For women who want larger, more shapely breasts, breast augmentation with implants can be an effective way to achieve the look they desire. Our plastic surgeon, John M. Sarbak, MD, is experienced in many breast augmentation techniques and implant placement methods. He also offers a range of implant types to deliver the best possible results for his patients. Dr. Sarbak walks each patient through a one-on-one consultation, which includes a thorough physical examination and a discussion of the patient’s goals, to develop a custom-tailored breast augmentation approach. During the consultation, Dr. Sarbak can review the benefits of one placement technique over another, and help patients decide which size and type of implant is most suitable for achieving the look they desire. If you have questions about breast augmentation and breast implants, we encourage you to contact our practice for more information, or to schedule your consultation with Dr. Sarbak.
Learn more about the different types of breast implants we offer at our practice and the various surgical approaches Dr. Sarbak offers to accomplish breast augmentation:
- Silicone Implants
- Saline Implants
- Anatomically Shaped Cohesive Gel Implants
- Transumbilical Breast Augmentation (TUBA)
Silicone implants are available for patients who are at least 22 years old. They provide a very natural feel, especially for patients who have a limited amount of breast tissue.
Multiple scientific studies have shown the safety of silicone implants. Silicone gel implants were introduced in 1963 and used routinely by plastic surgeons until January of 1992 when they were taken off the market for cosmetic patients (not reconstructive patients). At that time, there were concerns about the potential causal relationship between certain diseases, such as lupus and Rheumatoid arthritis, and breast implants. Further research in both the United States and throughout the rest of the world (where silicone implants were not removed from the market) showed that these diseases were common in women and so were breast implants, but there was no causal relationship between the two. There was even a study of multiple sets of twins in which each twin had lupus but only one of the two had implants.
Silicone implants require a slightly larger access incision than saline implants- 4.6 cm to be exact. This limits the incision choice to the inframammary (beneath the breast) and in some patients the areolar (if the pigmented area around the nipple is large enough) approach.
The FDA recommends MRI evaluations of these implants over time to monitor for possible rupture. This is not a requirement, but a suggestion.
Historically, the capsular contracture rate (scar tissue formation around the implant) of silicone implants is slightly higher than saline implants.
Saline implants have improved significantly over time. It is very rare that we see an implant failure due to a manufacturing defect. I can’t even remember one over the past three or four years.
It is important for patients to choose a saline implant that fits well with the existing breast dimensions. If the implant is wider than the patient’s native breast, then it is more likely that the implant will be felt and possibly seen in its lateral aspect. This can occur even when the implant is placed beneath the muscle (which does not extend into the lower lateral chest).
Saline implants are flexible in their fill volumes which are nice especially when there is a size difference between breasts. The smaller side then can receive more fluid in the operating room. Silicone implants come pre-filled and can’t be adjusted. If a saline implant is filled too much, it can feel hard. Saline implants can be placed through smaller incisions than silicone implants.
In most cases, saline implants can provide a very nice result; however, if patients have a bare minimum of their own tissue, then silicone implants are probably a better option.
Saline implants are the only option if for patients younger than 22 years old. They are also less expensive than silicone implants.
Anatomically Shaped Cohesive Gel Implants
Shaped silicone breast implants are an exciting development that may be able to give you the lift, fullness, and natural feel you desire. Often called “gummy bear” or “form-stable” implants due to the soft, responsive texture, cohesive gel shaped implants represent the next generation of implant technology.
Depending on your needs and goals, anatomically shaped implants may offer an improved appearance compared with conventional round versions. With their recognizable teardrop form, shaped “gummy bear” implants are fuller at the bottom for the most natural-looking contour possible. They may also reduce the risk for capsular contracture—a condition where thick scar tissue can form around the implant, making the breast feel hard. Additionally, shaped implants can allow for better elevation of the nipple without the need for additional incisions.
We offer anatomically shaped cohesive gel implants from the major implant manufacturers. These implants are FDA-approved for use in patients 22 years and older. Anatomically shaped implants have a firmer composition and a textured exterior to help reduce the risk of rippling or position shifting, as well as to maintain their shape long-term.
The right implant for you will be determined during your initial consultation, based on your unique needs and expressed goals. Dr. Sarbak will discuss all your options and work with you to develop a customized treatment plan that can optimize your results.
Transumbilical Breast Augmentation (TUBA)
The transumbilical breast augmentation (TUBA) approach gives women the opportunity to avoid scars directly upon the breast. Scars within the belly button tend to heal extremely well, leaving little to no evidence of surgery. The only other approach that avoids scars on the breast is the axillary (arm pit), which normally heals well. If it does not, this scar can be visible in certain styles of clothing (i.e. tube top).
Using the TUBA breast augmentation technique, we can place the implants through the belly button, to avoid any scarring on the breasts, and minimize recovery time.
“I decided to go with Dr. Sarbak because of the trust and confidence he made me feel even before surgery. If I could suggest an office for plastic surgery, I would suggest Dr. Sarbak. This took it to the next level. I couldn’t ask for better results. Dr. Sarbak is a cut above because of his intelligence and his honesty. “