Breast Implant vs. Butt Implant

Some women wish to enhance the size of their breasts, others wish to enhance the size of their rear end, and others want both. Buttock augmentation, also known as butt implant or gluteoplasty is a type of enhancement procedure very similar to breast implants. It involves the surgical insertion of artificial implants into the buttocks in order to enhance their size and shape. The incision is usually made in the buttock crease, where scars are not noticeable; although this area does carry a high infection risk. The doctor then creates a pocket large enough to insert the implant. Like breast implants, butt implants can be placed under or on the top of the muscle—submuscular and subglandular breast incision respectively; although, most times surgeons have opted to place implants above the sitting area in order to keep patients from sitting on them and thus reducing the risk of implants shifting and asymmetry. (http://www.americanhealthandbeauty.com/plastic%20surgery/procedures/Buttock%20Augmentation/ )

For any patient horrified with the thought of putting and unknown substance into the body such as myself, Buttock augmentation is just as terrible as breast augmentation. Buttock augmentations, however, do give another option besides placing silicone implants, and that is the Brazilian butt lift. In earlier blogs I talked about ‘on-course’ approaches for breast implants such as the micrografting of stem cells; well, somehow, scientists did discovered a way to use a person’s own fat to enhance rear ends. In using the grafting technique, the patient not only is able to use their own fat cells from their own body, but they in turn are able to have a modified liposuction for in order to perform this surgery, fat from areas of the body such as the back, abdomen, hips, and thighs must be removed through liposuction. Minor complications are associated with this type of butt augmentation; therefore, the major factor one must worry about would be financing because this procedure can range from $6000 to $15,000.

***NEWS The World’s Largest Breast Augmentation

I’m seriously not sure whether or not this is real image, but apparently this woman in the picture below has implanted the biggest implant size in the world of 1200cc. The volume of a breast implant is measured in cc where thirty cc equals 1oz, and the typical sizes are between 275cc and 800cc. Many women are nowadays are not only unaware of the risks associated with the procedure of breast implants, but also with disadvantages of large size implants. They seem to forget that large breasts can not only limit their freedom of movement and lead to back pain and headaches, but they can also increase chances of exposing them to all the risks related to breast implants.

(http://www.breast-implants-info.com/breast-implants-news/the-worlds-largest-breast-implants.html )

Techniques Used for Liposuction

Several techniques are used to for doing liposuction, tumescent liposuction, dry and wet techniques, ultrasonic assisted liposuction (UAL), and power assisted technique (PAL).

1. Tumescent Technque--this procedure takes about 4 to 5 hours, and consists in large amount of fluids (three times the amount of fat to be removed) into the targeted tissue thus making it swollen and firm, or tumescent. It is said that with tumescent local anesthesia, patients are able to avoid the post-operative nausea and vomiting associated with general anesthesia.

2. Dry Technique—this procedure is not in frequent use today because of the excessive blood loss it can cause. It consists in removing fat without any type of local anesthesia.

3. Wet Technique— this technique requires the injection of approximately 100 milliliters of local anesthesia containing epinephrine. Although the wet technique causes less blood loss than the dry technique, blood loss with the wet technique was still excessive and dangerous.

4. Super Wet Technique— in this technique, lesser amounts of fluids are used compared to tumescent. Usually the amount of fluid injected is equal to the amount of fat to be removed. It is performed under general anesthesia and takes one or two hours of surgery time.

5. Ultrasonic assisted liposuction (UAL) — this technique uses a special tube that produces ultrasound energy. As the tube passes through the fat areas, the energy ruptures the fat cell wall which then liquefies the fat. The fat is removed by a suction pump.

6. Power assisted technique (PAL)—this technique is performed in conjunction with the tumescent technique, and it uses a suction tip vibrating at a rapid speed. This causes the fat to easily dislodge from surrounding tissues so that it may be suctioned away gently and quickly.

