Trends/Articles/Facts from Dr. Tom Bartell

 

“Scarless” Breast Augmentation

Breast augmentation is the most common cosmetic procedure performed in the US. Every year, over 350,000 women have breast implants to enhance their figures. There are thousands of surgeons performing these operations every year, and each one seems to have their own technique. Most of these result in a scar on the breast, but it does not have to be that way. Breast augmentation can be performed with no scars at all on the breasts.

I have been doing it this way for 20 years, and the thousands of patients I have treated will tell you that the choice of scars or no-scars was an easy one. Scars are a permanent reminder that surgery was performed. Very few women want to advertise the fact that they have had surgical enhancement, and without any scars to give them away, no one need ever know that surgery was ever performed. I do this by using a small incision in the armpit. Six months after surgery, the scar is practically invisible.

Why do most surgeons not offer this approach? Usually it is because they either did not learn how to do it in their training, or they just do not feel comfortable with performing the technique. Any of the other plastic surgeons in our area can give you a good augmentation result, but I will do that as well without the scars. Take a look at the before and after photos, and I think you will agree.

 

Silcone vs. Saline Implants

Today women have a choice when considering breast augmentation; silicone or saline. Both types of implants have been available for several decades, but there has been some controversy with the silicone implants. At one time, there was a question whether these implants were related to connective tissue disorders, such as rheumatoid arthritis and scleroderma. While the FDA has been satisfied that there is no connection between silicone implants and connective tissue disorders, leakage of liquid silicone is still a major concern with these implants. In contrast, if a saline (salt water) implant leaks, the saline is harmlessly absorbed.

Some surgeons insist that silicone implants feel more “real” than saline. This may be true in extremely thin women. However, since the implants are placed behind the skin, breast and chest wall muscle, it is simply pushing the natural breast tissue forward. Therefore, what you see and feel on the outside is you.

Saline also has distinct advantages over silicone implants. Since they are filled only after insertion, they can be placed through a much smaller incision. Also, each saline implant comes with a minimum and maximum fill volume, which can be adjusted at the time of surgery. This allows the surgeon to account for any natural size asymmetry, which many women have.

Finally, while saline implants can leak, this is very unusual. The manufacturers guarantee the implants for the patient’s lifetime. If a patient is not having any problem with a saline implant, replacement is not necessary regardless of the age of the implant.