augmentation is one of the most commonly performed cosmetic surgical
procedure on women.
I use an incision in the
breast fold (inframammary) and the implant under the breast tissue (sub-glandular)
Basically there are two kind of implants, both consist of a silicone
shell, but can be filled with saline solution (salt water) or with
I think that gel filled implants are softer, feel
more natural, are lighter and their rate of deflation is very small (less
than 2%), I personally think they are safe. You may find more
information about silicone later in this page.
Saline filled implants have the lowest rate of
capsular contracture (hard breast), but are heavier, do
not feel so natural, and deflate from 5% to 20% of the patients
completely and in a higher rate partially.
The anesthesia is general, performed by an M.D.
It is an outpatient procedure, the surgery takes
about 90 minutes. The patient spends about 4 hours in the clinic.
For 2 weeks after surgery: No driving, do not lift
anything heavy (no more than 10 pounds), do not have marital relaltions,
do not elevate your elbows higher than your shoulders, and sleep on your
You will probably feel somewhat tired and
sore for several days
following the operation, and your breasts may remain swollen and
sensitive to physical contact for as long an 2 months.
a bra is important starting the day after surgery
advisable to stay at least 7 days after surgery in Costa Rica.
recommend the Las Cumbres Inn, where you will receive personal
attention, required medications and transportation to and from surgery.
I visit my patients at Las Cumbres frequently following surgery to check
on your recovery.
Undergoing any invasive surgical procedure means running the risk of
complications like the effects of anesthesia, infection, swelling,
bleeding, pain, and delayed healing. In addition, there are potential
complications specific to breast implants. These complications include:
of the implant.
Contraction of the scar tissue capsule around the implant (capsular
Replacement or revision surgeries
deposits in the tissue capsule around the implant.
Silicones are a family of chemical compounds. They are made from
silicon, a naturally occurring element found in sand, quartz, and
rock. Next to oxygen, silicon is the most common element in the earth
crust, and becomes silicone when it is combined with oxygen, carbon, and
hydrogen. Depending on the arrangement of the molecules, silicones can
be manufactured in a variety of forms, including oils, gels, and
solids. Silicones have been part of the consumer industry for over 50
years. Because they can be manufactured in various ways, silicones
appear in a wide variety of products that most of us use everyday.
Hairsprays, suntan lotions, and moisturizing creams are just some of the
consumer products that contain one form of silicone called dimethicone.
The applications of silicone, whether used as anoil, gel, or
solid, are equally extensive in the medical field. For example, the
lubricating qualities of silicones make them ideal for coating surgical
needles and suture thread, as well as the inside of syringes and bottles
used for the storage of blood and intravenous medicines.
Protective silicone coatings have also been used in pacemakers and heart
valves. Other medical devices utilizing silicones include: artificial
joints, catheters, drainage systems, facial implants, tissue expanders,
and breast implants. Silicone products have been shown to be
biocompatible, reliable, flexible, and easy to sterilize, making them anideal choice for both implantable and non-implantable medical
devices. Safety issues concerning the use of silicone in medical
devices have primarily focused on the possible link between breast
implants (both saline-filled and gel-filled) and certain illnesses,
including breast cancer and connective tissue disorders (also referred
to as autoimmune diseases such as lupus, scleroderma, and rheumatoid
arthritis). Silicone materials have been tested extensively in
laboratory studies, as well as clinical studies (those that study human
health). Of the one to two million women who have received breast
implants, much scientific evidence has already been gathered.
As the following clinical studies indicate,
the likelihood of developing breast cancer does not seem to increase
with the use of silicone breast implants. A 1986 University of Southern
California study published in Plastic andReconstructive
Surgery investigated over 3,000 women in Los Angeles area who
received silicone breast implants between 1959 and 1980.
Results found no increased risk of breast
cancer following breast implant surgery compared to standard incidence
ratios. A 1992 five year update of this study followed the same group
and confirmed the original findings.
A 1992 University of Calgary study published
in the New England Journal ofMedicine investigated over
1,000 women in Alberta, Canada who received silicone breast implants
between 1973 and 1986. This study did not find an increased risk of
cancer among women who had received breast implants, although the length
and completeness of follow-up, would have allowed the detection of such
A 1996 Georgia, New Jersey, and Washington
study published in Plasticand Reconstructive Surgery,
investigated over 2,000 women with breast implants. The results of this
study are consistent with those of the Los Angeles and Alberta studies,
finding no association between silicone breast implants and breast
In the 1998 Edition of Advances in Plastic and
reconstructive surgery all the literature revision shows no
relation between breast
implants and any cancer or connective tissue disorders.
Connective tissue disorders
are described as a group of generalized disorders affecting
the connective tissues (i.e., fat, bone,
and mucous). It has been theorized that silicone breast implants may
increase the risk of developing a CTD. As the following clinical
studies indicate, actual statistical information has provided no
significant evidence that silicone breast implants greatly increase the
risk of developing CTDS.
University of Texas, Houston study published in the Annals of PlasticSurgery investigated 603 women undergoing reconstructive breast
surgery between 1986 and 1992. In this study 250 women had breast
reconstruction with silicone gel-filled breast implants and 353 women
had breast reconstruction utilizing their own tissue. Results of this
preliminary report found that "the incidence of autoimmune diseases in
mastectomy patients receiving silicone gel implants is not different
than in patients who had reconstruction with autogenous [patient's own]
tissue." (7), A 1994 Mayo Clinic study published in the New England
Joumal of Medicine compared 749 women who had breast implant surgery
between 1964 and 1991, with 1,498 women who did not have breast implant
surgery. Study results showed "no association between breast implants
and the connective tissue diseases and other disorders that were