Breast Enhancement with Saline or Silicone Implants

Breast augmentation enhances one's own breast tissue by placing silicone or saline implants beneath a woman’s breast tissue and chest muscle. With over 300,000 breast enhancement surgeries done each year in this country , breast augmentation has become the most common cosmetic surgical procedure performed in the United States and in Dr. Kluska's practice as well. Patients from all over the country seek Dr. Kluska's surgical expertise in performing a natural looking breast augmentation.

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Breast enhancement surgery involves placing a prosthetic implant in the patient’s breast region in order to enlarge the breast or to fill empty skin that has lost its fullness with age and having children. There are 2 ways to enhance the female breast. The first consists of placing an implant under the skin and breast tissue, all the while staying on top of the muscle. This is known as the “subglandular position”. The advantages of this procedure are that most of the time there is minimal pain and the breast will age naturally, sagging with time. Conversely, the disadvantages include a higher rate of capsular contracture, inevitable ptosis or excess sagging and eventual need for breast lift. In addition, increased appearance and feel of rippling from the implant is also very common with implants in the subglandular plane. A final disadvantage of this procedure is the increased risk for change in nipple sensation. This is especially true in the very thin, small breasted patient.

The second and probably more common placement of an implant is under the chest muscle. Known as the submuscular position, this procedure results in a natural appearing breast that maintains an excellent long term position with minimal risk of sagging. This position results in a decreased risk of capsular contracture due to the consistent massage of the implant by the pectoral chest muscle. Having the muscle cover the implant can also decrease the appearance and feel of rippling of the implant. The primary disadvantage of this procedure is the learning curve by the physician. Many physicians are uncomfortable with this procedure because it requires extra time and understanding of the anatomy in order to get a naturally appearing breast.

Once a patient has decided on the location of the implant, they then must pick the type and size of the implant along with the incision location. Even today, most physicians still elect to place the surgical scar somewhere on the breast. Options include around the nipple or beneath the breast fold. These incisions can leave visible scarring with increased risk for change in nipple sensation. Another approach is the arm pit incision. This incision heals virtually undetectable and completely removes all scarring from the “enhanced breast”. Again the primary potential problem with this approach is the physician learning curve. Many plastic or cosmetic surgeons are unfamiliar and therefore, uncomfortable with this approach.

After the patient has made a decision on the approach, she must then focus on size and type of implant. In polling 100’s of women over the last 10 years, one common theme is apparent… “go bigger”. Every women that presents for breast enhancement surgery, claims that they want to be a “34 C”. When asked to bring in pictures of women that they feel have attractive breasts, most bring in photos of women with “D” cup breast size. In addition, when the patient is asked several months after surgery if they made the right decision, almost everyone will reply that they wished they had gone bigger. With the natural aging process, the normal breast will lose volume. This extra covering over the implant creates more swelling right after surgery and ultimately a bigger appearing breast. As time goes by and the swelling subsides, the breast will appear to get smaller.

Finally, the patient must decide on the style of implant that they desire. Many different profiles are available along with the option of saline versus silicone and smooth versus textured. At the current time, saline and silicone implants are available for those patients older than 22 years old and saline only for those between the ages of 18- 22 years old. Today’s implants also come with an option for increased projection. The “high profile” implant creates more volume in the front of the chest. This is accomplished by narrowing the implants diameter and allowing more volume to be displaced to the front of the chest.

As one can see, there are a variety of options available for the breast augmentation patient. Along with these options come associated risks. Therefore, it is important for the patient to research the procedure carefully. They should also research their surgeon in order to insure that the physician is familiar with all of the current approaches and procedures.

The Right Patient for Breast Augmentation

A good candidate for breast augmentation is:

• Capable of understanding the risks of cosmetic surgery
• Motivated by her own values and desires to change her appearance
• Not satisfied with the size of her breasts or feels they are not proportional
• Healthy. A non-smoker. With realistic expectations.

Breast augmentation patients find that surgery brings many benefits: better self-confidence, expanded wardrobe options, and improved sexual wellbeing are just a few of the documented benefits.

Breast Augmentation Options: How to Get Great Results

With all of the recent advancements in cosmetic breast surgery, it is easier than ever before to get great results in breast augmentation. During a consultation, Dr. Kluska can guide you through the various options available in breast implants and surgery techniques. Here are a few questions you may want to consider before scheduling a consultation at our Greensburg office.

Would you prefer saline implants or silicone implants?

Both of these have their own advantages and disadvantages. Some women choose silicone implants because they feel more natural. Others can achieve appealing results from the versatile and less expensive saline implants.

What is the right breast implant size for you?

This is an important aspect. You want to choose a breast implant that is proportional with your anatomy, but you also want to be satisfied with the breast size increase for many years.

Where should the breast augmentation scars be located?

All of the available surgery techniques can produce scars that are hidden. However, some women prefer to have the scars located away from the breast, in areas such as the underarm or the navel. These breast implant placement options are possible thanks to endoscopic surgery techniques. Ask Dr. Kluska which breast implant placement method would be ideal for you.

Breast Augmentation Surgery Information

This surgery typically requires about 1 to 2 hours of operating time. General anesthesia is commonly used, meaning the patient is asleep during surgery. Incisions are placed to allow access to the breast, where the surgeon creates a pocket for the implant. The implant is placed in a central location below the nipple. It can be inserted above or beneath the pectoral muscle. Incisions are closed using sutures with tape or adhesive.

After breast augmentation, a special bra is provided for you to wear during recovery and pain medications are prescribed by Dr. Kluska. Total recovery time varies, partly depending on the technique chosen. With breast implants placed below the muscle, the recovery time is slightly longer. A prudent expectation for recovery time is about 1 to 2 weeks, but you might feel normal in less time. Sutures are removed after the first week of recovery.

Breast Augmentation Complications

All cosmetic surgery carries some uncertainty and risk. With breast augmentation, early complications might include changes in nipple sensation, hematoma, seroma, infection or inflammation. Delayed complications include capsule contracture, implant rupture or bottoming out of the breast implant. Ask Dr. Kluska for more information if you are concerned about these possibilities.

If you are seeking breast augmentation in Pittsburgh, Greensburg or greater Pennsylvania, contact the Center for Plastic and Cosmetic Surgery by calling 724-836-0400. To receive information about future special pricing on breast augmentation procedures, subscribe to our email list.