BOARD CERTIFIED PLASTIC SURGEON IN RENO

There are three types of implants offered at Advanced Aesthetic Plastic Surgery. We offer silicone gel implants, saline implants, and Gummy Bear implants.

Silicone gel implants - Silicone gel implants consist of a silicone outer shell filled with medical-grade silicone gel. The gel is “cohesive” meaning it stays together and within the shell more if the implant develops a leak. Silicone gel breast implants are considered safe and superior to saline breast implants. Most people believe silicone implants feel more like natural breast tissue when compared with saline implants. Silicone implants are more commonly used and desired by patients and plastic surgeons as they exhibit less rippling, look and feel more natural, and last longer than saline implants.

Saline implants - Saline implants consist of a silicone outer shell filled with a sterile saline solution. Unlike silicone implants, which are filled at the factory, saline implants are placed into the breast pocket empty and are then filled in place. This allows these implants to be placed through smaller incisions. It also allows some flexibility with size. However, saline implants exhibit more rippling, feel and look less natural, and do not last as long as silicone implants.

Gummy bear implants - Although technically silicone, gummy bear implants are different and deserve their own description. Gummy bear implants are made with “highly cohesive” silicone gel; think of the consistency of a gummy bear. This gel is much thicker than the gel used in other silicone implants. If a gummy bear implant is cut in half, the gel will remain within the shell and not leak out. Gummy bear implants are also created in a teardrop shape, which is closer to the shape of the natural breast. However, women who prefer more upper breast fullness and more cleavage will benefit from round silicone implants and not shaped implants.

Most women and plastic surgeons in America prefer smooth round silicone breast implants. Round implants come in more sizes and projections then shaped implants. They come in smooth or textured surfaces. Smooth implants are more popular since they can be massaged to improve position and symmetry. Smooth implants may also be massaged to reduce capsular contracture (hardening).

Textured implants have the disadvantage of being fixed in position like Velcro and should not be massaged. Textured implants have a higher incidence of spontaneous seroma (fluid collection around the implant) and there is an association with Anaplastic Large Cell Lymphoma (ALCL) of the breast. Dr. Dahan only recommends textured implants if you prefer to have shaped implants. Shaped implants are nearly twice the price of round implants and do not offer the patient as much fullness in the upper breast or cleavage.

Some women assume implants are sized similar to bra cup sizes. Actually, they are not. Implants are sized based on the amount of silicone gel or saline filling the implant. This volume is measured in cubic centimeters (cc), also known as milliliters (mL). For instance, a 250 cc or 300 cc implant may represent an increase of one cup size, an A cup to a B cup, in most women. Smaller women may require less volume to achieve one larger breast cup size, whereas larger women may require more volume to achieve one larger breast cup size.

The implant volume needed to make larger cup sizes may also vary based on individual physical characteristics of the breasts. Dr. Dahan has an implant sizing system that allows you to very accurately visualize how different implant sizes will look on your figure. Dr. Dahan is well-known for his accuracy in determining his patients’ desired implant and breast size, which is why the overwhelming majority of his breast implant patients are so happy with their results.

Dr. Dahan recommends that both silicone and saline breast implants be placed in the partial submuscular position (dual plane technique).

This has been demonstrated to offer the best results.* These patients experience fewer irregularities such as rippling, unnatural implant shape, capsular contracture (hardening) and less sagging. Some patients, however, may be good candidates for placement of the implants above the muscle and under the breast tissue or subglandular.

You will choose where you want Dr. Dahan to make the incisions to place your implants. He places implants through three incision locations: periareolar, inframammary, or transaxillary.

• Periareolar incisions — These incisions are made just outside the dark skin of the areola on the lower side. These incisions become almost invisible after healing. The implants can be placed above or below the pectoral muscle, although Dr. Dahan recommends placing it below the muscle to limit the possibility of infection and lower the risk of capsular contracture. This incision type can limit the size of silicone implants. It may not be possible to place larger silicone implants through a small areola. There’s also evidence that there is a slightly higher risk of capsular contracture (hardening) with this incision, however, Dr. Dahan’s patients have only a 3% risk of capsular contracture compared to a 10% risk reported in the United States. In Dr. Dahan’s hands, breast augmentation using the periareolar incision does not affect nipple sensation in the overwhelming majority of his patients. In fact, it is very rare for his patients to experience loss of nipple sensation.
• Inframammary crease incisions — This incision is made at or above the crease on the underside of the breast. This allows it to usually be hidden by the crease, beneath a bra or bikini top. However, this incision results in a slightly larger scar. In most cases, the implants may be placed through this incision partially beneath the muscle (Dual-Plane technique) or above the muscle (Subglandular). This incision can handle any size of the implant. Nipple sensation is rarely affected when Dr. Dahan uses the inframammary incision.
• Transaxillary incisions — These are made with a vertical incision in the armpit. Dr. Dahan may use an endoscope for better viewing of the breast pocket with this incision. This incision leaves no scarring on the breasts, and the line in the armpit will become virtually invisible with time. Saline or smaller silicone implants can easily be placed behind the chest muscle. Nipple sensation and later breastfeeding is usually unaffected by placement through transaxillary incisions. Recovery can be a little harder with this incision.