Breast augmentation is now the most commonly performed plastic surgery procedure in the United States. So when women come in to see me for breast augmentation, we want evaluate them to help them achieve their goals. Most ladies have an idea of what cup size they want to be. Perhaps they had modest goals that would be a nice B cup. Maybe they want to be a little more bold and be a D or a DD. So we kind of factor that into our decision-making process. First we want to examine their breasts and see what was the nature of their breasts, how much breast tissue we have. Do they have much sagging in their breast? Because if they have a lot of settling or sagging in their breast, then we might also need to consider a mastopexy which is a breast lift type of procedure.

But assuming that a breast augmentation alone would give them a good result, then we need to think about the volume of the implant. So again, patients think about breast cup size but we in turn translate that into cc's or milliliters of volume of the breast implants. So how do patients determine that? Well, one way we've done it for a long time is have them try on breast implants. They actually sit sizers on your breasts underneath the bra that is their goal. That helps them decide an implant size. It's actually fairly accurate. But we really love our new Vectra imaging system, and this shows the example of how that is done. It's a computer, it takes a photograph of the torso area. It's a 3-dimensional presentation of the chest area, and we can in turn dial in different breast sizes. So we can show larger sizes, smaller sizes, different implant styles. And this is a great way for the patients to sort of anticipate what their final post-op results would be like.

Having decided what implant volume we would like, or a range at least, then we turn to what type of implant we want. We have saline breast implants. They've been around for a long, long time. Traditional silicone gel breast implants have been around for a number of years. And now just on the market are what we call "form stable" or highly cohesive gel implants. And this is an Allergan implant just approved by the FDA. And it's going to be kind of neat because it has much more cohesive gel. It's going to hold its shape better. But I've done plenty of saline breast augmentations, and really loved them with very nice results. Sometimes women are reassured by the fact that saline implants if they leak, well it's kind of a no-brainer. Suddenly you're flat. It's easy to recognize. It's easy to come back and fix. So they're reassured by the fact that the body absorbs that salt water harmlessly.

Now saline implants might be a little firmer in how they feel. Yet they could be a little palpable to some extent. So oftentimes off to the side of the breast the patient might be able to feel some slight wrinkling. But it would be very unlikely to see the fluid movement or have widespread wrinkling with the scene of the implant. Silicone implants, and this is a typical gel implant that we've used traditionally for a number of years, are softer. They feel more like breast tissue. They're round. You can see they have a smooth surface. So if a woman is looking for, perhaps, a softer consistency to her breast, then this is a good choice as well. Now you can see that it has a few little wrinkles in it, but oddly, that doesn't really show up when it's underneath the breast and the muscle of the chest wall. And so it gives a nice look with a nice soft consistency.

Now some women are a little maybe fearful of what if this leaks? What happens to the silicone? Well the silicone tends to stay right where it is. It's sort of contained by the natural scar tissue around the breast. So we don't worry too much about it. If you discover this implant leaking, say with a mammogram or an ultrasound, and you want to have it replaced, both of the implants actually have warranties that help replace them. So smooth, round implants are sort of the traditional things we use if you put them in the chest area. They can float around a little bit. It doesn't really matter too much. The new implant is what's called a form stable implant.

Now with these traditional silicone implants and with the salt water implants there's going to be a little fullness at the top of the breast. And so here's a patient of mine that had breast augmentation, and you can see that she's got a little fullness at the top of her chest area. That's what I call an augmented look. That's really kind of a desirable look for new patients. You see it in fashion magazines, you see it on your friends and neighbors. Since a lot of women do like the fullness at the upper area of the breast that you get with the smooth, round implants, either saline or silicone.


Breast Augmentation Approved Silicone Implants

Doctor Michael Yates discusses breast augmentation approved silicone implants.