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The UCLA Division of Plastic & Reconstructive Surgery

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Breast Implants

A breast implant is a silicone shell and is similar to a balloon filled with either silicone gel or a salt-water solution known as "saline". Implant reconstruction is designed to recreate the original breast shape and contour.

A component of the mastectomy is to remove the nipple and areola (the pigmented portion of the skin). The removal of this skin and tissue often times does not leave enough volume to accommodate the breast implants. Therefore, in order to allow for the placement of the implants, the skin and tissue must be expanded, or stretched. This is done by placing an expander, or a deflated silicone "balloon", under the remaining skin and chest wall muscle (the pectoralis major). The skin is then closed without tension and allowed to heal for a few weeks.

Once the incisions have healed, the expander is slowly inflated through a series of injections through a small port under the skin. This is done over a period of several months, using a small needle and syringe through the skin. After the expander has been completely filled, the expander can be replaced with the final implants. This requires an additional surgical procedure, usually under anesthesia, in an outpatient setting.

Download PDF - Read more about breast reconstructionAlthough most patients are pleased with the improved appearance of their breasts due to the implants, this reconstructive method does present several fundamental limitations and problems. The implants, being placed so close to the skin, are almost palpable -patients can feel the texture of the implants, the folds, rippling. In addition, sometimes, the implants become infected, exposed, or require replacement due to a sudden or gradual deflation due to normal wear and tear on the implant itself with a subsequent failure of the implant. Finally, all foreign bodies placed within the body will be associated with some type of scar tissue development. The degree of this scar tissue and its ability to contract will be different for each person and may cause "capsular contracture" or a distortion of the breast shape.

While implants have been used to successfully augment (or enlarge) breasts for greater than 20 years, the results for reconstruction are, in general, not as good. This is due to the differences in the amount of body tissue overlying the implant and your body's reaction to foreign material. In augmentation, the implant is placed under the breast, or oftentimes under the breast AND the chest wall muscle (pec major) to provide the increase in breast volume and projection. Once the implant is in place, the body will recognize the foreign material and develop a scar around the implant.

The actual thickness of this scar (or capsule) will vary from person to person and will be more or less noticeable depending upon the thickness of the overlying breast tissue. Since the mastectomy will remove most of the tissue from the under-surface of the skin, the thin nature of this skin coverage may not be able to mask or hide any of the contour changes associated with implants. This means that the texture of the implant (envelope characteristics, ripples, folds) may be felt through the overlying breast tissue.

Despite these problems, breast implants remain the most common reconstructive technique performed in the world. They provide a reasonable facsimile of a breast with no other scars, minimal operative risks, and quick operating times.

What are the effects of radiation therapy on implants?
Problems and complications with breast implants are significantly increased with radiation therapy. In general, if one requires or has had radiation therapy, the use of breast implants should be discouraged unless there are no other options and both surgeon and patient understand the higher complication rates.

Los Angeles plastic surgeons from UCLA Plastic Surgery offer all aspects of plastic surgery including breast lifts, breast augmentation, breast reduction, information about breast implants, breast reconstruction, and more. View before and after photos of these plastic surgery procedures, learn more about cosmetic surgery and schedule a consultation today.

These Los Angeles plastic surgeons serve areas throughout Southern California. Read about Timothy Miller, Henry Kawamoto, Jaco Festekjian, Andrew Da Lio, James Bradley and Prosper Benhaim and Christopher Crisera Jay Granzow and J. Brian Boyd.

Contact our plastic surgeons about saline breast implants and silicone breast implants today.

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