Tag Archives: breast augmentation


Permalink to Breast Implants: Saline or Silicone?

Breast Implants: Saline or Silicone?

Breast  implants used in breast augmentation have been around since the 1960’s.  Over the years, breast implant technology has gotten better and better and breast implants have continued to improve.  So the breast implants currently available are the best in history.  But there are still a number of confusing issues.  The first is silicon or saline?

Silicone breast implants were the most common implants for much of the history of breast implants.  Then about 15 years ago Connie Chung ran an expose which claimed that implants were responsible for all kinds of health problems.  This led to lawsuits a huge windfall for lawyers and the subsequent ban on silicone implants.  Shortly after this, the ban became worldwide.  This lasted for years until more than 100 clinical studies showed that breast implants don’t cause cancer, lupus, scleroderma, or a host of other problems.  Eventually, a federal judge threw out the lawsuits, declaring them junk science and sent the lawyers packing.  This led to the present re-introduction of silicone implants and their approval by the FDA.  Interestingly enough, most of the rest of the world re-introduced them many years ago.

Saline breast implants have always been available and continued to be available as a choice.

Apart from the differences in history and reputation, what’s the actual difference between the two?  Both are made of a silicone shell.  One has silicone gel inside; the other one has salt water.  But how do they act in the body?

Silicone breast implants are softer squishier and move better.  They are less likely to cause wrinkling, rippling, malposition, and sagging.  With larger sizes more than 400 cc silicone implants perform better and are less likely to cause severe sagging.

Saline breast implants are more likely to be felt under the skin because the shell is thicker.  This is not a problem for average or slightly heavier women.  In thin women, this can be an issue.  This also applies to wrinkling and rippling.  If there is enough tissue to cover the implant well then said implants do very well.  The other issue is that when the implant fails, as all implants do eventually, saline implants go down completely within a day.  When silicone implants break, the material stays in the pocket or implant space and allows more time until replacement surgery.

Fortunately now the type of  breast implant used is a woman’s choice.  Her body type and her concerns all influence her choice.  In my practice Advanced Concepts in Plastic Surgery in Sacramento, I have performed breast augmentation surgery on many women who made their own choices of either saline or silicone breast implants and were very happy with the results.


Permalink to Capsular Contracture After Breast Implants, What is it?

Capsular Contracture After Breast Implants, What is it?

Capsular contracture is the most common undesired outcome with breast augmentation. The rates are reported to be as high as 30%. In my practice Advanced Concepts in Plastic Surgery of Sacramento this is roughly 5%. Anatomically capsular contracture is the process of shrinkage of the scar tissue that normally forms around every breast implant. This is usually thin, about the thickness of a sheet of paper. Normally this leaves an enlarged pocket in which the beast implant can move around, or with a textured breast implant a smaller pocket that fits the shape of the implant. However when this occurs the scar tissue shrinks, the implants feels hard, looks distorted, and may even be uncomfortable or painful. Nobody really knows the answer to why some people get it and others don’t, and when they do why is it almost always only on one side and not the other? No one really knows the answers but the solution is coming close. One of the working theories deals with possible mild low-grade infection from the patients skin or breasts. This is because bacteria have been cultured or found in the scar tissue of patients with capsular contracture. Despite using sterile gowns and gloves, and sterilizing skin with content microbial soap, all of the bacteria can not be removed. About 99% are removed but sometimes this is not enough.

Over the years at Advanced Concepts in Plastic Surgery of Sacramento various measures to decrease this exposure have been adopted. These includes our state-of-the-art surgery facility strict attention to sterile technique, better skin preparation as well as rinsing the pocket with Betadine, antibacterial solution, IV antibiotics, no touch techniques, (trying to avoid touching skin) and changing gloves for implant insertion. All of these have been beneficial to a certain extent but the percentage of contracture is still never zero. Research goes on.

So what can be done if someone gets capsular contracture? Recent research shows that a class of drugs called Leukotriene Inhibitors which have usually been used for asthma have been effective in reversing these changes. These drugs include Singulair and Accolate. Another method to help reverse this problem is Low Level Laser Light. This activates cellular energy and seems to help soften the scar tissue especially when it is combined with constant pressure during treatment.

As a last resort a second surgery removing the scar tissue and removing the implant can be done with good results. If done early, this is a simple operation and involves less downtime, discomfort, or recovery than the original procedure.


Permalink to Benelli Breast Lift

Benelli Breast Lift

Benneli Breast Lift

Time, gravity, pregnancy, and breast-feeding all take their toll on the female breast. The youthful and natural shape of the breast loses volume and begins to sag. In fact, for each additional baby a woman has, her breasts will become less full and firm. Over time, many women can even develop flat, or empty breasts.

For many years plastic surgeons have lifted breasts (referred to as a mastopexy). The most common breast lift involves creating incisions on the breast, removing extra skin, and re-suturing the remaining skin tighter. This leaves what is known as an anchor scar, so called because the pattern of incisions that are made resemble the shape of an anchor. There is a circular scar around the areola, a vertical scar down the middle of the breasts from the areola to the breast fold, and a horizontal scar in the breast fold.

In the mid-1980s a French doctor named Dr. Louis Benelli developed a Circular Scar Lift which eliminated all the scars except the circle. I was fortunate enough to be studying in France at the time and learned this technique directly from Dr. Benelli himself. Basically, a circle or doughnut of skin—and only skin—is removed from around the nipple. The nipple always stays attached. The breast is then both lifted and tightened underneath the skin. A pursestring suture is then placed in the doughnut incision and tightened. This lifts the breast and tightens the skin all in one move. Since most women lose volume with age and breast-feeding, an implant is also often used with this particular breast lift technique, returning the breast to its more natural volume, as well as position and shape.

The Benelli Breast Lift is revolutionary because it eliminates 90% of the scarring resulting from previous techniques. Those older, and more scarring procedures understandably discouraged many women from ever getting a breast lift. The scarring from the Benelli Breast Lift is so very minor, and as a result, so much more discreet. The procedure also allows alterations to the areola if desired. During the surgery the areola can be made smaller, or reshaped, or even moved to the left or right. For those who are candidates, the Benelli Breast Lift is an almost ideal operation: minimal scarring for maximum lift and fullness, all done in one simple procedure.

Page 3 of 3123

RSS Beauty Pyramid on Facebook

Do you have questions or need more information? Please contact us!

Your Name (required)

Your Email (required)

Your Phone Number

Subject

Your Message

captcha

Enter the text string above and hit send.

Location Info

  • Andrew Kaczynski, MD

  • Advanced Concepts in Plastic Surgery
  • 77 Cadillac Drive
  • Sacramento, CA, 95825
  • or

  • 9719 Village Center Drive, Suite 110
  • Granite Bay, CA 95746
  • (916) 925-5522