Silicone Breast Implants

What are Silicone Breast Implants?

Silicone Breast Implants are soft shells filled with a cohesive silicone gel, placed to add volume and improve shape. The gel holds together as one mass, so it behaves like a firm jelly rather than a runny liquid. Because of that consistency, the device keeps its form while still moving with the breast. However, an implant remains a medical device inside the body, therefore it needs review over the years instead of being forgotten.

How does cohesive gel feel compared with natural tissue?

Most women find cohesive gel closer to natural breast tissue than any other filling, particularly where it sits partly under the muscle. Softness depends less on the device itself than on how much of your own tissue covers it, since thin cover reveals the edge of anything placed beneath. Therefore a woman with generous natural tissue usually ends up with a more natural result. Meanwhile a very slim chest shows contour and movement more readily, and that deserves honest discussion before anything is booked.

Which breast changes need checking before any cosmetic surgery?

Several symptoms need prompt medical assessment first, because they can be signs of breast cancer. Cosmetic surgery is never the first step while any of them is present.

• a new lump, or one that is clearly growing
• a lump that feels hard, or feels fixed to the tissue around it
• discharge from the nipple, above all when it is bloody or comes from one side only
• a nipple that has newly turned inward or become retracted
• dimpling or puckering anywhere on the skin
• skin with an orange peel texture
• pain on one side that keeps returning
• a difference between the two sides that is changing quickly

Assessment usually means examination together with imaging, and then a needle test of the area where doubt remains. In short, the breast is cleared first, then cosmetic options are worth discussing.

Should I choose a round or a shaped implant?

Round devices give more fullness at the upper pole, whereas shaped devices carry volume lower down and taper above. Shaped implants have a textured surface so they grip tissue and hold position, yet texturing is the surface linked with BIA ALCL, which is explained below. Because a round smooth implant looks the same all round, rotation does no harm, while a shaped implant that turns can visibly distort the breast. Selection therefore follows your measurements, your tissue and your wishes, not fashion.

Where is the implant placed and which cut is used?

Placement is either behind the breast tissue or partly behind the chest muscle, and the choice follows from how much natural cover you have, since cover is what disguises a device. Under the muscle hides the upper edge better, however the breast can move a little when that muscle contracts. Cuts are commonly made in the fold beneath the breast, while the edge of the areola is another option. Since the areolar route passes closer to the ducts, it is discussed carefully where feeding a baby later matters to you.

Why can a silicone rupture be silent?

Cohesive gel can tear without producing any obvious change, because the gel stays inside the scar capsule instead of leaking away. Silent rupture is then the term used for exactly that situation. Consequently, follow up imaging is advised so a tear is found rather than missed, usually with ultrasound and where needed with MRI. Meanwhile any new firmness, altered shape or fresh discomfort should also prompt a check, since those can be the only clue.

What is capsular contracture, and is this a one time operation?

Your body walls off every implant with a natural scar capsule, and in some women that capsule then tightens, which is called capsular contracture. Tightening can make the breast feel hard, look distorted or ache, so revision surgery is sometimes needed to release or exchange the device. Importantly, implants are not lifetime devices. They do not last forever, therefore further surgery to exchange or remove them is likely at some point in a woman's life, and any sensible plan assumes that from the outset.

What is BIA ALCL, and what is breast implant illness?

BIA ALCL means breast implant associated anaplastic large cell lymphoma, a rare cancer of the immune system linked mainly with textured surface implants. Rare does not mean imaginary, therefore it is named here rather than hidden in small print. Typically it appears late as swelling or fluid collecting around a device, and treatment is available once it is diagnosed. Breast implant illness is a separate term, used for a range of body wide symptoms such as fatigue, joint aches and poor concentration that some women report after implants. Evidence on cause is still developing, so the honest position neither dismisses these reports nor overstates what is proven.

Will implants make my mammogram harder to read?

Yes, a device can hide part of the breast tissue on a mammogram, so screening has to be adapted. Tell the radiographer and the radiologist exactly what you have had done and when, since they cannot allow for what they do not know. Extra or different views are then taken to bring more tissue into the picture, while ultrasound or MRI may be added where the view is limited. Screening still continues as usual for your age, because having implants does not remove the need for it.

Can I breastfeed after breast augmentation?

Many women feed their babies successfully after augmentation, yet no surgeon can promise that feeding will be unaffected. Risk differs by technique, since routes that involve the areola or disturb ducts carry more chance of difficulty than a cut in the fold. Nipple sensation can also change, which matters because sensation drives the let down reflex. Therefore, if a family is planned, say so at consultation so that incision and placement can take it into account.

Who is a suitable candidate?

Suitability begins with physical maturity, stable weight and expectations that match what surgery can do. Implants are not suitable for teenagers, and growth should be complete before any device is considered. Silicone Breast Implants also ask for a woman who accepts future surgery, good general health and no untreated breast symptom. Smoking is reviewed as well, since it slows healing and raises complication rates. Above all, anyone hoping for a fixed forever answer is not a good candidate, because that is not what an implant offers.

What is recovery like, and what does it cost in India?

Most women are up and about the next day, while soreness and tightness last one to two weeks. Driving, desk work and light routine usually resume within a week, whereas gym work, running and heavy lifting wait four to six weeks. Swelling settles slowly, therefore the settled shape is judged at around three months. Costs in rupees vary with the device chosen, theatre time and anaesthesia, so a clear written estimate is given after examination rather than over the phone.

If you are weighing this up, a private consultation with Dr. Ashutosh Shah at Elegance Clinic in Surat is a sensible next step. Examination, measurement and an unhurried talk about breast augmentation come first, then a written plan you can take home and think over. You may also wish to read about the wider range of breast and chest care, or simply get in touch to arrange a time that suits you.

Note: This page is for general information and is not a substitute for a medical consultation. Any new breast lump, nipple change or skin change should be assessed by a doctor before considering cosmetic treatment. Results vary between individuals and no outcome can be promised.