Sunday, November 1, 2009


Breast Augmentation is still a hot topic. Our recent American Society of Plastic Surgery meeting in Seattle was attended by board-certified plastic surgeons from around the world. Multiple panels, courses and scientific presentations covered various aspects of breast implants and techniques. The infra-mammary incision is still the most popular. The incision through the umbilicus has fallen out of favor. A 3 cm. incision for saline implants and a 6 cm. incision for silicone implants is typical. To reduce scar tightening around the implants (capsular contracture) and to improve mammographic visualization, the submuscular position is preferred. The one exception would be a patient with early breast ptosis -a better shape and contour can be obtained if the implants are placed above the muscles (submammary position). Saline filled and Silicone gel filled implants are both popular options. Silicone implants have the advantage of a softer feel and a more natural look. There is also less chance of wrinkling with silicone. In very thin patients with minimal breast tissue, the silicone implants give a better result. The cohesive gel implant is not yet approved by the F.D.A. for general use in the U.S.A. I will keep you up-to-date on this exciting breast implant. Breasts implants come in different sizes, shapes and projections, as well as textured vs. smooth surfaces. In order to achieve a "custom fit" for a natural result, the pre-operative and intra-operative sizing process is critical. This involves the patient's individual anatomy, chest wall dimensions, skin elasticity, and patient desires. In summary, breast augmentation is still a "hot commodity" with a high patient satisfaction level, minimal "down-time" and few complications.