Which is The Better Implant: Saline Implants or the New Cohesive Gel Implant?

Saline implants are the safest implant available in the United States but they certainly aren’t the only implant available. There is a new implant on the scene. It is called the Cohesive Gel Implant. Not only is this new implant gaining in popularity, but it is also threatening to claim the title of the safest implant available.

 

The American woman has two choices for her breast augmentation: saline implants or silicone gel implants. There is actually a third choice available that many women don’t yet know about. It’s called the Cohesive Gel Implant. The only problem is the FDA has not yet approved them for unrestricted use which means that it could be many more years before women can freely choose them for their breast augmentation surgery. However, it is still possible to have them for your surgery – you’ll have to apply to become a part of the FDA’s clinical trial.

 

Not everyone that applies for the cohesive gel clinical trial gets approved but that doesn’t mean you shouldn’t try! If you do get accepted, you’ll most likely get your surgery fees reimbursed. In exchange, you’ll need to agree to follow-up visits with your breast augmentation surgeon over the next ten years.

 

What makes a cohesive gel implant different than a saline implant? For starters, the cohesive gel implant is not filled with a liquid. It uses a solid mass of silicone gel. During its production, the manufacturer adds a cross-linker to the gel which makes the gel solidify into a solid mass. Depending on the cross-linker used, the consistency of the gel can range from soft to hard. There are currently four grades of cohesive gel being tested for the clinical trial.

 

The cohesive gel’s solid filler has garnered it the nickname Gummy Bear Breast Implant. The filler used in saline implants is a liquid: it is a saltwater solution that is relatively harmless to the human body. The reason why saline implants are considered the safest implant available is because its saline solution, if leaked from the implant, will simply be absorbed into the body and eventually passed via urination.

 

Saline implants are prone to rupture. In all fairness, all implants that use liquid filler are prone to rupture. A leaking saline implant will usually deflate within a 48 hour period, allowing the woman to quickly identify that one of her implants has ruptured. In regards to safety, saline implants are quickly detected should they rupture, and their filler is practically harmless to the body. Both of those traits have made the saline implant the safest implant available for breast augmentation surgery.

 

The new cohesive gel implant appears to be impervious to rupture. Early evidence suggests that the solid gel design makes them extremely resistant to rupturing. The solid gel also makes them leak-proof. Because of those two safety-related aspects, the cohesive gel implant may indeed become the safest of available implants once the FDA finishes their clinical trial.

 

Cohesive gel implants are a solid mass of gel; therefore they require large incisions in order for them to be positioned within the breast. Unlike saline implants which can be squeezed through a small incision, cohesive gel implants require the surgeon to make a larger than normal incision for the procedure. Larger incisions equate to a higher potential for scarring. In respect to minimal scarring, choosing saline implants for your procedure is the wiser choice.

 

If you are interested in saline breast implants, it’s recommended you speak with a certified plastic surgeon like Dr. Brian Evans that specializes in breast augmentation surgery. If you are interested in cohesive gel implants, you will need to speak with a breast augmentation surgeon who is participating in the FDA’s clinical trial.

 

For more details you can consult Dr. Brian Evans a Board Certified Plastic Surgeon. Brian Evans MD can evaluate your anatomy and take accurate measurements of your chest and breasts to determine the proper proportions for your frame. He will also take into account how lax, or loose, your skin is — an important consideration because, for an aesthetically pleasing augmentation, you must have enough tissue to cover the breast implants.

Call (818) 676-4001 him today!

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Breast Augmentation 1

Breast Augmentation Surgery Problems: Dr. Brian Evans’s Advice

Breast augmentation surgery is extremely popular. Generally, it is quite safe. However, surgery is never risk free. This article will help you discover the common problems with breast surgery and give you to on how to solve them.

In more than 20 years of private practice as a board certified plastic surgeon, Brian Evans MD has encountered lots of patients with a wide variety of problems after breast augmentation surgery.

 

Rupture of the implants is a main issue. Fortunately, this is fairly rare but it does happen. Older implants were more prone to rupture than today’s implants. If your implants are more than 12-15 years old you should have them checked. Rupture is not always that easy to detect. For a definitive diagnosis, an MRI is required. A rupture should be taken care of immediately, but they are not terribly dangerous as was once feared.

 

The concerns raised in the ’90′s about ruptures leading to increased auto immune diseases have been proven false in the research. Fears of ruptures and auto immune disease linger, but Dr. Brian Evans MD assures you those particular fears can be put to rest due to extensive, positive research results.

 

Some problems boil down to disappoint with the aesthetic results of breast augmentation surgery. Women may feel they were not placed correctly, are the wrong size or are asymetrical.

 

What often happens to cause these problems?

 

The best way to perform the surgery is to place the implant behind the muscles and the breast tissue, not just the breast tissue. Unfortunately, some surgeons do not do it the right way; they do it the easy way.

 

If you have not yet had surgery, avoid these problems by requesting a retro-muscular placement, not a retro-glandular implant.

 

Shift in the body over time is more likely if the implants are not under the muscle too. so if a woman experiences significant weight loss or gain, or pregnancies after implantation, the stretching of the skin causes capsular contraction.