(http://www.liposuction.com/ )

Breast Implants vs. Liposuction—RISKS

Just as breast implants, liposuction presents minor risks as well as severe (but rare) complication. The common risks include hematomas, skin necrosis (death of the affected skin), hyperpigmentation of incision sites, swelling, and among others rapid heart rate which can be caused epinephrine (adrenalin) which is an essential ingredient of the tumescent local anesthetic solution, by medications containing ephedrine-like drugs often found in nasal decongestants such as Sudafed or pseudoephedrine. (http://www.liposuction.com/safety/common_minor.php )

Comparing to breast implants, liposuctions are not associated with a great number for severe complications; nevertheless, they can cause blood cloths that can travel to the lungs, injury of nerves, blood vessels, muscles, lungs, and of abdominal organs following penetration of the abdominal cavity by a liposuction cannula; excessive IV Fluids can cause total body fluid overload, grave infections, and cardiac arrest which can be cause by a dangerous fall in the body's temperature (http://www.liposuction.com/safety/rare_severe.php ).
There has only been encountered one death in every 5000 cases of liposuction.
(http://www.liposuction.com/faqs/complications_risks.php )

Breast Implants vs. Liposuction

Liposuction and breast augmentation are the most prevalent body contouring procedures. The most commonly used options for beautifying one’s body. I personally I’d rather take than put.

Nevertheless, liposuction, also known as lipoplasty, is a surgical procedure that improves body shape by removing excess fat and skin from the lower abdomen and tightening the muscles of the abdominal wall. . Liposuction involves the use of a small stainless steel tube, called a cannula (tube), and it is performed through small, inconspicuous incisions. The procedure begins by infusing a sterile liquid solution to reduce bleeding and trauma. Then a thin hollow tube, is inserted through the incisions to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the tube. The entire procedure may last an hour or less, depending on the areas to be suctioned.
( http://www.emedicinehealth.com/liposuction/article_em.htm )

Several techniques are used to for doing liposuction, tumescent liposuction, dry and wet techniques, ultrasonic assisted liposuction (UAL), and power assisted technique (PAL); and most those techniques can be used to remove fat from abdomen, thighs, arms, back, breast, face, pretty much anywhere in the body.

( http://en.wikipedia.org/wiki/Liposuction )

Figure 1. Different Body Areas That Can be Liposuctioned.

(http://www.plasticsurgery.org/patients_consumers/procedures/Lipoplasty.cfm?CFID=91124401&CFTOKEN=22612300#six )

Costs of Implants

According to the American Society of Plastic Surgeons, breast implant prices average from $4,000 to $10,000 per procedure depending upon several factors:

1. Type of procedure. Depending on the incision type and placement the average cost can range from depending on factors such as: choice of surgeons, type of procedure, type of anesthesia, and type of implant.

2. The surgeon. The plastic surgeon's training and skill are important factors in the cost. The most qualified surgeons who have performed extensive surgeries typically command a higher fee which ranges around $4000. There is no guarantee, however, that a surgeon who charges higher prices will be more qualified than a surgeon who offers the same procedures for less money; thus, patients should probably just choose the doctor who performed more implants before and who the patients are most comfortable with.

3. Anesthesia. General anesthesia (you are asleep) is more costly than a local anesthetic (you are sedated but remain awake), and it can range from $600 to $1000.

4. Incision type and Procedure. The type of breast surgery also influences cost for there are some implants techniques are easier and less time consuming.

5. Facility. There are some facilities that cost more than others, and they can range from $1000 to $2000.

Other Concerns—Breast Implants on Teens

In addition to the safety issues that I mentioned earlier, there is concern about the growing use of breast implant among adolescents. According to the American Society of Plastic Surgeons, more than 333,000 adolescents 18 years of age or younger underwent plastic surgery and cosmetic procedures in 2005, and most of the procedures were breast augmentation.

