by Alexa Steele

Created on: April 23, 2009

"How big do I want to be?" is not the only question a women faces when preparing for breast augmentation surgery. Several important decisions need to be made prior to the procedure; each requiring careful consideration.

Surgeon

The first and most vital decision is choosing your plastic surgeon. Interview several doctors and select one with whom you are completely comfortable and in whom you are 100% confident. It is, after all, your surgeon who will be guiding you through all remaining decisions and helping you set realistic expectations.

Type of Implant

Next you will need to select your implant type: silicone gel or saline filled. Both have been approved for use by the FDA and each has its own advantages.

Saline implants consist of silicone shells that are injected with a saltwater solution after they have been placed by your surgeon. Because the shell is empty upon insertion, the incisions required for these implants are generally smaller. Additionally, your surgeon will have some flexibility in how full to make the implants which can be especially beneficial if your breasts are uneven. Some saline implants are even designed to be adjustable for up to six months post-surgery.

On the other hand, silicone gel implants come pre-filled and cannot be resized. However, silicone gel implants come in a wide variety of sizes and are quite popular due to the fact that the texture of the silicone gel closely mimics the feel of natural breast tissue. Also, despite prior controversy, modern silicone gel implants are considered safe and acceptable for use in all patients.

Incision Site

Another consideration that you must give thought to is the incision site. Most surgeons use one of three common incisions: periareolar,
inframammary or transaxillary. The periareolar incision is placed around the nipple. It has the advantage of being the least conspicuous in terms of scarring; however, it also has the highest likelihood of interfering with future breast feeding. The inframammary incision is a popular choice placed at the base of the breast where scarring can be concealed within the breast crease. The
transaxillary incision is more popular in Europe than it is in America. It is placed below the arm; in or around the armpit. This option is a good one for women who do not wish to have any scarring on their breasts.

Placement

Breast implants can be placed either over or under your pectoral muscles. An implant placed under the muscle is said called
submuscular. This placement has several advantages starting with a reduced likelihood of developing capsular contracture, a condition in which abnormal scar tissue forms around the implant. This placement is also less likely to interfere with future mammograms. Implants placed between the pectoral muscle and the breast tissue (called a subglandular placement), on the other hand, tend to heal faster and with less discomfort.

Ultimately, the decisions you make while preparing for breast augmentation surgery are personal ones that must take into consideration your individual goals. Consult your surgeon for the best advice on how to achieve your desired results.

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