Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast. It is performed for a number of reasons:

*To enhance the body contour of a woman who feels her breast size is too small.

*To correct a reduction in breast size after pregnancy.

*To balance uneven breasts.

*As reconstructive surgery following other breast surgeries such as a mastectomy.

By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by 1 or more cup sizes. If you are considering breast augmentation in the Baltimore area, this site will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. However, it can't answer all of your questions, since a lot depends on your individual circumstances. Your Baltimore-based surgeon can answer anything you don't understand about the procedure.

Types of Breast Implants

Since 1962, about one million women have had breast augmentation and 90% of patients report being pleased with the results. The vast majority of complaints came from problems with silicone breast implants, related to the fact that silicone gel is chemically inert and cannot be easily removed from the body. In June of 2006, the government lifted the ban on silicone gel-filled breast implants. The FDA determined, through a decade's worth of independent studies, that silicone gel implants are in no way associated with connective tissue disease or cancer.

Click here to read more about silicone breast implants.

Because of the 15-year ban on silicone implants, several alternatives were developed. This includes water-soluble jelly-like material implants such as Novagold or Mistigold (PVP), saline and various vegetable oils such as soybean and peanut oil.

Polyvinyl pyrrolidine (PVP) is a material used in a variety of pharmaceuticals since 1934. Hundreds of thousands of people have had PVP used as a blood substitute, injected intravenously in Europe. It is widely used throughout the United States and elsewhere and has multiple FDA approvals for a variety of uses. It was approved by the FDA for breast implants in October of 1990.

PVP has a viscosity much greater than water or saline but is not quite as jellylike as silicone gel. PVP is the best available, nearly ideal substance for breast implants. It x-rays just like normal tissue. It lubricates the inside of the shell 7 times better than saline or silicone so that the likelihood of full flaw fracture phenomenon or weakening of the shell from friction is greatly reduced. PVP is chemically inert within the body; so, should the implant break, it is scavenged by the lymphatic system and excreted in the urine, unchanged, within a week. It does not harbor any bacteria. Thousands and thousands of women have had Mistigold and Novagold implants throughout the world.

Saline has been around as an implant filler material since 1964 and it x-rays almost exactly like normal breast tissue. Saline has a watery feel. Generally considered to be safer than silicone gel, it is a reasonable substitute. Saline may support the growth of some bacteria and other organisms, although this is rarely significant.

Click here to read more about saline breast implants.

A variety of oils and fats have been tried and they had the advantage of x-raying well, though not as well as saline or normal breast tissue. However, if the implant should break, as in a car accident, this material is not water soluble and lingers around the tissue as small bubbles of oil for several months before the body can break ft up and digest it. The material is not toxic but it has been reported by Barnes University in St. Louis, Missouri, to support the growth of some microorganisms. It lubricates the inside of the shell, however, and is less watery than saline, though not as viscous as other materials.

Placement of Breast Implants In general, breast implants are placed beneath the breast tissue or beneath the pectoral muscle under the breast. The incision can either be positioned around the nipple, through the nipple, under the breast, in the crease, or through the armpit. In a few cases, an incision is made through a tummy tuck incision.

Incision placement is a matter of personal taste. Most women choose the armpit incision because it does not leave any mark on the breast at all. The implant is placed under the muscle unless the breast is rather long or the muscle rather high. Patients needing a breast lift will also generally have the implant placed above the muscle. However, beneath the muscle is still the standard as the muscle then serves as a buffer zone between the breast tissue and the implant and it reduces exposure to bacteria which could later lead to scar tissue and the resultant hardening of the implant.

Implant Textures and Sizes Currently, there are smooth-surfaced and textured-surface implants available. Most women prefer the textured surface because tissue in-growth prevents micro-motion so the implant stays in place. Implants come in a variety of sizes, as small as a tangerine to as large as a cantaloupe. Implant size depends to some extent on the patient's configuration. You can discuss your size goals with your Baltimore surgeon and even try on samples to determine what is best for your body size and type.

Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your Baltimore surgeon. The best candidates for breast augmentation are women who are looking for improvement, not perfection. If you're physically healthy and realistic in your expectations, you may be a good candidate.