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Breast implants 101: Dr. Flint has the answers

Posted at 8:36 AM, Dec 02, 2014
and last updated 2014-12-02 12:33:22-05

Dr. Patti Flint is a paid sponsor of Sonoran Living Live


Doctor Flint's brief guide to breast augmentation decision making:

1. Saline or silicone implants    
Each doctor and patient will have their own opinions on this issue, but for me, natural trumps all (after safety that is) and silicone just feels and looks softer and more breast-like. There are some highly cohesive silicone implants called gummy-bear implants that are much too firm for my taste, but current day cohesive gel implants feel very natural. The problems with silicone implant durability have been worked out. Ninety percent of current-day silicone implants remain intact at ten years post-placement, and even if the shell does tear, no silicone leaks out because the gel is too thick.

2. Implant Size
I could not feel more strongly that bigger is not always better. It has been studied and proven that large implants lead to much higher rates of revisionary surgery, which is frequently more complex and expensive than the original augmentation. It is vitally important that you let an experienced board certified plastic surgeon guide you in selecting implant size. For the best outcomes, measurements of your frame should be performed prior to selecting a range of sizes that will fit and stay put. Implant volumes do not correlate well with exact bra cup sizes, so don't get too hung up on an exact cup size. Let the surgeon be your advisor.

3. Incision location
There was a day when most plastic surgeons let their patients pick their incision location for insertion of their implants. Based on currently published data, those days should be over. Both armpit and nipple insertion points lead to much higher rates of scar tissue developing around the implants, which is called capsular contracture. Since this problem is the number one cause of unwanted additional surgery, anything that can be done to avoid it should be done. Insertion through the fold underneath the breast has the lowest revision rates and the lowest scar tissue rates around the implant. The scar is only about two inches in length, and with proper post-operative care, fades beautifully

4. Implant pocket location
Because safety comes first in my practice, I always place implants under the chest wall muscle. While radiologists are becoming more adept at interpreting mammograms, when implants are on top of the muscle, they compress the breast tissue, making these studies more difficult to interpret. The old myth that you can't work out your chest if implants are placed under the muscle is just that, myth. If the lower portion of the muscle is surgically released properly, any and all athletic activity is perfectly fine.

5. Lift or no lift
Part of this decision has to do with the personal preference, including desired nipple location and adversity to scars on the front of the breast. If you place a pencil underneath your breast in the fold, and it stays there when you stand up, you may need to consider a left to obtain the best cosmetic result.

Patti Flint MD PC
Old Town Scottsdale and Mesa, AZ

Dr. Patti Flint is a paid sponsor of Sonoran Living Live