Breast implant is now a trend among teens across the globe. Enough with a new wardrobe, the latest computers, and/or the newest car model; they now want breast implants. And unfortunately a lot of them are getting it; thus, raising concerns even to the authorities. According to an article by Saul Hudson, Venezuelan president Hugo Chavez had to step down against giving teenagers breast implants as any type of gift. He calls it the “ultimate degeneration,” which I totally agree. There is already a great number of risks involved with breast implants, now lets add breast implant on patients whose bodies haven’t even matured yet. There are no legal restriction on breast implant procedures on American teens; however the Food and Drug Administration's (FDA) does recommend it against women under age of 18.

http://www.reuters.com/article/latestCrisis/idUSN24250042

http://www.plasticsurgery.org/public_education/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=17849

FDA and Breast Implants

The U.S. Food and Drug Administration (FDA) removed silicone breast implants in 1992 because of insufficient proof for safety presented by the implant manufacturers. However, due to the public need for implants (mainly from breast reconstruction patients), the FDA allowed some companies to continue research on the use of silicone implants for breast reconstruction and revision patients. Between 1992 and 2005, silicone breast implants were used for patients enrolled in investigational studies, reconstructive patients, and could not be marketed commercially to the general public. The United States was one of the few countries during this time period in which silicone breast implants could not be marketed commercially. Today however, silicone breast implants are back on the market.

According to an article posted by the CNN News, the FDA approved silicone implants manufactured by Inamed Aesthetics, now a part of Allergan, and Mentor for breast reconstruction and augmentation in women of all ages (http://www.cnn.com/2006/HEALTH/11/17/implants/index.html) . Apparently the as M.D.Director Daniel Schultz says, “FDA has reviewed an extensive amount of data from clinical trials of women studied for up to four years, as well as a wealth of other information to determine the benefits and risks of these products.” (http://www.consumeraffairs.com/news04/2006/11/fda_silicone.html)

Adjustable Breast Implants

After the surgery many women complain that they are not comfortable with the size of their implants for they are either too big or too small. Thus, surgeons have created the adjustable breast implants in order to end this “implant remorse”.

The adjustable breast implant is a design that allows surgeon to reshape and to pump up or tone down a cup size within six months of the surgery, to meet the patients’ needs. There are two main types adjustable breast implants: saline, and saline core and silicone shell adjustable implants. The procedures consists making an incision on the lower part of the breast near the chest wall or under the lower portion of the areola (Inframmary incision). A couple of months after the operation, the surgeon then uses a syringe to inject either one of the implant previously used.

There several benefits associated with adjustable breast implants such as: the decreased patient anxiety regarding size, better breast symmetry, and patients’ control over the size and final results. The only known risks would be the ones I mentioned in past blogs— Susceptible Risks of Breast Implants.. Nevetheless, according to an article by the ABC News, “ Not all plastic surgeons are excited bout the idea of adjustable implants.” I guess, further studies will be needed to determine all the pros and cons of such implants. ( http://abcnews.go.com/Health/Cosmetic/story?id=2750240&page=1 )

Going Back

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As I said in past blogs, breasts have been since early times the synonym of femininity, one of women’s greatest physical attributes. The bigger the better, and unfortunately most women allow themselves to be compared to this cultural idea of beauty. They do not accept themselves as they are; thus, they often decide to undergo cosmetic surgery for the simple reason of pleasing their societies, rather than themselves. I have nothing against cosmetic surgery; however, I do believe that if you’re to cut yourself it’d better be for the right reasons, not because someone thinks that you’re not good enough.

Nevertheless, when thinking about having breast augmentation, one must know which procedures will have the best results and how to find the best surgeon. She’ll want to inform herself on the steps that she can take to have the best possible results. Thus, I’ve been writing these blogs: to inform women about all the factors related to breast implants that will allow them to make the right decision.

****NEWS Type of Breast Implants: Natural Breast Implants

According to an article by FOX NEWS (and others), silicone breast implants may be replaced by a new ‘natural’ form of implant that uses tissue grown by a person’s own stem cells—immature cells with the ability to change into any type of body cells under the right conditions. I hear scientists have throughout years tried to increase breast size with, with no success (apparently). However, if they were to suceed women would greatly benefit from it.

