All the rage in the reality TV world, breast implants have
become the focus of increased public discourse as stars, models and
everyday suburbanites go under the knife to pump up their cup
size.
All the rage in the reality TV world, breast implants have become the focus of increased public discourse as stars, models and everyday suburbanites go under the knife to pump up their cup size.
Nearly 335,000 American women had a breast augmentation procedure last year, and with the rates of such operations climbing at a relatively steady five percent across the board, according to industry group the American Society of Plastic Surgeons, the number is only poised to grow.
Women seeking the surgery have several options, according to Gilroy-based plastic surgeon Dr. A.J. Matthews, most of which are designed to minimize the scarring that accompanies the procedure, but still allow physicians up-close access to the breast.
There are four types of main procedures for inserting the implant.
One goes through the armpit, another through an incision at the edge of the areola and one through the belly button, but the most common procedure that Matthews performs is an insertion through the inframammary crease, the area where the breast meets the torso.
Matthews prefers the spot because it is the procedure he is most comfortable performing, but he said different doctors will prefer different methods.
In the case of inframammary insertion, the physician creates a three-centimeter incision just below each breast which, once the breast heals, can easily be concealed under even the most revealing clothing thanks to the natural fold of skin, said Matthews. The proximity to the final resting spot of the implant is also handy, in his opinion, because it allows the access of his most important tool.
“A lot of times in creating the pouch area (the opening in the skin and muscle where the breast implant is placed), I use a finger because it’s a lot more sensitive than the instruments, but if I’m doing the insertion through the armpit, I can’t really reach that far,” said Matthews.
Implants come in a variety of shapes and textures but most commonly are installed as round, smooth discs that are inflated with saline once they have been inserted behind the breast tissue or under the muscle behind the breast tissue. Again, the best point of insertion is a matter of personal preference among plastic surgeons, said Matthews, who prefers to place his behind the muscle.
“The more tissue you have between the implant and the outside world, the better, in my opinion,” he said. “Sometimes the saline bags can ripple, and you have more likelihood of that showing if it’s above the muscle, especially if you’re really thin.”
After the surgery comes the recovery, which requires patients to exercise their breasts to keep the scar tissue around the implants loose.
“Your body is smart and it knows that stuff isn’t you,” said Matthews. “It will build a capsule of scar tissue around the implant, but you want to keep that capsule loose so the breast still moves.
“It’s like Baywatch. You see someone running, and they should be bouncing. If they’re not, you know something’s up.”
When it comes to breast implants, not all women who think they need added size really do, said Matthews.
“In the initial consultation, I measure all of the key distances, like how far the nipple is below the sternal notch to determine if the breast is small but in a good position or if the patient may be in need of a breast implant with a breast lift,” said Matthews. “Sometimes, if the breasts just hang low, a woman thinks she needs a breast augmentation. If they’re hanging and you have the tissue, it just needs a lift.”
Not all women are good candidates for breast implants. Women with a personal or family history of breast issues such as cancer or other breast masses may require special screening after the procedure. And while no link between implants and the development of breast cancer has been shown, the scar tissue created by the procedure could mask harmful masses or cause doctors to conduct unnecessary tests because of suspicions about breast tissue that is simply scarred, said Matthews.
Matthews will also turn away patients who he does not feel are good candidates for the surgery based on their state of mind.
Unrealistic expectations are a major problem with plastic surgery candidates according to the ASPS, and patients often do not include sufficient forethought in their decision-making process.
“I have patients who come to me and have very nice breasts for their body, but they want to be humongously large,” said Matthews. “A lot of people don’t see what’s going to happen down the road with gravity.”
Matthews also turns away patients who have unrealistic goals attached to their surgical prospects, like thinking that breast implants will solve their marriage or dating problems, or seeking the service out because they’ve been asked to by another person such as a partner or loved one.
For those who do have the surgery, especially at a young age, future follow-up will be necessary. Most breast implants are designed to last 10 to 15 years, according to Matthews and women who have the surgery remain at risk for complications from their implants for life.
Plastic surgery and minorities
The number of Hispanic females opting for elective plastic surgery nearly doubled between 2000 and 2004, making this subgroup the fastest growing segment of the plastic surgery market, according to industry group the American Society of Plastic Surgeons.
“This tremendous growth shows that Hispanics have adopted and adapted to many U.S. cultural norms,” said ASPS Past President Dr. James Wells, a bilingual plastic surgeon, in a statement issued by the society. “Hispanics are the fastest growing ethnic group in America, and body image is increasingly important to them as they move up the socio-economic ladder.”
According to the group’s statistics, the three most requested procedures among Hispanics were nose reshaping, breast augmentation and liposuction.
Plastic surgery rates among other minorities remained level with national rates, with both African Americans and Asians increasing their rates of plastic surgery 24 percent in the last four years. The most popular procedures among African American women in 2004 were nose reshaping, breast reduction and liposuction. Asian women opted for nose reshaping, eyelid surgery and breast augmentation.
