The surgical enlargement of the female breast (usually) is known as augmentation mammaplasty. This involves placement of a silicone bag either behind the breast tissue or behind the muscle behind the breast tissue. Yes, while most people understand that there are “saline” and “silicone” implants, the actual bag is constructed of silicone rubber, also known as “silastic”. Therefore all breast implants contain silicone. Most implantations now are placed behind the pectoral muscle and are known as “submuscular” implants. There are several good reasons for this, but in short there are fewer problems with this approach, and if there are problems they are easier to take care of. An important consideration involves how the implant is introduced into the body. I prefer a transaxillary approach or through the “armpit”. All things considered, I prefer this method because it does not involve an actual scar on the breast itself. I have used this method for over 32 years and can place virtually any size implant into it’s proper pocket.
A commonly asked question is “what is better–silicone or saline?” In general, silicone more precisely matches the density and consistency of human fat, which is what the breast itself is largely made up of. The principle is simply to replace like with like.
Currently the law prohibits the use of silicone implants in anyone less then 22 years of age, but generally this age group does well with saline implants anyway, because of better skin tone and less problems with sagging.
The procedure is performed under general anesthesia and takes between one and two hours. Some degree of discomfort is normal but is usually much better in three or four days. Complications are not common except for “capsule formation” which we call fibrous capsular contraction and occurs in about ten percent of cases. We still are not clear as to what causes this phenomenon.
I normally suggest a breast enlargement to a “classical ideal” or about a “C” cup size. Whether a woman wants this or a smaller or larger size then this a personal choice and can be discussed.
While a breast augmentation is a simple surgical procedure, there are many complicated facets involved, which are best discussed with the surgeon.