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Answering Your Breast Augmentation Questions

One of the principles guiding my medical career is my belief in the importance of education. That’s true whether I’m teaching future plastic surgeons in my job as a professor at Northwestern University or providing information to my patients during consultations. It’s also a reason I devote a significant amount of time to answering questions posted on about a range of procedures, including breast augmentation.

I can reach patients beyond my Chicago practice by using RealSelf to provide advice to people from all over the world. Many of the questions I’ve answered are from women who need revision surgery after undergoing breast augmentation surgery with another surgeon. Some are patients who want advice about the best type of breast implants. Here are a couple of examples of questions about breast augmentation that I’ve answered:

Q:  Silicone breast implants vs. saline — How to choose?  

A:  Choosing between silicone and saline breast implants is one of the major decisions in breast augmentation. Both implants have advantages. Silicone implants feel more natural, especially in thin patients with small breasts who want to go up more than 2 cup sizes, where most of the breast volume is made up of the implant. Saline implants have less chance of capsular contracture (firmness) because they are filled with a natural saline solution rather than a silicone gel, which breaks down over time into an oil that the body reacts to with inflammation. With saline implants, a leak results in breast volume loss, but it is easy to detect. Detecting a leak in a silicone implant can require an MRI scan (which can be costly), but the breast will not lose volume, so urgent surgery is not required. Saline implants are less expensive and can be placed through a smaller incision, which are minor advantages. From an aesthetic perspective, most patients do well with either type of implant, and so the decision becomes highly individual.

Q:  “Have I got capsular contracture again?”

A:  Mild capsular contracture can cause the implant to appear slightly higher, even though the breast does not feel firm. Your observation that the right implant does not move quite as freely as the left raises that possibility. However, a definite diagnosis of capsular contracture could not be made without an examination.

One of the key points I make in most of my answers is that patients should be examined by a board-certified plastic surgeon before making any decisions about a procedure. But RealSelf is an excellent starting place for women and men who are either beginning their journeys of physical transformation or have questions about their results.

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