Breast augmentation is a cosmetic procedure performed to create fuller breasts or to restore the volume of the breasts. In this clip, Missoula surgeon Dr. Hardy explains about the procedure, where to place the incisions, the difference between silicone and saline, and what to expect during the procedure, and the recovery time.
DR. STEPHEN HARDY: The standard breast augmentation patient usually comes in for one of two reasons. They either want to be generally larger, or they've developed some sag or fall to the breast after having breastfed children or generally just with age and want to make their breast appear fuller.
There are two ways to approach the issue, and I tell patients there are two forks in the decision. First of all, do you place your implant on top of the muscle or underneath the muscle, and do you use a saline implant or a silicone implant? Everybody's very individual, and some patients are great candidates for a saline implant underneath the muscle. Some patients are great implants [phonetic] for a silicone implant on top of the muscle or underneath the muscle.
In general, I don't very often place saline implants on top of the muscle because they tend to be a little bit more obvious and palpable. You can kind of tell the difference. So that's one of the things I tend to stay away from is saline implants on top of the muscle.
Saline implants are really all we could use for a while because the silicone implants were really pulled off the market. There were problems with the old silicone implants with a general sort of bleed of the silicone through the bag of the implant, but they were able to fix that, and multiple medical studies showed that the silicone itself wasn't toxic. So the silicone came back, and so now we have the choices.
But the saline is really just a water solution with salt in it at the same level as it is in our blood stream. So if the implant were to break, you would just reabsorb a physiologic level of sodium and chloride into your body along with the water.
But the downside of the saline implants is that they really feel like kind of a baggy filled with water. They're sort of bouncy and a little bit movable whereas the silicone implant has a much more viscous gel-type of component that really feels like tissue. And so if you were to lay, just say, a sweatshirt over the top of a silicone or a saline implant and just put your hand on each one of them, you'd feel like, gee, I just put my hand on a breast, and the other, you'd feel like, oh, I just put my hand on a bag filled with water.
So the silicone implants are clearly a nicer implant for a purely esthetic standpoint and for a physical standpoint of how they feel.
The surgery itself is about an hour to an hour-and-a-half long. It's always done as an out-patient. In general, the patient can get back to work within a week or two. It depends really on what they do. A patient who has got a desk job that's not very physical, within a week, they can get back to work.
It gives patients self-confidence. They generally just feel better about the way they look in clothes. I mean, it's really amazing how good women will feel about themselves, and sometimes we'll take a pre-operative and post-operative, and they'll just look at the pre-operative and just say, yuck, I can't believe I used to look like that.
It's really kind of fun. It's one of those operations that if I had just five operations to do for the rest of my career, it'd probably be one of them because they're all so happy. They're such happy patients, and they come back with a smile on their face. And you can just tell that you made a difference in their life, and that they're much more confident. It's just a nice feeling to see.