What is Breast Augmentation?

Breast augmentation remains one of the most popular plastic surgery procedures to date, particularly in Santa Barbara.

This procedure is done to enhance the size, symmetry and shape of the breasts using silicone or saline implants.

Women choose breast augmentation for a variety of reasons. Some are dissatisfied with the shape and size of their breasts; others seek breast augmentation to improve their appearance after weight loss, surgery or pregnancy. Whatever your reasons, it’s important to choose a surgeon that can pay close attention to your unique concerns, is certified by the American Board of Plastic Surgery and has a good track record.

As one of his particular specialties, Dr. Lowenstein places great importance on preoperative patient education. He will spend as much time as needed during your consultation to ensure you have a thorough understanding of your options as well as the decisions that go into producing an exceptional postoperative outcome.

Type of Breast Implants

Saline Breast Implants

Saline implants have an outer silicone shell filled with a saline solution similar to IV fluid, making it compatible with your body and safe in the event of a leak. Another advantage of this type of implant is that they can be placed through a relatively small incision. Saline implants are inserted empty into the breast, then filled with the saline solution — much like inflating a water balloon. A potential downside of saline implants is their tendency to ripple in the lower part of the breast. This is why Dr. Lowenstein usually recommends them to women with significant breast tissue that can help disguise the rippling. A saline implant rupture can be noticed when one breast seems smaller than the other. If this occurs, it is important to be seen by Dr. Lowenstein as soon as possible so the tissue does not shrink around the deflated implant, making it harder to achieve symmetry when the implant is replaced.

Shaped Silicone Breast Implants

Shaped implants are the newest type of implant to become available. In their early days, they enjoyed a vigorous marketing effort as the newest and “best.” Now, as they have lost some of their luster, shaped implants are primarily utilized in breast reconstruction following mastectomy. They are also a good aesthetic option for some patients, and Dr. Lowenstein’s experience with all types of breast implants will allow him to help you decide if these are right for you. Like smooth round silicone implants, shaped silicone implants also come with a low risk of rupture and capsular contracture (hardening of scar tissue around the implant). The teardrop shape and textured outer surface help these implants stay in place, which can be advantageous for women who prefer a firm look and feel and for those who have a little bit of drooping. Shaped implants require a larger incision for placement but can be an excellent choice for the right candidate.

Round Silicone Breast Implants

The mainstay of breast augmentation, round silicone implants come pre-filled with medical-grade silicone. The newest silicone implants offered by Dr. Lowenstein are also referred to as “gummy,” as they have higher “cohesivity,” meaning that the silicone is more like gelatin than liquid. The main advantage of smooth, round silicone implants is their soft feel and motility that closely resembles natural breasts — the primary reasons why so many women prefer them over saline implants. The round shape is also beneficial for women who desire enhanced cleavage or fullness in the upper pole. The FDA recommends MRI scans every other year for women with silicone implants to monitor for “silent ruptures.” When a rupture occurs, there is no emergency, but a call or consultation with Dr. Lowenstein is recommended to formulate a plan. Silicone implants also come in a textured form, but because of their less natural feel and appearance, as well as some other issues that he can discuss with you, Dr. Lowenstein usually prefers the smooth round type of silicone breast implant.

The IDEAL IMPLANT^®

This structured saline implant blends the safety of saline implants and the natural feel of silicone implants into one product. The IDEAL IMPLANT® has a series of implant shells nested together and two chambers that contain the saline. This unique structure controls movement of the saline and supports the implant edges to reduce rippling and folding. In addition, the IDEAL IMPLANT® is designed to contour to the natural curve of the chest wall, producing the most natural-looking (and feeling) breasts. The IDEAL IMPLANT® is a high-profile implant that is best for women desiring a very full appearance from their breast augmentation.

Questions about these different types of breast implants? Contact us today or call 805-969-9004.

Choice of Breast Implant Pockets

Subglandular Pocket

When an implant is placed over the pectoral muscle and behind the breast tissue, it is in the subglandular pocket. This position helps add volume in the lower region of the breast behind the nipple. It may also be a good option for women concerned about drooping and deflated breasts. The recovery time is usually shorter with this placement. However, breast implants placed in this position have a higher incidence of hardening. They are also more easily seen and felt without the muscle tissue aiding in covering the implants. This placement is only suitable in some cases.

