Offered at our Convenient Location in Birmingham, Alabama
Many women find the size of their breasts unappealing, and wish to improve how they fill out their clothing. Grady Core, M.D., F.A.C.S., a board-certified plastic surgeon in Birmingham, AL, performs breast implant surgery on women living in and around Birmingham and Mountain Brook who want to increase the size of their breasts.
Breast implants are a cosmetic prosthesis designed to enlarge the breasts while improving their shape. The two main types of implants include saline and silicone. Each has its own advantages and disadvantages regarding feel, appearance and, most importantly, safety.
Breast implants are one of the most requested cosmetic surgery procedures requested. They offer the following benefits:
In regards to saline, these implants have been the primary implant that we have used in our augmentation practice over the last 12 years. Patient satisfaction has been extremely high, and the minimal access endoscopic technique can be used to have the scar in a remote location. As long as patients have adequate tissue coverage over this implant, it has been a highly reliable and successful procedure, which has enhanced the lives of hundreds of women that have come to our practice for endoscopic breast augmentation.
The disadvantages of saline implants occur when one starts to have large implants and a small amount of tissue coverage. In these cases, the edges of the implant can be seen rippling, and the implant can feel firm. In these cases, we have been successful in converting these patients to smooth silicone gel implants, which have alleviated most of these problems. Leakage from a saline implant has been estimated to be approximately one per 100 implants per calendar year. This estimate is actually likely somewhat high since we have over 1,000 patients with saline implants throughout the southeast and we only replace an average of 1.5 implants per year. In addition, when a saline implant leaks, it is an event, which is not in any way of medical risk to the patient.
The material that leaks out of the implant is sterile saline, which is the same material that is included in an IV that a patient receives during surgery, so there is absolutely no risk of any health problems when the implant leaks. However, the implant will have to be changed, which can be done easily through the same endoscopic incision using sedation and local anesthesia as long as there is not a modification to the implant pocket that needs to be performed at the same time.
In regards to silicone implants, most people feel that the advantage of these implants is that they are somewhat more aesthetic, especially in slim patients in that they have more of a natural feel. Silicone implants are not quite as firm as the saline implants we have now, and they seem to have less rippling and in addition are slightly lighter per unit volume than a saline implant.
Therefore, larger silicone gel implants are lighter than larger saline implants. In addition, a silicone implant up to 325 cc’s can be placed through endoscopic incision in the axilla without a problem; however, sizes above 325 cc’s are easier to place through inframammary incision, which is in the fold underneath breasts so that when one raises their arms, the incision is not visible below a swimsuit top. The residual concern about silicone implants primarily relates to the media hysteria that occurred in the early 90s about possible medical conditions, which could occur secondary to silicone gel being placed in one’s body. For the most part, these medical issues have been resolved to the extent that the FDA now feels that placement of silicone gel implants is safe and that there is an extremely low risk of developing other medical problems, such as an autoimmune disease.
The capsular contracture rate for silicone implant is much lower than it used to be. However, silicone gel implants do still have a slightly higher rate of capsular contracture where the natural scar that forms around the breast implant after surgery can start to squeeze down on the implant and make the implant appear firm.
In actuality, the implant is not firm; it is just under pressure by the scar capsule that is now putting the implant under pressure. This is similar to placing a towel around a water balloon, which feels soft as long as you don’t squeeze on it, but when you start squeezing on the towel, the water balloon will appear very firm. Back in the 1980s and 90s, the contracture rate for silicone implants was quite high, with some people stating as high as 30 to 50 percent.
However, due to the introduction of cohesive gel now as opposed to liquid silicone gel in these implants, the capsule rate has dropped to somewhere in the range to three to five percent. Saline implant capsular contracture rates are somewhere in the neighborhood of one to three percent. In addition, when there is a leak in silicone implants, the gel, which is now cohesive, does not bleed out of the implant shell as the old liquid silicone did; therefore, there is no risk of the gel traveling to other places in your body.
A good candidate for breast implants is anyone wanting to enlarge their breast size and/or reshape them to look rounder and fuller. It is important for anyone wanting breast implants to have a realistic expectation regarding the size and the desired look. Lastly, candidates for implants must have fully developed breasts.
Prior to having breast implant surgery, we typically require you to undergo an overall health check-up and bloodwork to make sure you have no health issues that may interfere with the surgery. We also recommend you avoid any blood-thinning medications and supplements at least a week prior to the procedure and stop smoking two weeks prior and two weeks following the surgery.
Breast implant removal is becoming more and more common as well. This procedure is done for women who want to replace older implants, change the size of their implants or simply remove them to restore the original size of their breasts. This procedure is done in the same manner but adds the step of removing the implants prior to replacing them if requested.
The cost of breast implants varies with each patient based on the type and size of the implant, the incision and whether other plastic surgery procedures are performed at the same time. Grady Core, M.D., F.A.C.S., a board-certified plastic surgeon, offers plastic and reconstructive surgery to people living in and around Birmingham, Mountain Brook and the surrounding communities to look and feel younger. Contact Dr. Core’s office today to schedule your consultation!
We review costs with you during your consultation as well as our payment and financing options.
Once the procedure is complete, you may be allowed to leave after the anesthesia has significantly worn off. It is important that you have someone accompany you and stay with you for the first few days. Your breasts stay wrapped for a few days to allow the implants to incorporate themselves within the implant pockets.
It is recommended that you take up to a week off work to rest and let the breasts heal. Once you return to your work and daily activities, we recommend avoiding heavy lifting and strenuous exercise for a few weeks following breast implant surgery. Swelling and bruising diminish over the next several weeks while the scars take several months to fade.