely settle opposite with each other.  However, there is a solution to the problem: use breast implants that offer more projection off the chest wall.

While some surgeons prefer simultaneously performing breast augmentation and mastopexy, others would rather wait for three months before another surgery (augmentation) is conducted.

Some doctors argue that breast augmentation with mastopexy—if performed on the same day—can lead to higher risk of asymmetrical breasts and complications since the skin is being removed and tightened while at the same time the implants stretch it even further.  Another concern is the tension on the incision site can adversely affect the blood supply.

They also argue that it is challenging to position the nipple and breast crease if mastopexy and breast augmentation are performed simultaneously.

Regardless if breast augmentation is performed on the same day of mastopexy or at a later date, most plastic surgeons recommend placing the implants totally under the pec muscle which can provide good coverage and strong “support.”

Patient Options in Breast Augmentation Surgery

The primary goal of breastaugmentation is not just about increasing the bust size but also making the result as natural as possible.  Fortunately, this is easier nowadays as breast implants come in different sizes, shapes, shell, filling, and projection, in addition to a wide range of surgical techniques used by plasticsurgeons.

Nowadays, three options in breast implant placement are available for patients: complete submuscular (under the muscle), partial submuscular (partially under the muscle), and subglandular (behind the tissue).  These surgical techniques have their own pros and cons which are carefully explained to women so they can decide for themselves.

The complete submuscular implant placement results to longer recovery and more pain during healing period because the pec muscles are stretched and pushed.  However, the technique provides countless of benefits such as more coverage to reduce the risk of implant wrinkling; more lifting effect; better mammogram reading; and lower risk of capsular contracture, which is a condition resulting to hardening of the scar tissue around the implants.

On the other hand, the subglandular implant placement results to shorter recovery because the pec muscle remains intact.  But since no muscle covers the implant shell, the technique is only ideal for patients with enough glandular tissue, fats, and skin.  Another consideration to make is that an ongoing ptosis (drooping) may be further aggravated because of the lack of strong “support.”

Meanwhile, the partial submuscular combines the benefits of subglandular and complete submuscular implant placements.

Aside from the implant placement, the type of implants can also have a significant impact on the final result.  For instance, women who want to achieve more cleavage are advised to choose round implant rather than the teardrop-shaped version, although the latter is more notable for simulating the natural contour of the breast.

Breast implants are either filled with saline or silicone gel.  For those who want to achieve a more natural “feel” and “look,” and women with a limited glandular tissue, the silicone implant is a better option; however, one downside is that the patients are required to undergo MRI screening every two years to detect any asymptomatic or “silent” leak.

On the other hand, women with saline implants are not required to have a regular MRI screening because a leak is easily manifested by deflated-looking breasts, making it possible to immediately seek revision breast augmentation.

Regardless if saline or siliconeimplants are used, their size should not only be based on one’s goal but also on her body-frame, amount of tissue and skin, and chest width.  It is important to note that a good plastic surgeon will not push the body’s limit by introducing implants that are too large for it.

Breast implants can be inserted via four incision sites: axillary (armpit), TUBA (navel), breast crease, and areola complex.  Patients should remember that the best surgical technique largely depends on their goals, acceptable risk level, and type and size of implants.

The axillary and TUBA incision sites require the use of an endoscope, which is a fiber optic camera attached to a large monitor.  Through this instrument, plastic surgeons can insert an empty saline shell inside the breast pocket and then fill this with a sterile saltwater solution.

But because the axillary and TUBA incisions work farther away from the bust area, there is a greater margin of error.  By contrast, the breast crease and areola incision sites provide surgeons with greater control over the final result of the surgery, making them a more popular choice.

Since there are many surgical options and type of implants available for women, breast augmentation typically involves lengthy consultation between patients and plastic surgeons.  In this way, doctors can also determine if the goals and expectations of a person with the surgery are plausible and achievable.