While most patients conduct online research on the procedures they are interested in before coming in for a consultation, some breast augmentation candidates at my Dubai practice are surprised by the number of factors to consider when planning their plastic surgery.
Aside from the obvious choices for implant size and projection, there are a few other factors to consider.
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Size
This is probably the first and most common question we get during a breast augmentation consultation. The appropriate implant size is primarily determined by each individual’s anatomy, so it varies for each patient! It is critical to consult with a surgeon who understands the complex interactions between existing breast tissue and a new implant. This enables implant selection to produce beautiful, elegant, and long-lasting results while reducing the risk of complications. A Tissue-Based Paradigm takes into account relevant aspects of the patient’s anatomy, such as chest base width and breast tissue subtype, when making decisions.
Shape
Breast implants can be round or “shaped” (like a teardrop). Shaped implants were initially developed for breast reconstruction candidates to provide an implant option that mimicked the natural slope/tapering (with increasing projection from top to bottom) of most breasts prior to surgery, but they are now also used by cosmetic augmentation candidates.
Both types have advantages and disadvantages. Teardrop implants may appear more natural to many women, but they may require a slightly longer incision and appear unusual if rotated within their breast pocket.
Round implants may be preferable for patients with smaller breasts at the top who would benefit from increased upper pole volume. Their shape also helps to reduce rotational issues.
Furthermore, newer gel types that are considered cohesive or “gummy” allow for varying levels of gel firmness in a round shape, allowing us to better match the ideal implant to the patient’s skin and tissue types.
Shell
Round implants can have either smooth or textured shells. Teardrop implants are typically designed with textured shells that encourage the formation of scar tissue, which helps to keep the implant in place. Smooth implants are commonly used for primary augmentation, giving the procedure a natural feel.
Filling
Never assume that breast augmentation with implants is a one-time procedure. Breast implants can last for a long time and have a low risk of rupture, but they are not permanent. Modern implants can last over a decade before needing to be replaced. Breast implants are made of silicone shells that are filled with either saline (sterile saltwater) or silicone gel. Saline implants were once more popular, but this has changed dramatically with the introduction of newer generations of silicone gel implants, which can provide an increasingly natural feel and contour while also lowering the risk of ripple and wrinkle deformity.
The majority of patients prefer “gummy” or “gummy bear” silicone breast implants, which are named after the solid-state gel and have a more natural appearance and feel. Even if their shells rupture, the likelihood of leakage is greatly reduced due to their ability to retain their shape.
Saline implants can be inserted using a broader range of surgical techniques because they do not require a long incision; after insertion, an empty shell can be filled with saline. Silicone implants come pre-filled and require a slightly longer (but still tiny!) incision to create an opening for insertion.
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Incision And Insertion Method
The placement of surgical incisions for implant insertion is determined by the patient’s concerns and characteristics, as well as the type of implant to be used (as previously stated).
There are four main areas where incisions can be made.
- A periareolar incision is made around the areola.
- The inframammary incision is made beneath the breast in its crease.
- A transaxillary incision is made in the armpit, while a transumbilical incision or tuba (transumbilical breast augmentation) is made at the belly button. Pre-filled implants cannot be used with this method.
Current research and data support the use of the first three techniques mentioned. However, some evidence indicates that the inframammary approach is the safest way to reduce the risk of capsular contractures. As a result, this is the most commonly used approach in my practice.
Implant Pocket
The Implant Pocket is where the implant will be positioned in relation to the mammary gland and the chest muscles. It is an important part of the procedure because it affects both appearance and function.
- Subpectoral or submuscular implants are placed partially or completely under the chest muscle (also known as the “Dual Plane” technique, developed where I trained).
- Subglandular implants are inserted between the chest muscles and the mammary gland.
- Subfascial implants are also placed between the muscle and the gland, but the fascia (the thin layer of connective tissue above the muscles) is lifted to rest on top of them.
