Women wrestle with options, dangers of breast enlargement

By Martha Petersante
Norwich Guidon Staff Writer

Much of a woman's self-confidence is defined by how well she fits into the mold of what she thinks society defines as "the perfect body." How extreme that desire to possess the perfect form is can often drive some women to take extreme measures.

One of the most common areas for some women to feel they need improvement is in the size of their breasts. It is often perceived that men are more attracted to women with larger chests. As a result, every year, millions of women undergo surgery to enhance the size of their breasts.

There are two types of implant that are currently legal in the United States: silicone and saline.

Silicone is the older of the two, and more research has been done on this type of implant. A silicone implant consists of a "shell" or outer layer that is comprised of silicone. The gel inside the implant, which gives the mass to the implant, is comprised of a silicone gel material, according to Women's Health Web Page, (www.womenshealth.com).

However, one major problem that has affected patients with this type of implant is that the implant may rupture and/or "bleed" according to Women's Health.

"Implant rupture has been reported in association with closed capulotomy (the manual compression of the breast to break a painful, hard, contracted scar that may form around the breast)," stated the Women's Heath website. "Another possible cause of rupture, or potential conversion of intracapsular to extracapsular rupture, is breast compression during mammography."

"Bleeding" occurs when the gel of the implant leaks out when there is no visible tear or leak.

"There is an emerging consensus that both the incidence and prevalence of breast-implant rupture are much higher than previously suspected; that the risk of rupture increases as the implant ages; and that the process of breast-implanted failure may involve a progression from focal rupture and leaking to visible tears and possibly more complete disruption," according to the Women's Health Website.

For many years, silicone itself was believed to be "biologically inert," according the Women's Health website. Now, however, some doubts are being cast onto the practice of using silicone in breast implant surgeries.

According to the Woman's Health site, it is believed that silicone "may be the cause of chronic inflammation, malignant disorders of the breast, and systemic diseases, such as syndromes resembling connective-tissue diseases."

But there are also some physicians who believe that the silicone cannot harm a human body. "Should those with artificial silicone joints, silicone wrist bone replacements, a history of Norplant use, vascular shunts, hair spray and WD-40 users (we breathe in that silicone) and those who have chin implants be discouraged from breast feeding?" asks Dr. Joel R.Studin, MD of the Plastic Surgery Forum, at (www.webplastics.com).

In one of the early procedures for breast augmentation, silicone was injected directly into the breast. This practice was later discontinued in the USA by order of the FDA.

Unlike silicone implants, saline implants are comprised of a "silicone shell and salt water," according to Women's Health.

According to Studin. "While the material is still classified as investigational by the FDA, it has been used in many types of medical devices for decades."

After a bit of "shopping around", Sabrina Fuller of Clayton, NC, decided to "go with the round saline implants."

"I weighted the risks of silicone and saline," said Fuller, "Most doctors don't even offer silicone, anymore. Altogether, I had a very positive experience."

In Fuller's report on her surgery, she states that, "The surgeon came highly recommended" and that, "the surgery only took about 45 minutes to complete, and the recovery time was not that long."

"This surgery is done with local plus sedation and takes less than an hour," according to Studin. "Most people are back to near normal activity in 4-6 days; upper body exercise is usually deferred for 2-3 weeks."

Another benefit of the saline implants is that "changing a saline implant that has deflated can usually be done under local anesthesia, and the major implant companies pay for both the new implant and procedure," according to Studin.

In Fuller's case, the implants were "inserted underneath the breast underneath a layer of muscle."

According to Dr. Studin, by placing the implant under a layer of muscle as well as skin and fatty deposits, the breasts will look more natural. "The muscle acts as an internal bra, holding the implant into a natural position," said Studin.

One problem that patients may have with this method is that the breasts appear to be cone shaped, pointy, or unnatural looking. "Just after my surgery, my boobs were like ba-boing, very Madonna cone like," Fuller said.

However, Dr. Studin says "the breasts, given time, will settle naturally."

"After a while, they did settle down," Fuller said. "Now they look very natural. If you didn't know that I had implants, you would never know."

A major issue for anyone considering breast augmentation is the cost.

"Breast implants, including surgery, implants, operating room and anesthesia, can run anywhere from $4,000 to $10,000," according to Studin. "In my practice, the cost is presently $5,000."

"I paid $5,000 for mine," Fuller said. "I was quoted anywhere from $2,000-$10,000."

Another issue women must contemplate when deciding on this procedure is what shape of implant to get. There are "tear-drop" or anatomically correct implants and round.

"A tear drop breast implant favors fullness at the lower part of the breast. Most of patients are equally concerned with the upper portion of the breast to create some fullness on top; a round breast implant tends to created fullness throughout the breast," said Studin.

Also, the incision and where it is going to be made is part of the process of this procedure. There are four areas where the implant can be inserted into the body.

The first is the belly-button (or navel area). "This claims to eliminate any scarring in the area of the breast, but this is a bad choice, because it is difficult to impossible to insure that the implant is actually covered by muscle," said Studin.

The second possible placement is through the armpit, "which leaves small but visible scars which can be seen when you raise your arms," according to Studin.

The third is in the fold under the breast. "I had mine put in underneath my breast," Fuller said. "I have tiny little scars that can only be seen when I am naked."

The fourth is when the incision is placed on the lower side of the areola (the pigmented area surrounding the nipple). "I favor placing implants through an incision made at the lower edge of the areola in most cases," said Studin, " the color change in the skin usually hides the tiny scar very well."

Women who undergo this procedure have the option of choosing what size breasts they want to have. The largest legal implant available in the US is 1200cc, according to Studin, but he asks his patients to carefully consider their options before going through with the surgery.

"I encourage my patients to come in to the office with a flat panel sports bra and the different size implants are added for the patient to see what size they like the best," said Studin, "I encourage them to bring in bathing suits, dresses, and any other clothing that they like to wear."

Before deciding to have this surgery, one must weigh her options and then decide what it is that she wants, according to Studin.

"I am an extremely satisfied customer. I went from an A cup to a C cup," Fuller said.

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