1. How does the shape of the ribs affect augmentation decisions?

The shape of the ribs can affect the choice of implants. The shape of the ribs can vary in curvature, prominence and symmetry among women. For example, if there is one side of the ribs which project more than the other side, a lower projection implant may be needed on that side in order to ensure symmetry. It is important for the surgeon to examine the ribcage, therefore, when deciding on the plan for surgery.


2. What is minimally-invasive surgery?

This usually refers to a surgical procedure which accomplishes the same results as another surgery while using smaller size incisions. It is sometimes used to refer to a variation on a surgical procedure in which there is less bruising and swelling and a shorter recovery. However, the results in these cases tend to be less powerful as well.


3. Will the veins on the breast skin become more noticeable?

It is possible that immediately after surgery, the veins on the breasts may become more swollen and noticeable. However, this usually goes away after a couple of weeks. In rare cases, it is possible that a vein may become very enlarged because of formation of a blood clot. Fortunately, this happens only very rarely.


4. What is the difference between implants in-front-of vs behind the pectoral muscle?

When the implant is behind the muscle, it has two layers of coverage. That is, the muscle AND the breast gland are covering it. When it is above the muscle, there is only breast gland over it. There are two main advantages to having the implant placed below the muscle. First of all, because it has extra coverage, the edges and the surface of the implant are less visible. This helps prevent rippling and implant visibility. The second advantage is that data shows a reduced risk of capsular contracture when the implant is below the muscle. Capsular contracture is when scar tissue around the implant becomes excessively hard and tight. This causes the breast to look distorted. The theory is that the muscle above the implant massages the implant and scar tissue and thus prevents capsular contracture from occurring.


5. Can you explain about textured vs smooth implants?

This refers to the surface of the implant. A textured implant is made so that the surface of the implant has tiny indentations over its entire surface. There is some data that shows a decreased risk of capsular contracture when the implant is textured. The theory is that the tiny indentations on the surface of the implant interfere with the ability of the scar to become tight. A smooth implant is exactly that. It means that there are no indentations on the surface.


6. What is meant by wrinkling or rippling of implants?

The implant, whether it is filled with saline or silicone, is not unlike a small balloon. Depending on the position of the implants, it is possible that there may be some wrinkling or rippling along the surface just like a balloon which is twisted or bent. All implants have some rippling or wrinkling and this is usually not a problem. However, sometimes these wrinkles and ripples may be seen on the skin. This problem is less common with silicone implants because the silicone fills the implant better than the saline implant. Also, placing the implant below the muscle also reduces the risk of this problem.


7. What does the term "Optimal Fill" mean?

Optimal fill refers to saline implants. Saline implants are empty when they are opened. During surgery, the surgeon has to fill the implants with saline. Depending on the size of the implant, there is a range in the volume of saline that can be used to fill it. Obviously, if too little saline is used, there will be empty space in the implant and air will remain. This will create a poor result. If too much saline is used, the implant will become excessively tight and round, just like a balloon which is blown up with extra air. This will also create a poor result. The "optimal fill" is the amount of saline which will fill the implant the right amount so that there is no empty space and so that the shape is ideal.