Tips on Decisions

For Your Breast Augmentation

Dr. Loftus suggests the following tips to her patients and has found that her patients experience a very low rate of revision surgery compared to the national average.

• When trying to decide between silicone and saline, remember this: silicone implants look and feel more natural than saline. Saline will likely have a lower rate of capsular contracture, impose a shorter scar, cost less, and not create the potential concern over silent rupture. Once you identify the issue that is most important to you, you can make your decision based on that. Unfortunately, you can’t have it all. To help you sort through this important issue, be sure to visit the advantages of saline and silicone breast implants in great detail, as well as Dr. Loftus’ advice on whether you should go with saline or silicone.
• When considering under versus over the muscle, remember that most long-term benefits are with under the muscle: lower rate of capsular contracture, nipple numbness, displacement, interference with mammography, wrinkling and rippling. Long-term aesthetics of the upper half of the breast are also more favorable for most women. The main disadvantages are distortion of the breasts when flexing pectoral muscles and increased discomfort and swelling during the post-operative period. Read more details about over versus under the muscle.
• Round implants are appropriate for most women. Compared to teardrop implants, they provide an aesthetically similar result, do not restrict options regarding implant surface, obviate the potential problem of implant rotation, and cost less.
• Request overfilling (if you choose saline implants) to reduce the risk of deflation, rippling, and sloshing. The best strategy here is to decide upon a final size (in cc or ml). Then, your plastic surgeon can select an implant that, when over-filled, matches the volume you desire.
• Do not expect tight cleavage if your breasts are widely separated and you choose subpectoral augmentation. Implants do not change the position of your breasts—only the volume.
• Anticipate that small breasts with saline implants will tend to look and feel somewhat stiff. If this is not acceptable, consider silicone implants.
• Women whose mother or sister had breast cancer should recognize that they are at increased risk for breast cancer and that implants do interfere with mammography. These women should have their implants placed below the pectoralis muscle, which poses least interference.
• Women unwilling to accept the potential loss of nipple or breast sensation should not have breast augmentation.
• Women unwilling to accept the potential need for further surgery should not have breast augmentation. Read about why you may want or need revision breast augmentation surgery.
• Above all, do not underestimate the importance of selecting the best size for you. Dr. Loftus feel that regardless of what size you seek, getting the size right for you is among the most important decisions.