Breast augmentation results can vary greatly between patients. While the number of factors to consider may appear to be overwhelming, the procedure has one of the highest patient satisfaction rates and is consistently one of the most popular cosmetic surgeries in Dubai.
Silicone Gel Implants: Composition, Feel And Benefits
Modern silicone gel implants provide a remarkably natural appearance and feel, a significant improvement from their initial introduction. The silicone elastomer shell of these implants is filled with a cohesive silicone gel that closely resembles the consistency of natural breast tissue.
The composition of silicone gel implants is contingent upon the manufacturer and generation. The gel in today’s fifth-generation cohesive gel implants, which are sometimes referred to as “gummy bear implants,” is more form-stable and thicker, and it maintains its shape even when cut or compressed. This cohesive property ensures that the gel does not migrate or leak in the event that the implant shell is compromised, thereby addressing historical safety concerns.
The primary advantage of silicone gel implants is their natural movement and sensation. The gel’s viscosity is strikingly similar to that of human fat, resulting in a breast that is both soft to the touch and maintains its natural movement patterns. Silicone implants are particularly well-suited for women with minimal breast tissue, as there is less natural tissue to conceal the implant. This is due to their realistic quality.
Additionally, silicone implants provide aesthetic benefits, such as:
- In comparison to saline alternatives, there is less discernible wrinkling or rippling.
- Increased natural contouring and sloping, particularly in the breast’s upper pole
- Improved projection maintenance over time
- Available in both round and anatomical (teardrop) shapes to achieve personalized results
Advanced surgical techniques enable the placement of discreet scars, despite the fact that silicone gel implants necessitate a slightly larger incision for placement. The pre-filled nature of these implants also guarantees precise volume and symmetry, as the manufacturer determines the exact size rather than filling during surgery.
It is important to mention that silicone implants necessitate routine monitoring, typically conducted every few years through MRI or ultrasound scans, to detect “silent ruptures” in which the cohesive gel is contained within the surrounding tissue capsule but the shell breaks.
Saline Breast Implants: How They Work And Advantages
Saline breast implants provide a simple yet effective method of breast augmentation. A silicone elastomer shell is inserted into the breast pocket empty and subsequently filled with sterile salt water (saline) during the procedure. These implants are composed of this material. In the comparison of saline and silicone implants, this distinctive filling method offers a number of distinct advantages.
In comparison to their silicone counterparts, the insertion process for saline implants typically necessitates smaller incisions, often measuring only 3-4 cm. Surgeons have the ability to place these smaller incisions in less conspicuous locations, such as the armpit, in the inframammary fold, or around the areola, which results in less visible scarring. The surgeon fills the implant to the desired volume after it has been positioned, allowing for minor adjustments during the procedure to optimize symmetry between the breasts.
The primary benefits of saline breast implants are as follows:
- Safety profile: The saline solution is safely absorbed by the body in the event of a rupture.
- Visual deflation facilitates the immediate identification of rupture.
- Lower age requirement (FDA-approved for women 19+ versus 23+ for silicone)
- Potential for scarring and smaller incisions
- Fine-tuning symmetry through volume adjustability during placement
- In general, silicone alternatives are more expensive.
Women who have moderate breast tissue that can conceal the implant edges may find saline implants to be particularly advantageous. In addition, they are an exceptional choice for patients who value the convenience of easy rupture detection, as the breast will undergo a discernible reduction in size in the event that the implant shell becomes compromised.
Modern saline implants have also undergone evolution to address certain historical concerns. For instance, structured saline implants are equipped with internal baffling that regulates the saline’s movement, thereby mitigating the risk of rippling that occasionally occurs with conventional saline options and resulting in a more natural feel.
Best Plastic Surgeon In Dubai For Breast Augmentation
Best Plastic Surgeon In Dubai for breast augmentation is available at Perfect Doctors Clinic, where patients receive expert advice on all of the important factors to consider. From implant size, shape, and placement to recovery time and long-term outcomes, the Clinic’s top plastic surgeons provide personalized consultations to ensure that each decision is tailored to your body and goals.