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1. What type of implant? - Saline or Silicone?
Saline is salt water. Silicone is an inert (unreactive) substance which can be a solid, a liquid or a gel. All implants have a solid silicone covering. The difference is in the filling. Silicone filled implants always feel, and often look, more natural than those filled with saline. Saline implants ripple and this can usually be felt through the skin and can also often be visible, especially if the person leans forward. This is known as the ‘waterbed effect’. Saline implants also tend to feel firmer than natural breast tissue. Should they leak, the saline is absorbed by the body and does not cause any health risk. Despite their disadvantages many women are happy with the look and feel of their saline implants.
Modern silicone implants are filled with silicone gel. They feel very similar to natural breasts and they do not usually cause visible rippling. Even though silicone implants look and feel better, women are still anxious about their safety record so it is important to get the facts straight. There are two main differences between the silicone implant of today and the original silicone implants. Firstly the covering or shell is much stronger and therefore much less likely to leak. Secondly, the gel inside is no longer a liquid. All the silicone implants we use contain a cohesive gel which has the consistency of Turkish Delight. Even if the covering ruptures this gel should not leak out.
It was claimed that silicone in the body might cause disease. This has been completely disproved by numerous studies comparing women with silicone implants with women with no implants at all. There is no difference in the disease rates between these two groups.
2.
Incision Site for Breast Implants
The options are in the fold underneath the breast, around the nipple, under the arm or (for saline implants only) via the tummy button. Each approach has its pros and cons and usually a doctor will have a preferred site. Because saline implants are inserted empty and then filled, they need a smaller incision (about 3cm long) compared with silicone implants, which are inserted already filled. The size of the incision for silicone depends on the size of the implant and ranges from 4.5cms to 6.5cms. Typically, scars from implants heal well and should ultimately be a fine, white, barely visible line. The photo shows an incision under the breast in a silicone implant patient six months after her procedure with Dr Fleming.
3. Placement of breast implants
Working from the inside out, on top of the ribs
are the chest muscles or ‘pecs’. On top of these is the breast
tissue then a layer of fat, then the skin. Implants can be placed either
under the chest muscles or in front of them but still behind the breast
tissue. Since in both cases the implant is behind the breast tissue there
should be no interference with subsequent breast-feeding. There are advantages
and disadvantages with both placement sites. For example, a saline implant
in front of the muscle is more likely to have visible rippling than if
placed behind. This is because if it is behind the muscle there is more
of the patient’s own tissue between the implant and the skin to
conceal it. This is especially important in thin women with the saline
implants. An implant placed under the muscle will generally have a more
gradual ‘take off’ at the top edge of the implant giving a
smoother silhouette and minimising the very round tennis ball appearance
often seen on TV’s Baywatch. Some patients benefit from a special
technique called "dual plane" in which the implants are placed
half under and half in front of the muscle. Click
Here to view an article written by Dr Fleming in the Cosmetic
Surgery Magazine which explains more about this. Also you may wish to
view patient number 8 in the gallery to learn more about the dual plane
technique.
Dr Fleming offers all types of placements and will listen carefully to
the description of the look you want and advise on which placement will
be most likely to give it.
