Dr. Tattelbaum Discussion on Breast Implant Techniques
An Overview of Breast Implant Techniques
For this article, I would like to go beyond the basic facts that are posted all over the internet and give a personal opinion based on almost two decades of experience performing thousands of breast implant procedures. This blog covers the most frequently asked breast implant questions:
1) Under or over the muscle:
I generally favor implants under the muscle because they tend to look more natural. This is because the muscle gives a gentle slope to the upper breast. When the breast implant lies under the muscle mammograms are easier to interpret. The infection rate is lower because muscle has a better blood supply and blood supply fights infection, there is also a lower rate of capsular contracture. If you want a breast lift later in life, more of the blood supply to the breast is preserved when under the muscle.
2) Best sizing method: Trying on implants –
I think trying on an actual implant sizers gives the most accurate information, and allows you to see your whole frame. Breast Implants relate to the entire body, hips, shoulders and height. Things like magazine pictures, internet photos or computer imaging don’t tell the whole story. You often don’t see the patient’s full stature. Other options such as rice or water bags have no shape, these methods are very inaccurate.
Here are the most common body locations for incision:
- Armpit- This sounds cool but implants often ride too high, because it’s hard to be precise when you have a limited view inside the breast.
- Belly button- This technique is done more by feel, therefore it is less precise.
- Areola – The is the most precise, and allows best visualization inside the breast.
- Inframammary – This is good for large gels and allows good visualization.
- TABA (transabdominal breast augmentation)– Implant through a tummy tuck, for select patients, slightly less precise.
4) Silicone or Saline: (this could be a blog unto itself)
Silicone implants are softer and more natural feeling, they give a softer transition in the upper breast, and have the least rippling around the edges. Because of these properties, they tend to look more natural.
The downside of silicone implants is they sometimes need a longer incision, and the volume can’t be changed. Surveillance is recommended with an MRI every 3 years. Silicone implants are generally more expensive than saline implants.