Archive for the ‘Breast’ Category

Why Do Breast Implants Get Hard?

Monday, August 29th, 2011


The body recognizes the insertion of any substance that is not a genetic match to normal tissue. The response is to wall off (isolate with a capsule) the foreign substance with scar tissue. The personality of scar is to contract to isolate and secure the foreign substance.

Of all the soft substances that can be placed to mimic breast tissue, the best tolerated is silicone. But even silicone is recognize as foreign. Within four days of insertion, the body forms a scar “capsule” around any silicone implant. Normally, the capsule remains loose, and is never noticeable. However, when scar tightens around a breast implant, it is called “capsular contracture”.

The implant does not get hard. When removed, it feels normal. On the contrary, the breast feels hard because of scar tightening around the implant. The process is not dangerous, but it compromises the naturalness of the breast.


Breast Implants: in front or behind the muscle?

Friday, July 29th, 2011


In the upper chest there is a fan shaped muscle extending from the breast bone (sternum) to the shoulder. Anatomically, the muscle is known as the pectoralis major. Breast implants can be placed either in front of, or behind, the pectoral muscle.

Historically, implants were placed in front of the muscle. This method is still commonly employed. The advantage to placing the implant in front of the muscle ( “pre-pectoral”) is that it is less painful initially, there is no shape distortion with muscular contraction, and more central placement (“cleavage”) can be achieved. The disadvantages are that the upper edge of the implant is more obvious, and there may be a higher incidence of surrounding scar tightening.

Placement behind the muscle ( “sub-pectoral”) has been more recently popularized. Only the upper portion of the implant is actually under the muscle edge. The advantages to placement beneath the muscle are that it creates a more natural drape to the upper breast, and there may be a lower incidence of scar tightening around the implant. The disadvantage is that less central “cleavage” can be achieved, and there is slight distortion of the breast with muscle contraction.


FDA Implant Update

Thursday, June 23rd, 2011


This message forwarded from the American Society of Plastic Surgeons (ASPS):

The Food and Drug Administration (FDA) yesterday issued an updated white paper on the safety of silicone gel-filled breast implants. ASPS agrees with the FDA statement that “silicone gel-filled breast implants have a reasonable assurance of safety and effectiveness when used as labeled,” and it accepts the Agency’s position that women who receive silicone gel-filled breast implants for reconstructive or cosmetic purposes will need to monitor the devices over their lifetime. Both the FDA and ASPS agree that breast implants are not lifetime devices.  ASPS believes that the FDA white paper is informative and will be a fruitful resource for plastic surgeons – as well as for patients considering reconstructive or cosmetic breast augmentation.  ASPS shares the FDA’s view in the white paper that more than 90 percent of patients are satisfied with their outcomes from breast implantation and report an improved quality of life.  ASPS has collaborated – and will continue to collaborate – with the FDA to ensure that science forms the basis for all decision-making on breast implants, as well as all other medical devices. The Society supports post-market breast implant surveillance and ongoing data collection related to the safety and efficacy of breast implants. ASPS will continue to reiterate that patient safety is its No. 1 priority.  The FDA has provided the following links to related documents:  FDA – Breast Implants <> Update on the Safety of Silicone Gel-Filled Breast Implants (2011) – Executive Summary <> The FDA also has made available a Consumer Update <> that contains current and background information on breast implants, as well as other links to additional documents and FAQs.  ASPS has posted additional resources for members and consumers on its website at <–_IuuysfDU-wadXAootfVXhB5Gcj876yDHw==> .  The Society is determined to work collaboratively with the FDA to ensure that plastic surgery patients, consumers and ASPS members are provided the information they need to make informed decisions.



Thursday, April 28th, 2011


The first implants developed were gel-filled. They performed well, but some developed surrounding scar, particularly when the shell broke. In response, manufacturers developed inflatable, saline-filled implants.

In general, gel-filled implants are thought to feel slightly more natural to touch. The down-side is that they require a slightly larger incision for placement, and when the shell breaks, they have a historically higher incidence of scar formation ( “getting hard”).

Saline-filled implants avoid the concerns with silicone gel and have traditionally had a lower incidence of scar formation ( “getting hard”). The criticism of saline implants has been a slightly more “wrinkly” feel.