Breast Implant Surgery
Breast implants remain the best means of making breasts larger. Today, they are recognized as safe, and many of the little problems that for years shaded their reputation have largely faded away. The saline (salt water) filled silicone implants is by far the most popular option. Other materials have been introduced, but plastic surgeons will have to be convinced that they are at least as good before they are widely accepted.
The preferred incision site is along the bottom edge of the dark areola skin. The plastic surgeon then tunnels around the breast tissue and lifts up the pectoralis muscle to make a pocket behind it about the size of the implant. It goes in empty and saline is then added through a fill tube attached to a valve on the front of the implant. When it is full, he does some last minute contouring altering the pocket to allow the implant to fill out the breast. If one breast is larger, he compensates by adding different sized implants or by varying the amount of saline. When size and shape are optimal, the fill tube is removed, the valve is plugged and the incision is closed with a suture designed for minimal scarring. The scar at the edge of the areola is typically difficult to see after it matures.
In some cases, implants can be in front of the muscle, however most women look better when they are placed behind the muscle. By positioning the implants appropriately, the surgeon can make the desired cleavage. The disadvantage with placement in front is that if there is not enough breast tissue to cover then, saltwater implants can show waves or ripples through the skin, impairing the natural look. Front placement can also impair visualization in routine mammography.
Alternatively, incisions can be in the crease under the breast or in the axilla (armpit), but these tend to be more noticeable. The endoscope (an instrument designed for better visualization) does make the axilla incision acceptable, but it is a bit clumsier to do and the result is not any better. Despite what many have heard, numbness of the nipple after surgery is not more likely with areola incisions.
