(We call it “viral” because one website copies material from another and the information multiples as quickly as virus cells in a Petri dish.)

Here are most frequently reported top five myths about breast implants:

Myth 1: Silicone is dangerous

 Silicone implants were removed from the market in 1992 when medical sleuths searched for the link between cancer and silicone. Results: nothing found so silicone became available again in 2006.  But rest easy – even after 14 years of study, they are still studying the question.

Myth 2: You must change your implants every ten years.

Implants are subject to wear and tear but there is no way of predicting a failure point. The implants may last ten years, a lifetime or a year, depending on medical factors and the activity type and level of the patient.

Myth 3: You can’t have mammograms with breast implants.

Only if your silicone or saline implants are above the chest muscle will the results of your mammogram be clouded. But if the same implants are placed under the chest muscle, results will be excellent.

Regardless which position your implants occupy, tell your radiologist about your breast surgery. Many technicians like to take side and other views to insure they have fully examined the breast.

Myth 4: The TUBA (transumbilical breast augmentation) incision and approach is best.

Actually, many plastic surgeons get great results using any one of four surgical approaches to breast enhancement. Some surgeons skilled with the endoscope get good results entering through the armpit, the transaxillary approach.

The important factor is, after surgically opening the skin, the surgeons must create an excellent pocket for the implant. So while one surgeon may quickly do his work by making an incision under the breast, (the inframammary approach) another surgeon may be adept at incisions in the areola, the dark area surrounding the nipple.

Besides, whatever incision scar you have usually lightens to virtually nothing in about 18 months.

Myth 5: Women have boob jobs just to catch mens’ eyes.

Nope. Most women have breast enhancement to please themselves and to feel more feminine and attractive. While a few breast surgery procedures are obvious and over the top, the vast majority of women want only a natural look and feel.

· Saline

· Silicone

Now, a third generation of breast implants is coming down the pike. The new kid on the block – or maybe the next breast thing – is known as the Ideal Implant and is undergoing FDA clinical trials in California, Texas and Florida.

The new model purports to offer the best features found in the existing saline and silicone implants.

When a woman opts for a silicone implant, she must sign a statement saying she has been counseled to get an expensive MRI every three or four years.

Why?

Because if a silicone implant leaks, it may not be immediately noticeable. Compare that to saline. A leak there and the whole breast goes flat. Score one for saline implants.

But….most women and their significant others opt for silicone due to the softer, more natural feel. Score one for silicone.

However, if a woman gets saline implants above the chest muscle, the edges may show through the skin. Also, some saline implants slosh when the owner reclines. And if the implant envelope wrinkles, a rip can later develop.

So a Texas plastic surgeon and professor asked for ideas, thoughts and suggestions from both implant patients as well as board certified plastic surgeons who work with the implants and listen to patient comments – the good, the bad and the ugly — for years.

The result is a saline filled implant with an inner and outer shell separated by two more unattached, perforated shells. The idea is to better control the movement of the saline. (Read more about the new breast implant.)

The new implant is more curved to rest more naturally against the chest wall. Its inventor and other plastic surgeons think the new model offers the natural look of silicone gel and the safety of saline.

They can be put above or under the chest muscle.

So far, only about 100 pairs have been implanted in the U.S.

But don’t rush out and to buy one!

The F.D.A. test period is for a decade on 500 women. And because the test period is so long, each test subject expects to receive anywhere between $8,000 and $12,000 when the test is concluded after 12 follow- up visits.

The breast implant maker is springing for the payments.

When a woman thinks about having breast augmentation with implants, she has three choices where the implant is positioned:

• Over the chest muscle
• Under the chest muscle
• Under the thin, tough sheet of tissue, the fascia, covering the chest muscle

All three have their advantages and disadvantages so no one position is right for every patient. 

The basic drawbacks to the subglandular position over the chest muscle are: 

• Any rippling in the implant can be seen and felt through the skin
• Mammography is more difficult
• Capsular contracture, a painful scarring and hardening of the breast is more common
• Implants are more likely to fall down into the breast pocket, or, “bottom out”

But the procedure, also known as the submammary placement, is quicker for the surgeon to do, involves less recovery time and, most likely, less expense. If something goes wrong with the implant later, it’s easier for the surgeon to reach. 

When a plastic surgeon puts an implant under the chest, or, Pectoralis muscle, he or she usually cuts the muscles in half, creates pockets, places the implants and sutures the chest muscles back. That creates more recovery time and expense because the technique is more difficult to master. (Note: muscle cutting can be avoided by entering the breasts through the armpits.) 