First off, women would have the implants that would feel and look like natural breasts without the risk of neither deflation nor interference with mammographies. Second, since the natural implants require the surgeons to suck the fat from different parts of the body, particularly stomach, women would be having a ‘two in one’ type of deal. Also, scientists believe that adding stem cells into the body may actually encourage the growth of new blood vessels; in addition, there is no risk of rejection by the patient’s immune system.

‘Natural’ breast implants will certainly more desirable than artificial ones. I must emphasize how anxious I am for the completion of the studies.

Types of Breast Implant Texture

When choosing a breast implant, texture is an important consideration. There are two basic implant textures: smooth and textured. Smooth implants, the most commonly used texture, are able to move freely in the breast pocket for they have thinner shells; thus, making it soft.Textured implants on the other hand, do not. Smooth implants are also often placed under the muscle (subpectoral/submuscular placement) for it decreases the chances of the patient having capsular contracture, and it is believed that they may have less change of rupture.

Textured implants were designed as an attempt to reduce capsular contracture. However, whether or not they really prevent capsular contracture it’s still unknown. Texture implants have rough outer surface which allows them to create cohesion between the implant and the surrounding tissue, and to create traction rippling—that is, when the overlying tissue grabs the implant surface and begins to pull on it.
(http://www.justbreastimplants.com/implants/texture-shape.htm )

Breast Implant Shapes: Round and Anatomical

To determine what would be an appropriate shape for the implant, is an important factor when choosing breast implants. There are two shapes that a woman can choose from: round, which conforms to the natural shape of the breasts, and anatomical, which is often recommended for patients who underwent breast reconstruction.

Round breast implants the most popular type for breast augmentation. They are just that . . . round; however, there are certain types of round implants that enhance the forward projection of the breasts better than others. Round shaped implants not only present the fewest amount of complication, and provide the greastest amount of lift, fullness and cleavage; but it also provide less control over the upper portion of the breasts. Thus, they cost a little cheaper than anatomical shaped implant.

Anatomicals, also known as contoured shaped implants, are the ones shapes like teadrops. These type of implants generally have more volume at the bottom, which projects a conical fashion. Woman usually opt for this shape of implant because it gives them a more naturally teadrop shaped breasts. However, they can cost a lot more for the implant requires a textured surface to prevent rotation; otherwise it can become distorted—round shaped implant do not pose the risk of implant rotation because of its symmetrical shape.

Inframmary Incision

First thing I must say, ‘gross, gross, and gross.’ As TUBA, I also saw inframammary incision on Dr. 90210, and I’m still a little shaky. In this technique, the incision is made under the breast fold, and it seriously looked as if the surgeon was cutting the breast off. Patients who undergo this procedure generally have longer and more painfull recovery, in addition to a pretty visible scar (in a horizontal position).

Nevertheless, although I like this incision the least for it looked the worst, the incision is actually less noticeable as the nipple incision, and since the incision bypasses the milk ducks, women typically experience less difficulty breastfeeding. Plus, it allows for both subpectoral and submuscular placement of the implant. Yet another advantage can be found during revisions such as capsular contracture, when the surgeon uses the same incision rather than ‘cutting-out’ another part of the breast.

Transauxiliary Incision

The transauxiliary incision, also known as crease, is when the incision is made in one of the crease lines of the armpit. Once the armpit breast implant has been made, a channel, where the breast implant is inserted, is made. This approach is often used for skinny women who undergo a submuscular placement of the implant.

Women who have chosen the ‘armpit’ incision, report to be scarless after the procedure—which is probably because armpits normally remain concealed—even without proper healing of the incision. Also, according to surgeons, armpit incision tend to cause less future breast feeding complication that other incisions; and this particular incision allows them to place the implants above or below the muscle.

As all other incisions however, transauxiliary incision presents disadvantages as well. The first disadvantage is that approximately 22% of women with this incision will need to undergo another surgery in lesser amount of time as women with different breast augmentation incision. Another con is that if a patient ever needs revision, which happens within 4 to 5 years after the surgery, the original breast incision cannot be used; thus, requiring additional incision (plus scars).

No wonder transauxiliary incision is the least used.

