Alternative To Silicone Implants?
An alternative to silicone implants has always been saline filled implants which still have an outer shell made of silicone. Saline implants have been in use for decades and are associated with very good aesthetic results. If the implants were to rupture the saline is harmlessly reabsorbed into the body’s circulation without any adverse effects. Another benefit of saline implants is that they can be inserted through a smaller incision on average than silicone filled implants, particularly the cohesive gel tear drop shaped implants which do require a significantly larger incision than smooth round saline or gel implants.
The downside of saline implants is that their rupture rate is likely to be significantly higher than silicone filled implants and when ruptured does occur it results in complete deflation of the breast and the need for surgery if symmetry is desired. Saline implants also have a tendency to more visible and palpable rippling which is far more obvious than with silicone implants, though rippling is a feature of all breast implants.
The surgical approach for inserting implants is a matter of patient and surgeon choice. Generally speaking the inframammary approach where there is an incision placed underneath the breast provide the greatest degree of predictability, particularly with respect to the orientation and location of breast implants. Revision surgery, which is required in many breast augmentation patients eventually, virtually always requires an inframammary incision. Trans-axillary (armpit) incisions are favoured by those who do not wish to have visible scars on the breast and do offer a reasonable opportunity to insert breast implants with a relatively unobtrusive scar. Unfortunately the dissection of the pocket in which the implants are placed through the trans-axillary route is less precise and occasionally results in a less aesthetic result compared with the inframammary approach. In many cases the trans-axillary route is associated with a ‘blind dissection’ of the pocket using blunt surgical dissectors to create the pocket without the opportunity to cauterise blood vessels which are invariably present in the plane of dissection. This has led to issues such as bleeding and haematoma formation as well as the suspicion of a higher rate of capsule contracture associated with residual blood in the pocket.
Trans-Areolar Breast Augmentation
The third commonly used approach for breast augmentation is the trans-areolar (through the nipple) approach. This produces a very aesthetic result from a scarring point of view, however does require a reasonable sized areola in order to provide adequate exposure to perform the surgery safely. Furthermore, the trans-areolar approach is associated with increased damage to the ducts leading to the nipple which can interfere with breast feeding. It is also associated with increased risk to the nipple sensation and potentially a higher infection and capsular contracture rate.
The inframmary approach is the most widely used method of inserting breast implants and is generally associated with the least complications compared to the other two commonly used methods. It does allow the greatest degree of predictability for site, orientation and positioning of the breast implants as well as providing a result where the scars are often barely visible.
For more information contact Dr Mark Hanikeri; www.markhanikeri.com, Ph: 08 93800311.