Breast Augmentation Tacoma Washington

General Considerations

When a woman wishing to enhance the appearance of her breasts seeks implant-based breast augmentation, the operation can successfully accomplish this goal in most cases. In some cases, a breast lift (mastopexy), or a breast lift combined with an augmentation, may be necessary. Depending on the amount of excess or loose breast skin and the degree of descent of the nipple below the level of its normal anatomic location, implants by themselves may not be enough to recreate a youthful-appearing breast. During your consultation with Tacoma area board certified plastic surgeon Dr. Cohen, he will perform a physical exam with careful measurements in order to determine exactly which procedure is right for you.

breast augmentation tacoma washington federal way

Breast Implant Type

There are two broad categories of breast implants available on the market: silicone and saline. It is important to note that these terms refer to the material that fills the inside of the implant, because the outer shells of both types of implants are universally made of silicone. Thus, a silicone implant has a silicone outer shell and is filled with silicone gel; while a saline implant has a silicone outer shell and is filled with saline, which is a sterile solution of salt in water. Silicone is a highly inert material that is used for making many different implantable medical devices, including insulin pumps and prosthetic joints, because of its safety and its relative lack of reactivity with the body’s immune system. Within each category of implant, there are two sub-categories based on the outer surface of the implant shell: textured-surface and smooth-surface. When an implant is made in the shape of a teardrop in order to resemble the natural shape of a breast, it is not allowed to rotate inside the body, since a rotated teardrop implant will distort the shape of the breast. In order to prevent such rotation, these implants are made with a textured surface so that they will “velcro” themselves to the tissues from the inside. By contrast, a round (i.e. spherical) breast implant does not require a textured surface, since if a spherical implant rotates inside the body, it will not distort the breast shape. For this reason, most round implants have a smooth surface, although round implants with textured surfaces do exist as well, because at one time textured surfaces were believed to decrease the long-term risk of capsular contracture, a finding that has not stood the test of time. Due to mounting evidence pointing at decreased safety of textured implants, Dr. Cohen currently recommends using smooth-surface implants over textured implants to all his patients. It is important to know that, while the first “gummy” implants introduced in the United States were all textured, this is no longer the case, and “gummy” implants now come with smooth surfaces as well. If a woman insists on having textured teardrop-shape implants, Dr. Cohen can still accommodate her desires after counseling her on all the current data available regarding their safety. For more information about this, please refer to the link for the FDA website:

Breast Implant Safety

Concerns regarding safety of breast implants have been a recurring issue over the years, with new concerns emerging all the time. Some of these concerns have been legitimate, while others have not. The discussion on the history of breast implants and their safety can occupy hundreds of pages and therefore cannot be fully addressed on this website. It is important to distinguish between concerns that are based on rigorous scientific data (such as ones listed on FDA website), as opposed to concerns that are driven by anecdotal evidence, media hype, and litigation. Not everything that is being said about breast implants on the internet, television, and social media, is based on good scientific studies, and it is important to know the source of the information when evaluating various statements about implant safety. It is perhaps most important to bring these concerns to a board-certified plastic surgeon and to ultimately ask the question, “would you place this implant in your family member?”

Implant Size

The two most important considerations in selecting the size of the implant are the woman’s desires (“how big do you want to go?”) and her breast anatomy. The implant diameter needs to fit within the patient’s breast diameter, because women universally dislike having implants that are too wide for their breasts. The implant’s projection (sometimes referred to as “profile”) needs to fit within the breast skin in a way that is safe, proportionate, and congruent with the patient’s desires for her ultimate size. Implant projection ranges from implants that are nearly flat to implants that are almost round. During your consultation with Dr. Cohen, you will have an opportunity to “try on” multiple sizes of implants that would fit your desires and your anatomy in order to help you determine what size implants you would like to have. No two women have identical breasts, and therefore the size of the implant that worked well for one woman will not necessarily be ideal for another one.

Breast Implant Incision Location

Traditionally there have been four possible incisions used to place breast implants: under the breast, around the areola, in the armpit, and around the belly button. The belly button approach became very popular during the time period when only saline implants were available. It has mostly fallen out of vogue with the return of silicone implants. The armpit approach, while appealing in terms of keeping the scar off the breast, has a higher potential for bacterial contamination which can lead to a higher incidence of certain complications. Different surgeons prefer different incisions, and there is no absolute right or wrong choice when it comes to incision choice. A vast majority of plastic surgeons today use either the inframammary crease incision (under the breast) or the periareolar incision (around the nipple). Dr. Cohen’s preference is to use the incision in the crease under the breast, unless the patient requires a breast lift in addition to the augmentation, in which case the periareolar incision used for the breast lift is also used for implant placement.

For breast augmentation in Tacoma and Federal Way area contact Bayview Plastic Surgery.


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Bayview Plastic Surgery
Michael Cohen, M.D.

4700 Point Fosdick Dr. NW
#208
Gig Harbor, WA 98335

(253) 313-0443

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