Breast augmentation and augmentation mammoplasty are plastic surgery terms for the breast-implant and the fat-graft mammoplasty approaches used to increase the size, change the shape, and alter the texture of the breasts of a woman. As a primary reconstruction, augmentation mammoplasty is applied to effect a post–mastectomy breast reconstruction, the repair of the chest wound consequent to the removal of a cancerous breast; to correct congenital defects of the breast(s); and to correct congenital defects of the chest wall. As an elective, cosmetic surgery, primary augmentation changes the aesthetics — of size, shape, and texture — of healthy breasts.
The pre-operative aspects (left), and the post-operative aspects (right) of a bilateral, sub-muscular emplacement of 350cc saline implants through an inframmary fold (IMF) incision.
The surgical implantation approach effects the global augmentation of the breast hemisphere using a breast implant, either an implant filled with saline-solution, or an implant filled with silicone-gel; moreover, the surgical augmentation approach can include the application of transplanted autologous skin flaps harvested from the woman's body. The fat-graft transfer approach augments the size and corrects contour defects of the breast hemisphere with grafts of autologous adipocyte fat tissue, drawn from the woman's body
In a breast-reconstruction procedure, within a multi-stage reconstruction-mammoplasty, a tissue expander (a temporary breast-implant device) is emplaced and used to prepare (shape and enlarge) the recipient site (implant-pocket) to receive and accommodate the breast implant prosthesis. In a non-implant breast-augmentation procedure, some fat-graft injection approaches feature tissue-engineering, which is the pre-operative, external expansion of the tissues of the recipient site to receive the grafts of adipocyte tissue drawn from the woman's body. Non-surgical approaches to breast augmentation can consist either of an externally applied vacuum-device that will expand the tissues of the recipient site. Moreover, in most instances of fat-graft breast augmentation the increase is of medium volume — usually one brassière cup-size or less — which usually is the physiologic limit allowed by the metabolism of the woman's body.
Saline breast implant
The technical goal of saline-implant technology was a physically less invasive surgical technique for emplacing an empty breast-implant device through a smaller surgical incision. In surgical praxis, after having emplaced the empty breast implants to the implant pockets, the plastic surgeon then filled each device with saline solution, and, because the required insertion-incisions are short and small, the resultant incision-scars will be smaller and shorter than the surgical scars usual to the long incisions required for inserting pre-filled, silicone-gel implants.
When compared to the results achieved with a silicone-gel breast implant, the saline implant can yield good-to-excellent results, of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, and technical problems, such as the presence of the implant being noticeable to the eye and to the touch. The occurrence of such cosmetic problems is likelier in the case of the woman with very little breast tissue, and in the case of the woman who requires post-mastectomy breast reconstruction; thus, the silicone-gel implant is the technically superior prosthetic device for breast augmentation, and for breast reconstruction. In the case of the woman with much breast tissue, for whom sub-muscular emplacement is the recommended surgical approach, saline breast implants can afford an aesthetic result much like that afforded by silicone breast implants — a "look" of proportionate breast size, smooth contour, and realistic texture.
Silicone-gel breast implant
Silicone gel-filled breast implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells.
Silicone gel-filled breast implants are approved for breast augmentation in women age 22 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.
What's the difference between saline and silicone breast implants?
Saline and silicone breast implants both have an outer silicone shell. The implants differ in material and consistency, however.
Saline breast implants
Saline implants are filled with sterile salt water. They're inserted empty, and then filled once they're in place.
Saline breast implants are available to women 18 and older for breast augmentation and to women of any age for breast reconstruction.
Silicone breast implants
Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Most women feel that silicone breast implants look and feel more like natural breast tissue.
Silicone breast implants are available to women 22 and older for breast augmentation and to women of any age for breast reconstruction.