Submuscular Pocket

When an implant is placed in the submuscular pocket, it lies behind the pectoral muscle. This is a commonly utilized implant technique that comes with many advantages. For example, this position reduces the risk of implant hardening and gives the breasts a more natural look and feel due to the extra muscle coverage over the implants. This position tends to result in a higher riding breast implant. In rare cases, the natural breast tissue can droop over the implant, causing a complication called “double bubble.”

Dual Plane Pocket

The dual plane technique combines the best of submuscular placement with the best of subglandular placement. With the dual plane pocket, most of the implant is placed under the pectoral muscle. However, the surgeon releases some of the tissue in the lower breast, allowing the bottom of the implant to better fill out the apex of the breast. This results in a slightly lifted but natural teardrop look that so many patients want.

This is the preferred breast implant position for the majority of Dr. Lowenstein’s patients. Although it requires more expertise on the part of the surgeon, the natural appearance that Dr. Lowenstein achieves with the dual plane pocket is why he is sought out for breast augmentation by so many women.

FAQs

Is it painful?

Breast implant surgery leads to short-term discomfort that is easy to manage with medication. Dr. Lowenstein also routinely administers long-term anesthetic medications inside the breast to further minimize postoperative discomfort.

When do breasts stop changing size?

Breast size stabilizes after puberty. However, changes in weight, hormones and aging can affect breast size throughout a woman’s life. Pregnancy, breastfeeding, menopause and hormonal fluctuations are other causes of short-term and long-term changes in breast size. Surgical breast enhancement is possible for most stages of life, but it should be held off in young women at least until initial breast growth is stable following puberty.

Can I exercise after having breast implants?

Dr. Lowenstein recommends postponing strenuous exercise for at least a month following surgery. Postponing exercise helps minimize the appearance of scars and aids in proper wound healing. After that time, there’s no reason for any of our Santa Barbara breast implant patients to avoid workouts, and that includes professional athletes who have also been our patients.

Why are my friend’s breasts hard?

Hardening of breast implants is often due to capsular contracture. While national rates of this problem can exceed 10%, Dr. Lowenstein’s techniques have resulted in rates below 3%. Dr. Lowenstein’s high success rate in preventing this complication is due to his careful technique, special incisions and a new technology called the Keller Funnel.

Do breast implants rupture?

Like any medical device, breast implants can fail with time. Ruptures of the outer shell of the implant lead to leaking of the saline or silicone filling. In cases of a saline implant rupture, the saline is absorbed by the body, and the breast deflates relatively quickly. With silicone gel implants, the body does not absorb the leaking silicone, and there may not be any outward signs of rupture. This is why the FDA recommends MRI screening for silicone breast implants and not for saline implants. In either case, a replacement can be easily performed.

What is the risk of cancer with breast implants?

There’s no evidence that breast implants increase your risk of breast cancer. However, there is a very small risk of anaplastic large cell lymphoma, most often associated with textured breast implants. This is of the reasons Dr. Lowenstein prefers using safer, smooth-shelled breast implants. For more information about cancer risks associated with breast implants, see our page dedicated to this topic here.

How long is recovery from surgery?

You can resume your normal day-to-day activities, like walking, showering and stretching, within days to two weeks following surgery. Hold off swimming, hot tubs and vigorous exercise for at least three weeks. Dr. Lowenstein will explain what you need to do for quick postoperative recovery.

What is the IDEAL IMPLANT® Structured Breast Implant?

The IDEAL IMPLANT® Structured Breast Implant is a novel device that provides the natural feel of silicone implants but without the use of silicone gel. It is a saline implant with an advanced internal support structure that controls the movement of the saline, providing you with a natural feel and look as well as peace of mind.

Following years of research, engineering, product development and one large US clinical trial, the IDEAL IMPLANT® was approved by FDA and Health Canada. It is now available through a limited network of board-certified or eligible plastic surgeons. The IDEAL IMPLANT® has been in clinical use since February 2009, and by February 2010, 502 women received the IDEAL IMPLANT from 45 board-certified plastic surgeon investigators nationwide.

