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Visit Frank R. Lista's profile.
Choosing the right implant, the position of the implant and where the incision
is placed are some of the most important decisions a woman can make when considering
breast implant surgery. When we see patients at the Plastic Surgery Clinic we
spend most of our time discussing these issues so every woman can make the right
choice for themselves.
The two major types of implants available for use in Canada today are Cohesive Gel Silicone implants and saline implants. Saline implants have been available for over 30 years. There is no other implant that has been more thoroughly studied or has a longer track record than saline implants. Essentially these implants are an empty bag that is filled with salt water or saline. The implant is placed into the body, after creation of the pocket, by rolling the implant up like a cigar and then filling it when it is in position. We use the same solution to fill the implant that we give a patient when we start an Intravenous or IV. The advantage of saline is that it is safe, less expensive and leaves the smallest incision and scar possible. Normal activities do not harm these implants. We have patients with saline implants who work as female fire-fighters, police officers, fighter pilots and personal trainers. Saline implants can occasionally leak, usually due to a defect which develops around the valve. When this occurs the saline is absorbed by the body and the implant goes flat. Replacing the implant is a fairly simple operation where the incision is opened, the deflated implant removed and a new implant inserted. The implant companies guarantee the implants for life and so will provide your surgeon with a replacement for free. You should check with your surgeon about possible surgical fees for implant replacement. In my practice we replace implants without charging any surgical fee. In fact we tell patients that if they develop a complication which can be fixed, that we will do so at no additional cost. The risk of implant deflation is 1% per year. That means that one out of a hundred implants will deflate every year. So in 10 years a woman has a 10% chance of developing a leak; in 20 years 20%, 30 years 30%. So in fact the odds are that most women will live their entire lives without requiring a replacement. There are some disadvantages with saline implants. These implants generally look best when placed behind the muscle. Placing saline implants above the muscle can lead to rippling and capsular contracture. Even when placed behind the muscle some women may be able to feel the implant in the bra crease area. This can give a ripply feel in the bra crease area. This problem is more likely to occur in very thin patients. Most patients however do not experience this problem. Saline implants can be placed under the muscle through an incision in the bra crease, around the bottom edge of the areola or in the armpit (axilla). In my practice we perform the operation using any of these incisions and allow patients to choose the incision which they feel is best for them. Cohesive gel silicone implants are the newest form of implant available in Canada. These implants have been used for breast augmentation since 2000 in Canada and for over 15 years in Europe. These implants are filled with a solid or cohesive silicone center. They are commonly called the “gummy bear” implant because if they rupture, they don’t leak. You can stick a needle in these implants, or even cut them in half, and nothing leaks out. There are some advantages to cohesive implants. They are less likely to give the problem of rippling or palpability of the lower edge in the bra crease area. While they do not reduce the risk to zero, they do make these problems less likely. The other advantage of these implants is that they can be used < Article Courtesy of Frank R. Lista, M.D., a Mississauga Breast Augmentation Surgeon
Additional Articles about Breast Implants by Frank R. Lista, M.D.:
Vertical Scar Reduction Mammaplasty: A 15-Year Experience Including a Review of 250 Consecutive Cases
 A recent study by Cruz-Korchin and Korchin showed that patients who underwent medial pedicle/vertical pattern breast reduction rated their satisfaction with the amount of scarring and the overall aesthetic outcome significantly higher than those who underwent inferior pedicle/Wise pattern breast reduction.
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