Manufacturers and the media have led the public to believe that implants have a limited life and need to be replaced every ten plus years. Why would an implant that cannot be destroyed in an oven or by any acid or alkali be destroyed in the human body. If an implant can be placed without an ever tightening ring of scar – it should last forever. I have well over 1000 patients of more than 25 years with a failure rate of less than .05%. I have done approximately 3000 plus procedures with a redo rate of approximately 2%.
Where to put, the implant- The majority of plastic surgeons now place the implant below the pectoral muscle – on the chest wall. This is more than appropriate on the extremely thin breasted women. However,
I have abandoned sub muscle implants in favour of implants under the breast.
I prefer (having tried all others) an incision around the lower margin of the areola. This is the most central area and allows perfect visualization with a fiberoptic system The breast ducts are not divided, but rather pushed a part. The incision is invisible lying down, or with the arms lifted. As the areola is an area which a newborn traumatizes, it inherently heals quickly and cleanly. There are no external stitches to remove. Areola sensation remains normal, as the principle nerve supply comes from the lateral arm area.
The down side of breast augmentation, particularly above the muscle is the formation of a tight firm capsule which constrict and restricts the breast. Implants below the muscle are effectively all encapsulated as they cannot freely move. It has taken the better part of my career to preclude this encapsulation. Moreover, I have developed operations to address patients who have had multiple failures with other plastic surgeons to produce a soft, mobile, pain-free breast.
I would be happy to discuss the niceties and details of these operations in the privacy of my office.