Breast Augmentation with Silicone Gel

When treated by Dr. Grossman, patient can frequently go out for dinner the same day as her surgery, go to work the next day and be able to start working out in the gym in about 5 days.
What is Silicone Gel filled implant? Today’s breast implants are made from a solid, yet thin silicone outer shell, which can be filled with just about anything, but under the FDA guidelines these implants can be filled with Saline (physiologic solution of salt water, just like the IV fluids) or some form of silicone in a cohesive gel form.
91+The New Silicone Gel is considered to have memory, because even when cut, the implant does not lose shape or volume, i.e., G []\the implant will stay intact even when its shell is torn up.
The Cohesive, Form Stable Silicone Breast Implants were first available in Europe (now available world-wide) and can be useful for a certain group of patients.
Silicone Gel Breast Implants come in two main forms: smooth and textured surface. There are different indications for each, but the smooth surface implants provide better results for most of the patients in Dr. Grossman’s opinion and are less palpable when the breast is being touched. The textured Breast Implants have been associated with rare forms of cancer and have never been used or recommended by Dr. Grossman. Some of the breast implant manufacturers are recalling many of their textured breast implants.
Breast Implants can also be round, or teardrop shaped. Round implants are a better choice for the majority of patients because they are teardrop shaped when a woman is standing and flatter when lying down, just like a natural breast. Teardrop implants look the same no matter the position of the woman, which is NOT natural.
What are the advantages and why should someone choose the silicone breast implant over the saline implant?
1. Even when ruptured, the silicone implant does not deflate, and the shape of the breast is maintained. 2. In a person who tolerates the silicone well and their body creates minimal foreign body reaction, their breast will feel very soft and natural with little to suggest of a breast augmentation. 3. A person who must have incisions made on the breasts for any reason, as in a breast lift, breast revision or breast reconstruction. This person may as well give this implant a chance and hope for a great outcome at the hands of a good surgeon.
What are the disadvantages of the silicone breast implants as compared to saline implant?
1. Because all gel implants are prefilled, they are naturally much larger than the empty saline implants, therefore all silicone and memory gel breast implants require a larger incision on the breast for placement.
2. Because of its large size, the silicone implant cannot be placed scarlessly, i.e., trans umbilically (through the belly button, umbilicus, or navel). The only time the incision on the breast can be avoided is when a Tummy Tuck is being done simultaneously with breast augmentation and the breasts are augmented through the Tummy Tuck incision or the surgeon chooses a trans-axillary (arm pit) approach.
3. Because there are natural, microscopic extravasations of the gel material through the outer shell, some patients are at an increased risk for Capsular Contracture Formation (scar tissue around the implants that make the breast feel very hard and sometimes painful or even deformed). The same group of patients are more susceptible to the Breast Implant Illness (BII).
4. The patients with silicone gel implants must undergo MRI evaluation of the breast approximately every three years to determine if there is a silent break in the implant shell, since most leaks and tears in the memory gel implants are difficult to detected on physical examination. The MRI of this type may not be covered by health insurance and can be quite expensive.
5. Some patients with gel implants will form Inflammatory Granulomas in the breast tissue (tumor like masses that are benign yet need to be surgically explored to rule out cancer. This is one of the presentations of the BII.
6. Because the incision for the gel implant is usually made on the breast, the size of the implant used in the first-time augmentation is limited. If too large of an implant is used, the wound on the breast may be under too much tension to heal well and can result in stretched out scars or even implant exposure.
7. The cost of the silicone gel implant itself is significantly greater than saline (approximately 4 times more expensive), making the overall cost of surgery is higher.
8. According to the FDA there is a connection between silicone gel implants and rare immunologic disorders.
How is the surgery performed?
After you have met with Dr. Grossman, had your preoperative consultation, and decided on the size of the implant, you will come to our Ambulatory Surgical Facility where the doctor will mark your chest for surgery. The staff nurse or anesthesiologist will take your vitals and make sure everything is set for a smooth “flight”. By the way, if desired, the procedure can be done under local anesthesia only with most patients saying there was NO pain, but they felt like a deep massage. In the operating room, you will be placed on a warm operating table and be covered with a nice, warm blanket as well. An intravenous will be started and after you fall gently asleep, Dr. Grossman will infiltrate the operative site with local anesthesia. This will in turn make your procedure more comfortable and practically painless after everything is finished and you wake up.
The surgical time is approximately 30 to 60 minutes, with most of the breast implants being placed under the Pectoralis Muscles (muscle of the chest).
Throughout the whole procedure you will be pain and anxiety free, breathing on your own and without a tube in your lungs as is typical in a hospital setting.
When you wake up, you will most likely be smiling and very happy after you look in the mirror, which will be brought in for your approval. With our wonderful combination anesthesia, you will not be cold or nauseous. In fact, you will be wide awake immediately or in just minutes and some 5 minutes later we will give you a cup of tea to quench your thirst. You will recover in the same room where your surgery had been performed and your family will be able to stay at your side. Some 20 or 30 minutes later you should be able to leave the room and go home.
The next day NYC plastic surgeon, Dr. Grossman will see you and all the dressings will come off. You will be allowed to take regular showers and resume your near normal lifestyle. Most patients are allowed to wear a regular bra within one to seven days after surgery.
You will see Dr. Grossman a few more times after your surgery and later you will only come in for your yearly follow up exams.
For more information or to set up a consultation with Dr. Grossman, please call 212-585-2133