Common Myths About Breast Implants
Plastic and reconstructive surgeon Steven Teitelbaum M.D. dispels common misconceptions about breast augmentation.
It's possible to tell when someone has breast implants
This statement is ridiculous; you could only know this if you asked every person you passed on the street to see if your guess was correct! Obviously, the only ones you notice are the obvious ones. Most women with implants look natural, and you would only know they had implants if they told you.
The implant is always best placed below the muscle
Many patients have heard putting the implant behind, rather than in front of the muscle is best. The truth is, there is an important role for both methods. The behind the muscle pocket adds a layer of tissue over the implant to disguise the implant edge and make it harder to feel, decreases risk of hardening, and puts a layer between the implant and the breast to help with mammography. The in front location gives a more attractive shape, particularly when there is any droop to the breast, gives better cleavage, sways more naturally, is interfered with by muscle movement less, and is less painful.
There is a "best" incisional approach
Patients often say: "I hear the armpit (or nipple) incision is best." Each incision should fade to a faint line, and there is a role for each. Armpit incision avoids a breast scar, but is the only scar visible when clothed. The problem is most surgeons tend to use blind blunt dissection, resulting in inaccurate implant placement, increased pain, and probably a higher hardening rate. Armpit incision is best used by surgeons adept at endoscopic techniques, who can precisely dissect the pocket. Underneath the breast incision is easiest to accurately dissect a pocket, and if properly done, is totally hidden in the crease underneath the breast. Around the areola, the incision heals well yet is the only incision visible when looking straight at a patient.
Any patient can have any shaped breasts
To get results a patient wants, I ask them to bring photographs of breasts they wish they could have. But you cannot create all breasts on all people: there is a finite range of outcomes a given patient can have. It is important patients see photographs of patients with similar configurations to themselves, and see examples of various outcomes achieved by using different shaped and sized implants, pocket location, etc.
It's all about choosing the volume
Cup size is not the result of the implant alone; it is the sum of breast tissue and implant, as well as the shape of the chest wall. A patient should focus on discussing the dimensions of their desired results rather than dwelling on the inexact concept of cup size.
Breast implants are dangerous
There is an issue of implants occasionally getting hard, distorted, and causing local complications, and this needs to be carefully considered by every prospective patient. But every study – without exception – has shown there is no association whatsoever between silicone gel breast implants and any systemic diseases.
Lower priced breast surgery doesn't compromise the result
There will be a range of fees among plastic surgeons responsibly performing breast surgery, but there is a certain floor beneath which prices cannot drop. There are costs associated with using good implants, a certified operation room, a board-certified anesthesiologist, and a surgeon certified by the American Board of Plastic Surgery. This is the only board recognized to credential surgeons for plastic surgery of the breast, and one should never consider cosmetic breast surgery by someone who has not met this standard.
Augmentation surgery is painful
When properly done, breast augmentation should cause only minor discomfort, easily relieved with a mild pain pill. Patients should be comfortable enough to drive in a few days. You should be sure you choose a surgeon who uses a gentle "sharp" technique rather than a blunt technique, as a blunt technique of dissection results in more trauma and pain.
Silicone gel is currently unavailable
In 1992 the FDA put a moratorium on use of silicone gel filled implants – not because there was evidence they were dangerous; but because there was lack of evidence they were safe. That evidence is now abundant, but we are waiting for the red tape to clear so gel implants are available for general use. In the meantime, patients can use them if willing to participate in a study for specific reasons, such as breast reconstruction, treatment of breast deformity, and replacement for old saline implants.
Women do it for someone else
A few people suggest women with implants do it just to please men. The truth is almost all women with implants do it for themselves. As discussed in the first myth above, the only people with implants we tend to know about are people who chose to make themselves look obvious. But most patients with this operation are discreet, utilizing the procedure to create a natural enhancement of their beauty.
Originally published in Cosmetic Surgery Magazine Issue 1 Page 36