But a larger implant may be required because the chest muscle presses down on the implant. 

However, the technique also offers: 

• Low risk of capsular contracture
• A softer and more natural feel
• Rarely seen bottoming out

The third option, placing implants under the fascia, also has many advantages, according to an article in the October, Aesthetic Plastic Surgery, a publication for cosmetic plastic surgeons. 

Three plastic surgeons in Nuevo Leon, Mexico, reviewed the records of 1000 breast enhancement patients over 10 years who had soft gel breast implants placed under the fascia covering the chest muscle.  

The surgeons entered 95 percent of the breasts through an incision in the inframammary fold, the area under the breast at the chest wall. 

The surgeons/authors found: 

• Less post-op pain
• A shorter operation
• Quicker return to daily activities
• Better projection (how far out in front the breast projects)
• Reduction of capsular contracture
• Less morbidity than subglandular and submuscular methods

(Read the fascia breast augmentation article.)

The Duchess of York (pictured) made news when she appeared in public in a low cut dress that revealed a sun damaged, aged cleavage.

The fault lies not in the 50-year-old’s stars but in the sun.

Being a redhead also means having the most sensitive skin known. But for any woman, why go to the trouble of having breast implants if the girls are covered in wrinkled, sun damaged skin?

What is a girl to do? Wear a turtle neck every day?

More plastic surgeons are stepping forward to provide treatments for the aged, sun spot splotched décolletage. It appears to be more of a problem as a woman approaches age 40.

Actually, there are some habits, beyond lying out under the sun, that contribute to cleavage wrinkling. For one, the skin in the cleavage and lower neck is very thin so it damages easily.

First, the no-no’s for keeping smooth skin just below the neckline:

• Tanning booths count as sun damage. Stay away!
• When you put sun block on your face, apply some to the cleavage
• Sleeping on your side wrinkles the cleavage. Special pillows and neck rests can help.

Some plastic surgeons who are good with injectables are using the newly approved Sculptra to plump up cleavage skin and drive the wrinkles away over time. Botox will also work, according to some practitioners.

 While most Retin A is applied to facial skin, the substance – which must be prescribed by a plastic or dermatologic surgeon – can also help aging and sun damaged skin on the lower neck and cleavage.

Ditto microdermabrasion. While that is another procedure that is often used on facial skin, it can also work nicely on the décolletage. However, lasers are intended to work on deeper layers and are not a good treatment that thin-skinned area.

But, that’s not the case with Intense Pulsed Light (IPL) or a treatment that is often called a Photo Facial.

IPL is a non-laser light that seeks out brown pigment – resulting from sun damage – and pesky blood vessels. The light breaks up the pigment that gives the brown spots and blood vessels their very noticeable color.

The smooth, unmarked results usually become apparent in three to four weeks.

And that allows admiring eyes to concentrate more on the new breast enhancement!

So some come up with uses for which breast implants were not actually intended.

For instance, one Orange County blogger reports playing catch with a silicone breast implant at a plastic surgeon open house.

One of the most notable instances was a blogger who gave instructions on how to make from scratch — in the comfort of your own kitchen – a silicone breast implant for stress relief.

It seems the woman’s partner would just not leave her alone so she shows other bothered women how to make a squeezable stress relief toy in the shape of a silicone breast implant that should allow for some quality alone time.

Some uses even defy common sense.

For instance, a Canadian magazine editor had a very busty woman (pictured) tattooed onto his leg.

He later asked the tattoo artist to insert tiny breast implants under the appropriate chest area of the tattoo so that the ink-on-skin sketch of the woman shined in three dimensions, rather than two.

However, the tattoo artist was not a plastic surgeon. The implants later burst and the man developed a nasty infection in his leg. Lesson learned? Only plastic surgeons should perform cosmetic surgery!

In another medical first involving breast implants, a Florida woman had a lung removed as a child.  That caused an imbalance inside her torso so that her heart actually changed positions, starting when she was only six.

At times, doctors listened to her heart beating near her kidney.

Doctors were stumped about what to do until somebody hit on the idea of using breast implants, stacked on top each other, to replace the volume taken away by missing lung.

It required a four-and-one-half hour operation at the world famous Mayo Clinic but standard breast implants were used to fill the space and keep her heart in one position.

Learn more about the heart supporting–breast implant operation.

What off-the-wall uses have you found for breast implants?

Breast implants are often replaced due to wear and tear but there is no set schedule. The determining factor is how active you are.