Areola Incision

In this technique the incision is made around the edge of the areola (the darker skin around the edge of the nipple), and according to surgeons, this allows for precise placement of the implant since the incision is in the close proximity to the treatment area. In addition, areola incision allows for the placement of the implants in various position in reference to the chest muscle; and like TUBA, areola incisions also leaves a small scar and it tends to heal well.

Three major cons are associated with this time of incision though:

1. If scars don’t heal properly, they may be very noticeable.
2. When placing the implant the muscles and connective tissue must be separated; otherwise the patient may feel great discomfort.
3. Patient may suffer from mastitis (breast infection), galactocele (milk-filled tumor), or galactorrhea (sudden milk production by a woman who isn’t pregnant nor has given birth); thus, decreasing her chances of nursing.

Nevertheless, areola breast incision is now the most popular choice among breast implant incision sites.

TUBA (Trans-Umbilical Incision)

First time I ever heard and saw and a TUBA incision was on the TV show Dr. 90210. I try to be unbiased when writing these blogs; however, I must say that I’m amazed find to see how far women are willing to go for beauty. Anyways, the incision in this procedure is made along the rim of the patient’s navel. Then a small scope is tunneled to the breasts, and the implants are inserted through the incision and moved into the breast pockets. Once inside, the implants are filled with a pre-determined amount of implant solution.

The biggest advantage over the other incisions: TUBA procedure requires only one small incision for both breasts; thus, there will be only a single and smaller surgical scar once the procedure is completed. Moreover, TUBA involves a shorter recovery period and less postoperative discomfort that other types of breast implant incisions.
(http://docshop.com/education/cosmetic/breast/implats/navel-incision/ )

Submuscular and Subpectoral Position

Depending on how small the patients’ cup is and their amount of breast tissue, some opt to go with submuscular breast augmentation. This procedure involves positions the implant beneath the muscle, but not total behind the pectoral muscles. In most cases the pectoral muscle will cover about 2/3 of the implant; however, there are even some who choose to go for a complete submuscular placement--which can be achieved via the transaxillary, periareolar, or inframammary breast incision (I'll talk more about the types of incision on future entries).

http://www.implantinfo.com/inforesources/placement.htm

Image 1. Subpectoral Position
Image 2. Submuscular Position

Altough submuscular augmentation results in less cleavage, less natural breast movement, and longer recovery, I believe it’d still be the best breast positioning placement for I can live better with its cons.

Subglandular Implant Placements

Subglandular, also known as submammary or over-the-muscle breast position involves the placement of the breast implant under the breast tissue but above pectoral muscles. Since the muscles are left intact and only skin and fat are cut, subglandular implant positioning presents numerous advantages:

1. It leads to less complicated surgery and quicker recovery
2. It provides easier access to the implant in case of reoperation
3. It presents less postoperative pain and discomfort
4. Cleavage is more easily created
(http://www.docshop.com/education/cosmetic/breast/implants/subglandular-implant/ )

Generally subglandular placement does not provide good results in women with small amount of breast tissue for the implant is easily notice. Other big disadvantages of subglandular implant placements are the high likelihood to interfere with mammography during breast cancer screening; visible rippling for the implant is covered only by skin; and capsular contracture.

Also, I read somewhere that some surgeons believe that over-the-muscle may deflate more due to less protection by the muscle, and that they actually do drop a lot faster .

Single Lumen and Double Lumen Implants

Single lumen (shell) implant that is prefilled by the manufacturer with a set amount of silicone gel. There are no valves with this type of implant and the volume of silicone cannot be adjusted.

Double lumen implant that is composed of two shells. The inner lumen is prefilled by the manufacturer with a set amount of silicone gel. The outer lumen contains a valve that is filled with saline through a valve during surgery. Adjustments to the volume of saline in the outer shell cannot be made following completion of surgery.

Double lumen with an outer shell that is prefilled by the manufacturer with a set amount of silicone gel. The inner shell is filled with saline during surgery through a valve. This type of implant allows for adjustment of the amount of saline in the inner shell after surgery.