Dr. Matthew Schulman: So now let's talk a little bit about breast augmentation. Breast augmentation or breast enhancement remains one of the most popular procedures performed in the United States. Basically involves replacing a breast implant. When deciding about breast implants, there's really three key things you need to decide. One is what type of implant you want whether it's silicon gel or saline. The other is where you want your incision. Your choices are around the areola, under the breast of sometimes through the arm pit. And third, where you want the implant to be inside your body, above the muscle or below the muscle.

So, if we look at some implants, first, this is a typical silicon gel implant. It's very natural looking, very natural feeling. Next to it is saline. Saline still remains very popular, but it tends to have some issues with visible rippling and sometimes the implant can feel like a water balloon and not as natural. The choice between the two is really a personal choice. Patients ask me all the time what I think is the better implant. I'll never tell them which I think is better, but I will say that silicon gel tends to look more natural and feel more natural.

So, if you think that means it's a better implant, then that's the answer. It's the better implant. The concern about the health issues with silicon gel really haven't proved to be true. There was a lot of concern over the past 15, 20 years that the gel can cause problems like cancer, lupus, rheumatoid arthritis, the type of autoimmune diseases. When we actually looked at the data, there's no connection at all between the silicon gel and those disease.

So, silicon gel is reapproved by the FDA. It's extremely popular. Right now about 80% of my implants that I put in are silicon gel and the gel itself is a much better quality gel than it was 15 years ago. It's a cohesive gel, so it's more like a jelly. If I were to cut this implant open, the gel would ooze out, but it wouldn't spill like the old implants that used to be a silicon oil. So, that's the basic difference silicon gel and saline.

If we talk about incision placement, one of the most common places to put the incision would be around the areola. The other option would be underneath the breast in the breast crease or it can also be put in through the arm pit. Again, it's really a personal choice. You'll have to speak with your doctor about your specific body shape and the implant type, and implant size that you're selecting because that may affect your decision for where you want the incision. But, other than that, it's really a personal decision. And all them when done by a properly trained plastic surgeon will have an excellent result.

The other issue that I spoke about is where you want the implant placed. The implant can be placed above the chest muscle or below the chest muscle. In general, below the chest muscle tends to be a better placement with a lower incense of infection, a lower incense of scarring or hardening around the implant, and also the implant tends to look a little more natural because you have the extra layer of your muscle that covers the implant.

Breast Augmentation and Breast Implants

Doctor Matthew Schulman discusses Breast Augmentation and Breast Implants.