An area that some plastic surgeons have an expertise in is primary or secondary breast augmentation. Most of these cosmetic surgeons perform breast augmentation surgery using all types of implants including silicone and saline. Cosmetic surgeons have an important decisions to make when it comes to breast implants. Breast implants are available in many different sizes, shapes, and projections. The type of implant that your plastic surgeon selects should be based on your physical and soft tissue characteristics, as well as the goals that you have for your appearance. Another important thing that these doctors specialize in is the decision of where to make the incision and pocket for the implant. Saline implants have been used in the majority of breast augmentation surgeries over the last fifteen years. One advantage of saline implants is that, if they rupture, the saline will be absorbed by the body without fear of any complications. Additional benefits include the ability for a cosmetic surgeon to subtly change the volume of the implant within the operating room to accommodate any small differences in the volume of the two breasts. The disadvantages of saline breast implants are that they have a higher risk of rippling in breast reconstructive or small-breasted patients. For patients with little breast tissue to cover the implants, rippling or wrinkling of the implant may become visible. However, the majority of breast augmentation procedures performed today with saline implants lead to beautiful, youthful, natural breasts. In November of 2006, the FDA approved silicone gel implants for primary augmentation mammoplasty surgery in women who are healthy and at least 22 years old. The newer generation of silicone breast implants are all made with a thicker shell which is capable of reducing the spread of silicone if a rupture should occur. The advantages of silicone implants are a more natural feeling that will appear after the breast augmentation procedure. The biggest disadvantage is that a slightly larger incision will be made to accommodate these types of breast implants. These implants may be inserted through several areas. They may be placed through the belly button, the arm pit, through the breast fold, or through the lower part of the areola. Only saline implants will be able to be inserted through the belly button however. All breast implants can be placed beneath or above the muscle. Cosmetic surgeons will typically place the implants beneath the muscles whenever possible in order to create and allow more tissue coverage. This will result in less rippling, a more beautiful and natural result, and less implant visibility.
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