Articles
BREAST AUGMENTATION ADVANCES
The development and research of breast implants has continued. Current implants can be considered the 3rd generation of implants. Changes have been made to not only the manufacture of implants but also to surgical techniques of placement.
The outer surface, envelope or shell of silicone implants is now three layers. This reduces the risk of bleed or leak of the contents. Older implants, even when intact, risked leaking contents through the outer lining. A middle impervious layer has all but eliminated this. Bonding the envelope to the contents reduces the risk of shear between the two components of the implant.
The outer surface was smooth or textured. Microtexturing is a fine textured external surface. This intermediate type combines the advantages of both smooth and textured implants. Scar tissue deposited around the implant, also known as the capsule, can contract with time. Implants become firmer to the feel and then visibly more rounded. Microtexturing is considered to reduce this risk equivalent to traditional textured implants. Handling and placement is easier with the microtexturing. Rough surface layers reduce the risk of rotation of shaped implants.
Remember that saline implants still have silicone in contact with the body. It is only the inner fill that is saline.
The development of more cohesive filling, by cross-linking the silicone, has reduced the risk of silicone leaking or rupturing. The consistency is akin to gel or Turkish delight. Further developments now include form, stable implants. These hold their shape better and have areas of different density and firmness. Precise and specific augmentation is possible.
Higher projection implants enable accurate breast reconstruction using implants. This is particularly important after mastectomy as there is no breast tissue left to drape over the implant. The reconstructed breast size, shape, volume and projection are more dependent on the implant characteristics. By having more variables in implant parameters enables accurate breat reconstruction and matching of the opposite breast.
Refinements in implant placement have developed from the traditional ‘infront of’ or ‘behind’ the muscle. Dual plane techniques combine elements of both – part of the implant being under the breast and part being under the muscle. This is known as dual plane placement. The relative amount of coverage from each can be varied. These are divided into four grades. Dual plane four, may have muscle cover over the very top of the implant to disguise the upper edge of the implant, the rest of the implant is under the breast tissue. Another development is using the fascia over the muscle. Placing the implant below the fascia of the muscle has advantages of both techniques - behind or in front of the muscle.
All these developments including the implants themselves and the surgical techniques of placement allow the surgeon greater and more predictable control of outcomes. Techniques can be specifically suited to individual variations in body size and shape, chest and breast characteristics. A far more natural result is the outcome.