Breast Augmentation (Breast Implants)
- No scars on the breast or chest wall
- A natural feel and look
- Dr Fox has been doing breast augmentation since 1986
Breast augmentation is the aesthetic enlargement of the breasts, usually with prosthetic devices known as breast implants. It has always been one of the most common cosmetic procedures, and it remains so today. Dr. Fox was trained many years ago by Tom Stephenson, a Los Angeles surgeon who at that time was President-elect of the American Society Of Cosmetic Breast Surgery. Stephenson was one of the pioneers of the transaxillary approach of breast augmentation.
This technique is the insertion of the implants through a crease in the armpit. This technique is more difficult for the surgeon to master, but is worth the extra training since it leaves no scar on the breast or the chest wall.
This technique is particularly sought after by Asian women because of their tendency to scar badly.
What are breast implants made of? And what are the different types?
Materials ~ All implants have a solid silicone shell (cover). The content can be silicone or saline (salt water).
Prior to 1994 the silicone was a liquid, and occasionally produced associated problems. Since 1994 the silicone content has been a cohesive gel which cannot cause problems by leaking into the surrounding breast tissue should the shell develop a defect. At the same time the shell quality was improved. Silicone gel implants are by far the most popular, both with surgeons and patients.
Saline implants do not drape as well as well as gel implants and have the potential to leak from the filling valve.
Polyurethane coated implants (also known as ‘Furry Brazilian’) are made by coating a silicone gel implant with polyurethane. The first ones were produced 20 years ago and caused problems. The more modern PCIs’ do not have the problems of the original ones, but are the most difficult implant to manipulate (insert) into position. Also, the variety of size and shapes available is restricted compared with other implants.
Shapes~ The two basic shapes are round and anatomical (tear drop). Round implants are dome shaped and simulate a normal breast in the horizontal position and with the effect of gravity on standing produce a ‘classical’ breast shape. They are overwhelmingly the most popular implant.
Anatomical implants are made of a firmer cohesive gel and are breast shaped. They have limited popularity because of their potential to rotate. Other problems are; the necessity of a 6cm incision in the crease beneath the breast in order to insert them.
With a person in the horizontal position the shape can resemble that of a breast when standing, this can appear unnatural.
Shell surface ~ This can be either smooth or textured. In production a textured surface is produced by a fine ‘roughening’ of the smooth surface. They were devised to reduce capsular contracture (see below). It is still debated whether they achieve this aim. A recent study seems to refute any advantage they have over smooth surfaced implants in this regard.
Size and Projection ~ Most women prefer significant enlargement and yet a natural appearance. Depending upon the make of the implant there are several available projections ranging from low to very high. The projection for any particular person depends on their anatomy and their perception on their final appearance. This is discussed at length during the consultation.
Where is the implant placed in relation to the muscle?
Placement of the implant can be either in front or behind the pectoralis major muscle. The anatomy of some women allows placement in either of these planes, whereas in some women there is a strong indication there is a strong indication of one of these planes but not the other.
If there is significant breast ptosis (sag) then placement behind the muscle can produce an unnatural double fold in the lower part of the breast, a natural breast producing one curvature and the implant another. This is the so-called ‘double bubble’ effect.
If there is extremely small breast volume, than placement in front of the muscle (behind the breast itself) can produce an unnatural curvature to the top of the breast. That is, the shape of the implant itself becomes more evident.
It is said that capsular contracture is less common with implant placement in the plane behind the muscle.
How safe is breast augmentation?
Modern day silicone gel implants have a good safety record. The earlier silicone gel implants, prior to 1994 contain liquid silicone (not gel) and had a thinner cover (shell). These two features of the earlier implants occasionally caused problems. The newer silicone gel implants can not leak there contents into the breast tissue if the shell of the implant develops a defect.
The claim in the early 90’s that implants were associated with various body disorders is now known to be untrue (backed by extensive research).
These days, the combination of technically sound implants, together with their lack of potential to cause body disorders makes modern day implants a safe device.
To a large extent safety then depends upon the experience, technical skill and care of your surgeon. The only potential problem that is unpredictable and to a large extent out of the hands of your surgeon, is the occurrence of capsular contracture (see below).
What is Capsular Contracture?
This is a most common problem to spoil an otherwise good result. Minor grades are not uncommon but cause no significant problem. Fortunately, major grades are far less common.
The body treats every implant as a foreign body and surrounds it with a layer of collagen to isolate it from the rest of the body. Within a matter of a few weeks this becomes a complete thin but strong layer surrounding the implant. This capsule usually remains thin or at most becomes a little thickened without causing any significant problems.
It is only when this capsule thickens that it causes an undesirable change in the feel and appearance of the breast. At its worst the patient would want the capsules removed. The implants are usually replaced at the same time. The occurrence of major grades of capsular contracture is usually unpredictable. It is believed that irritation of the capsule by anyone of a number of factors causes the thickening. There is also a genetic factor.
Important in its prevention is meticulous attention to sterility at operation, the vigorous but appropriate use of antibiotics at operation and the removal of debris from the pockets made for the implants.
Why do women seek breast enlargement
“I don’t feel very womanly, because of my small size”
“My small size prevents me from wearing the clothes I would like to”
“I’d like to be the size I am when I wear a padded bra”
“I want to feel comfortable in a bikini”
“Breast enlargement will allow me to have a cleavage”
“I want to get the breasts back that my beautiful children took away from me!”
“I want to have the breasts I had before they shrank after breast feeding”
“I don’t want to look like ‘Pamela Anderson’, I just want to be in proportion and look natural”
Before & After Gallery
Please note that all the Photographs below are actual patients of Dr.Bruce fox and the photographs have not been enhanced or altered in any way. This is the only change which has occurred. For more information about Breast Augmentation please contact Dr Bruce Fox’s rooms.