 

Capsular contraction is a condition characterized by scar tightening around the implants that makes them hard to the touch or cause an uneven shape, or both. The result is an augmentation that is obvious or simply not natural.

 

Other problems worth mentioning here are:

  • Poorly selected implants in terms of shape and form
  • Over-inflated implants
  • Implants that slip under the breast
  • Ugly scars
  • Breast asymmetry
  • Implants that are placed too high;
  • Developing the “double bubble” effect (this occurs when the muscle still attached to the underside of the breast produces a visible crease across the bottom half of the breast);
  • Implants migrate laterally over time into the armpit, thereby losing the projection in front and desired cleavage.

 

When these problems show up over time, it can often be traced back to mistakes made during the original surgery. Another reason why choosing a quality plastic surgeon is critical

 

If you experience any of the issues described above, you can visit Dr. Brian Evans MD a competent, board certified plastic surgeon. Call at (818) 676-4001 to learn more!

To know more, please visit: http://www.drbrianevansplasticsurgery.com/meet-dr-evans.html

Breast Implants

Breast Implants – Consult Dr. Brian Evans Plastic Surgery

So you want to get breast implants. Whether it was a difficult decision or a no-brainer, you’ve got more choices to make related to the actual procedure, California, to explain. Here are the four basic — but critical — decisions explained by Dr. Brian Evans (An Experienced Plastic Surgeon) you need to make when you choose to have breast implant surgery.

 

01. SALINE OR SILICONE?

Supports the American Society of Plastic Surgeons (ASPS) position that silicone gel-filled implants offer a more natural feel than saline implants. The gel feels and moves much like natural breast tissue. To this point he adds, “… saline implants sometimes form ripples, like the ridges of an old-fashioned washboard, which can be felt — or even seen under the skin. This is mainly a concern for thin and small-breasted women.” He adds that this occurrence is less noticeable in women who have a fair amount of breast or fatty tissue to begin with.

The difference

The main disadvantage of silicone implants is that it’s harder to detect when an implant breaks — “whereas a saline-filled implant leak is readily apparent by virtue of loss of volume in the breast. That’s why, the FDA recommends that women with silicone implants have an MRI examination three years post-implantation and every two years thereafter.

 

2. SIZE AND SHAPE

Decision on size includes various factors that are, in part, determined by a woman’s “tissue characteristics,” including how much stretch she has in her skin, the width of her chest, and the amount of fatty tissue she has under the skin.

Tissue characteristics certainly play a role, many plastic surgeons, myself included, feel that the patient’s desire regarding size is far and away the most important consideration. If a woman desires large implants, and she understands the implications of such, in terms of the long-term effects on her breasts, then size should be her personal decision.”

 

Shape, Dr. Brian Evans MD explains, is determined to a large extent by the inherent form of the breasts. But, he adds, “Shape can also be influenced by implant dimension: Implants of an identical size can result in a different appearance, depending on whether her doctor uses high-profile implants (narrow but producing significant projection) versus low-profile implants (wider but with less projection.)” He also adds that breast lift (mastopexy) can significantly reshape breasts that sag.

 

03. LOCATION

Breast implants can be placed over or under the chest (pectoralis major) muscle. According to, over-the-muscle placement results in less pain, while under-the-muscle placement offers less interference with mammograms, less chance of being able to feel the implant, better long-term support, and perhaps less chance of capsular contracture, the most common complication of breast augmentation surgery, which distorts the appearance of the breast. Dr. Brian Evans adds that “there is also a further distinction between a complete and partial approach with the sub-muscular method.” Ultimately, choosing the appropriate implant location, he points out, is a decision best made between you and your surgeon, based on advantages and disadvantages of each approach, relevant to your personal anatomy.

 

4. INCISION TECHNIQUE

Fact

According to Dr. Brian Evans MD, there are four main options for incision placement in breast augmentation: Under the breast (inframammary), around the nipple (periareolar), through the armpit (transaxillary) and through the belly button (transumbilical). Each incision method has its advantages and disadvantages.

 

If the incision goes under the breast or around the nipple, your doctor can directly see the pocket for the implant as it’s created, which maximizes the chance for proper implant positioning. If subsequent operation becomes necessary, the same incision can be re-used. However, while the incision is well-hidden around the nipple, it is more apparent under the breast. If your incision goes through the armpit, it may be well-hidden, but other challenges present themselves. It’s harder to place the implant properly, it’s difficult to insert a silicone implant of any size and there’s a small risk of damaging nerves traveling to arms. And finally, an incisional approach through the belly button has multiple limitations. Not only is it impossible to insert silicone implants with this approach, but placement from this larger distance is difficult and subsequent procedures require one of the other incisions.

 

Dr. Brian Evans Plastic Surgery at West Hills Hosptial & Medical center features several breast augmentation procedures to choose from, including breast implants, breast lift, or breast reduction. Dr. Brian Evans uses only the safest techniques and materials during breast augmentation surgery, and all of our breast enhancement procedures are performed within a safe, certified operating facility. If you are unhappy with the shape or size of your breasts, visit Dr. Brian Evans Plastic Surgery for a breast augmentation consultation.

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