Breast Augmentation: Salinas and Monterey, CA

Thousands of women every year in the United States alone undergo Breast Augmentation to enhance the size of their bust. Our board certified Plastic Surgeons and caring staff understand that there are many reasons a women may choose to undergo a Breast Augmentation procedure and each has unique needs, challenges and goals. We work very hard to listen and understand our patient’s needs so that we can best recommend and provide a plan to meet those needs to produce results in a way that is both beautiful and natural looking.

Our Plastic Surgeons offer both silicone and saline implants for our patients. Breast Augmentation surgery requires several decisions to be made from implant type and size to incision and implant placement. These decisions can seem overwhelming and our Doctors and staff are patient and thorough in walking our patients through these options and recommending what our experiences have taught us may be best for the patient and their individual goals.

Visit our Before and After Gallery to see the results.

Breast Augmentation: by Matthew Romans, MD

I have been doing breast augmentation in private practice since 1996. During that time, I have developed a list of important issues that patients need to know about breast augmentation.

Implant Choice: Silicone gel versus Saline

The first decision that most women who are considering breast augmentation need to make is what type of implant to use. I tell each of my potential breast augmentation patients the following:

• No implant is a lifetime device. Both saline and silicone gel implants can leak or rupture. If you choose to have breast augmentation, at some point in your life you will almost certainly need to have surgery to remove and/or replace your implants.
• If you have a saline implant and it starts leaking, your body will safely absorb the saline and you will call us to tell us your implant is leaking.
• If you have a silicone gel implant, when it starts to leak it is very gradual and the leaking gel does not go anywhere. You likely will not know right away that your implant is leaking. The first clue is usually a gradual hardening of the pocket around the implant, causing your breast to become more firm.
• The most accurate test to detect a leak in a silicone gel implant is an MRI, but this test is only accurate about 80% of the time.
• Saline implants tend to look less and feel less natural than silicone gel implants.
• Silicone gel implants are softer and look more natural.
• Silicone gel implants were unavailable for widespread use from 1992-2007 because of concerns that they could cause autoimmune diseases, connective tissue disease, or cancer. Over the 15-year period, numerous studies were done in thousands of patients. No study has ever shown a link between these diseases and silicone gel implants. Because of this, in 2007 the FDA lifted the restriction on their use.
• The FDA has stipulated that you have to be 22 years of age or older to qualify for silicone gel implants.
• There are now silicone gel implants available that have no liquid center (the “gummy bear” implant). They are shaped and textured. They have no liquid center to leak. They tend to look a little more “natural” than round gel implants so they provide a little less upper pole fullness. They are more expensive than traditional gel implants and are not for everyone. Currently we are offering them primarily to just a few select patients looking to have their breasts enlarged with cosmetic surgery. They are really great for breast reconstruction.

Summary	Silicone Gel Breast Implants	Silicone Breast Implants	“Gummy Bear” Implants
Appearance	More Natural	Less Natural	Very Natural, Less Upper Fullness
Feel	More Natural	Less Natural	Slightly Firmer than Gel
Cost	More Expensive (about $850 each)	Less Expensive (about $250 each)	Most Expensive (about 1350 each)
Leak Detection	Harder to Detect Leak	Easier to Detect Leak	Nothing to Leak!
Availability	Only for age 22 or older	Only for age 18 or older	22 and older

Incision Choices

• Implant is more visible and palpable, especially in thinner women with less breast tissue
• Less discomfort immediately after surgery

Smooth implants versus textured implants, round implants versus shaped implants

• About 85% of the implants used in the United States are smooth and round.
• I use only smooth implants because I feel they leak less and develop fewer capsular contractures, which is a tight scar tissue pocket around the implant.
• Tear-drop shaped implants were popular for a while because they were felt to be more natural in appearance, but they have to have a textured surface to keep them from rotating.
• Most people, including plastic surgeons, cannot tell the difference between shaped and round implants after they are implanted.