What is a saline breast implant?

Saline breast implants are medical devices composed of an outer silicone shell filled with a saline solution — the same type used during IV infusions. Women opt for saline implants when their main concern is detecting ruptures. When a saline implant ruptures, the saline solution is quickly absorbed by the body, and the breast visibly deflates within days. A disadvantage of these implants is that they look and feel less natural than other implants.

What is a silicone gel breast implant?

The most popular breast implant is the smooth, round silicone gel implant. It is popular because it feels and moves like natural breast tissue. Its biggest disadvantage is that ruptures may be hard to detect with these implants, so routine MRI screening is recommended every other year. Although silent ruptures rarely cause systemic disease, they may increase the likelihood of excessive scarring, lumps and capsular contracture.

What is a shaped silicone breast implant?

A novel type of silicone gel implant is the “shaped” or “form-stable” breast implant. It has a teardrop shape that creates more fullness toward the bottom of the breast for a natural look. Patients with mild drooping can sometimes benefit from this implant due to its slight lifting effect. Another advantage is its lower rupture and capsular contracture rates compared to other implants. They’re firmer than regular silicone implants and don’t have as much movement, which some patients prefer. Regular MRIs are recommended with these as well.

How do I prepare for my breast implant surgery?

You will see us for a preoperative visit, in which we will review your surgical plan and see if any additional tests are required before surgery. The night before surgery, you should not eat or drink after midnight, and we may ask you to shower with special antibiotic soap right before your operation.

How do I choose which breast implants to get?

The choice of breast implant is a very personal one. Dr. Lowenstein will help you in deciding which option is best for meeting your specific goals. Dr. Lowenstein will carefully review the type and size of the implant as well as the technique that will provide you satisfaction with the end results. At Montecito Plastic Surgery in Santa Barbara, we pay special attention to providing individualized treatments.

Will I lose nipple sensation?

Change in nipple sensation is a rare complication of breast augmentation surgery. Dr. Lowenstein has developed unique techniques that reduce your risk of this complication, including not cutting around the areola, not using sharp instruments in the lateral part of the breast implant pocket and identifying the nerves connected to the nipple region during surgery.

Will I be able to breastfeed with breast implants?

Breast implants should not have any effect on your ability to breastfeed. If you were able to breastfeed before your surgery, you should have no problems breastfeeding after your breast augmentation.

How long will it take to recover following breast augmentation?

Recovery time will depend on your lifestyle, work and pain tolerance. Breast augmentation involves some postoperative discomfort, which is why we recommend not lifting anything heavy (5-10 lbs) and avoiding strenuous exercise in the weeks following surgery. You will also need to avoid baths and swimming until your incisions are completely healed. The most uncomfortable part of breast augmentation recovery is usually the day after the surgery, and pain most often improves rapidly thereafter.

Can I have other procedures done at the same time as my breast augmentation?

Yes! Dr. Lowenstein offers double or triple procedures to many of his patients. The mommy makeover — a tummy tuck plus breast augmentation — is one example of such a procedure performed at Montecito Plastic Surgery in Santa Barbara. We also offer breast lifting in conjunction with breast augmentation plus a mommy makeover. We also offer facial procedures with breast augmentation or liposuction with breast augmentation. You will learn whether you’re a good candidate for these procedures during your consultation.

How long does breast augmentation surgery take?

The surgery should take 45 to 60 minutes. However, the entire procedure also involves preparation, anesthesia, waking up and recovery time, which adds an additional two to three hours.

What can I expect right after my procedure?

Breast augmentation operations are performed on an outpatient basis in Dr. Lowenstein’s Montecito Plastic Surgery Center in Santa Barbara. If you live out of town, Dr. Lowenstein may ask you to stay overnight so any questions you have the following day can be answered.

Do I need to replace my implants every 10 years?

Breast implants only need to be replaced when there is a problem with them. Routine MRI scans done every two years help rule out “silent ruptures” in silicone implant patients. Those with saline implants can easily tell a rapture has happened if one or both of their breasts have deflated. In both cases, implants need to be replaced. You may also require replacement if the look and feel of your breasts has changed and is not satisfactory.