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According to the American Society of Plastic Surgeons, breast augmentation is the third most commonly performed cosmetic surgical procedure in the United States. In 2005, 291,000 breast augmentation procedures were performed.

Millions of women are doing it, and every year the number increases. And they do not do it only once- large percentage is repeat costumers. Once is not enough- we want them bigger and bigger?? Is that the reason they return? Or must they get their breasts fixed again?
Does size matter that much? Be careful! Size is not the only variable to consider! Read on- we will provide you with information about implant choices, placements, incisions, side effects and much more.

FDA definition of breast implants

Breast implants are medical devices that typically consist of a silicone elastomer shell filled with saline or silicone gel. They are intended for women who are seeking breast augmentation (cosmetic) or breast reconstruction.
Breast implants are implanted either under breast tissue or under the chest muscle for breast augmentation or reconstruction.

What are breast implants used for?

They do not serve just to enhance your breasts; breast implants are used for:

  •     Primary augmentation: as most of think – for cosmetic reasons or in other words- to increase size of breasts
  •     Revision-augmentation: when breast augmentation surgery needs to be corrected or improved; again for cosmetic reasons
  •     Primary reconstruction: after cancer or some other trauma breast tissue is removed – in that cases breast tissue is replaced with breast implant
  •     Revision-reconstruction: as with revision-augmentation when breast augmentation surgery needs to be corrected or improved, revision surgery is used to correct or improve the result of an original breast reconstruction surgery

2 major types (groups) of breast implants

First of all, we must explain that breast implants vary in size, profile and shell surface.
There are 2 major groups of breast implants, approved by the FDA: Saline-filled and Silicone gel-filled.

Saline-filled breast implants

In year 2000, saline-filled breast implants were approved by FDA for breast augmentation in women 18 years or older, and for breast reconstruction in women of any age. Saline filled breast implants are consisted of silicone shells that are either pre-filled or filled with saline during surgery. Some of saline filled breast implants also allow adjustments of the filler volume after surgery.
The implants are empty when they are surgically inserted and they are filled after the insertion. For that reason the scar is smaller (comparing to silicone gel breast implants, which need to be filled with silicone before the insertion). Saline filled breast implants are also produced as pre-filled, but the failure rate in this group showed to be very high. 
This type of breast implants is the most commonly used in th US, but they are not as popular in other parts of the world. Main reason is that silicone breast implants (third and fourth generation) are sold under restricted conditions in the U.S. and Canada. Another reason is that comparing to silicone gel implants, saline implants are more likely to cause cosmetic problems, which is very common among women with little breast tissue or women that underwent post-mastectomy reconstruction.   

Silicone gel-filled

6 years later, silicone gel-filled breast implants were approved for breast augmentation in women 22 years or older and for breast reconstruction in women of any age. Silicone gel-filled breast implants also have silicone shells, but are filled with silicone gel. When we talk about silicone implants, we generally describe them in terms of five generations. They differ in common characteristics of manufacturing techniques.
The fifth generation, also referred as 'gummy bear' breast implants have proved greater succes over saline breast implants: significant improvements in safety and efficacy over the previous four generations.

You might ask yourself, why is age limit different in those two large groups. First of all, lets explain that age limit is concern only when dealing with breast implants for augmentation- or in more popular words- cosmetic reason; there is no age restriction if the breast tissue has been removed due to cancer or other trauma. Firstly, this is because breasts do not finish their development with 'legal maturity'- breasts continue to develop through late teens and early 20s. And secondly, young women are simply not mature enough to make an informed decision about the potential risks.   
Back to the original question: why is age limit different for augmentation for saline-filled and silicone gel-filled breast implants? First are approved for women ages 18 and older, and second (saline) for 22 and older. Answer is rather simple: because of risks involved in those two different products.   

Breast implants risks include:

  •     breast pain
  •     changes in nipples and breast sensation
  •     hardening of the area around the implant (capsular contracture)
  •     rupture (deflation for saline-filled implants, possibility of no symptoms for silicone gel-filled implants) 
  •     in silicone gel-filled implants migration of silicone gel
  •     additional surgeries (implant is removed or not)

Who does it and why?

We will end this article with a simple why doing it and is it worth it? Of course we answering to question why undergoing breast augmentation, surgery performed (mainly) for cosmetic reasons. In short, we will examine psychical approach to breast augmentation.
Patients seeking breast augmentation are young, healthy women from higher socio-economic class than majority of population.
Many times they have distress about their appearance and are diagnosed with body dysmorphic disorder. Body dysmorphic disorder is a condition defined as a preoccupation with an imagined or slight defect in appearance that leads to significant impairment in functioning- a condition, which has been found to be unresponsive to plastic surgery.         
This brings us to conclusion: it was all for nothing! (This is referring just to women with body dysmorphic disorder!)Women do breast augmentation, but the quality of life on mental level does not improve as they expected. Post operative surveys prove there is no improvement in self-esteem or general self-confidence. Breast augmentation only showed improvement in feeling sexually attractive- no improvement in other 'areas' of self-esteem whatsoever.