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BEVERLY HILLS BREAST AUGMENTATION

Written By: Stuart A. Linder, M.D., F.A.C.S.

In 2007, breast augmentation was one of the most popular elective surgeries performed in the United States. At his Beverly Hills Plastic Surgery Center, Dr. Linder places over 1000 breast implants annually.

Dr. Linder is world renown for breast augmentation or breast enhancement as well as breast revision surgery for patients who have had either unfavorable results or have had problems with their past surgery over time.

Saline or Silicone Breast Implants?

Breast augmentation can be performed using either saline or silicone gel implants.

Saline breast implants are usually high profile, smooth round implants that are placed under the muscle using the dual plane technique, two-thirds under and one-third over laterally, along the lateral chest wall.

Patients who are very thin may have visibility, palpability of the lateral breast edge and therefore silicone gel implants are useful in these patients to reduce those problems.

Saline implants will ripple regardless of what type or shape is used. They always form crease folding along the circumferential outer edge of the bags. The high profiles ripple less because it is a fuller back with less diameter and more anterior posterior projection and therefore, by the laws of physics, these implants have less visibility on the sides.

However, they too will ripple. Thin patients with very ectomorphic build may do well with silicone gel breast implants with greatly reduced visibility, palpability of the sides of the bag and then they also have a more natural appearance if they are very thin tissue to start with, as the upper pole will be softer.

In either case, our breast augmentation surgeries are performed under the periareolar approach, which allows for perfection of repositioning of the implant along the inframammary fold. This will allow the parasternal and the inframammary attachments of the pectoralis major muscle to be released accurately. This is not always the case in the transumbilical approach or the transaxillary approach.

Silicone gel implants are advantageous and as we have stated, they do not have the same visibility or rippling along the side; however, MRI's should be performed every 2-3 years with silicone implants to detect rupture of the bag and the integrity of the implant. A Linguine sign is associated with a ruptured silicone implant on MRI. Mammograms can be not sensitive and absolutely incorrect, showing that the implants are intact when yet they are ruptured. Intracapsular ruptured tears may not be noted on mammography and therefore MRI's per the FDA regulations should be performed every 2-3 years on women with silicone gel implants to determine integrity of the shell.

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Stuart. A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.

Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery (ABPS).

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