When it’s time to replace a breast implant, patients often go to a breast revision specialist. That’s a plastic surgeon who specializes in the complications sometimes encountered by breast enhancement patients.

Those complications can include:

• Capsular contracture - Scar tissue forms around the implant, making the breast feel hard. According to one study, there’s a 16 percent chance of developing it within seven years of having breast implant surgery.
• Bleeding - One of the many good reasons your cosmetic surgeon wants to see you the morning after your procedure. Given competent hands, bleeding quickly reveals itself and is easily controlled.
• Infections - Plastic surgeons give breast enlargement patients antibiotics before surgery to stop infections. Why? If an infection develops, the implant often must be removed until the body heals.
• Patient change of mind - After healing, many women decide they should have gone bigger and ask for a second procedure with larger implants.
• Implant rupture - A saline implant leak causes that breast to deflate, mandating replacement. Silicone leaks are harder to detect. (More about breast implant ruptures in our previous post.)
• Wrinkling - Usually takes place in thin women who have saline implants placed above the chest muscle; the wrinkling is seen and felt through the skin. The implants are usually replaced.
• Bottoming out - A rare occurrence, the breast implants fall from their pocket into the lower part of the breast, forcing the nipples to point up. Larger implants are more prone to falling down inside the breast.



• “Uniboob” - An extremely rare occurrence, two implants roll together over the breast bone, or sternum. A very difficult surgical procedure is required; it’s a combination of breast surgery procedures, including a breast lift.

Moreover, board-certified plastic surgeons will have seen all these conditions, know what to do to prevent them and how to make the necessary repairs.

Going with the cheapest breast augmentation can be the most expensive decision you ever made!

While news outlets everywhere are reporting that former model Jasmine Fiore has been identified by the serial numbers on her own breast implants.

(The assailant removed her fingers and teeth just after death to hide the victim’s identity).

But the same situation has happened before.

Back in 2003, a woman’s torso was found in a London apartment, leaving police stumped about the woman’s identity. But the medical examiner discovered the woman had breast and buttocks enlargement. (Read more about the British I.D. through breast implant case.)

Working backwards, the British sleuths took the registration numbers to the clinic where the procedure took place and fished out the victim’s name.

However, it’s not only life and death issues which are situations in which new uses for breast implants make the news.

For instance, back in 2003, Elena Marinova — who had 40DD breast implants — escaped more serious injury when she totaled her car in a head-on crash in Bulgaria.

Doctors there reported that her breast implants absorbed most of the impact, protecting her ribs and vital organs and allowing her to walk away. (More about breast-implants-as-airbags).

But, alas, the breast enlargement procedure was ruined because both implants ruptured on impact.

In 2006, an Israeli woman wounded in a rocket attack was taken to a hospital. Surgeons there discovered shards of rocket fragments lodged in the 24-year-old’s silicone implants, just inches from her heart.

“She was saved from death,” said a spokesman for the hospital.

Because silicone is much thicker, the outcome might have been different if the woman had saline implants instead. (More about silicone-implants-as-flak- jacket).

What’s all this mean?

Breast augmentation has taken a permanent place in the American culture, achieving icon status, something like baseball, the stars and stripes and apple pie. So it’s only a matter of time until a name writer creates an entire book or play – a murder mystery perhaps – around a novel use of breast implants.

Have you encountered any unusual uses of breast implants? Let us know!

But they do last many human years; Nonetheless, patients often ask what signs they should look for in case of failure.

The obvious symptoms depend on if the implant is:

• Silicone
• Saline

Saline implants are the most numerous although silicone is closing the gap due to a patient preference for a softer feel and look.

Silicone implants weren’t available from 1992 to 2006, so the vast majority of breast implants currently are saline.

All implants are well designed with an extremely strong and long-lasting shell. Neither of the fluids will make you sick if leakage does happen.

But movement does cause wear which brings its traveling companion tear. You may have heard of wear and tear in relation to cars but the same situation exists with breast implants.

As time goes on, wear and tear and the movement of the implants inside your body may cause a saline implant to tear and leak.

Those in the know – plastic surgeons – say the possibility of a rupture exists anywhere from day one to year 10. In reality, however, the vast majority of implants last at least a decade. Some last twice as long.

If a saline leak happens, the breast loses its fullness and appears deflated or dented quickly. You will definitely notice and bring it to the attention of your plastic surgeon who can recommend the best course of action.

However, silicone is much thicker and stays within the pocket the surgeon created inside your chest to hold the implant. So the affected breast will retain most of its shape.

A silicone leak is harder to detect and more expensive to replace. That’s probably why many silicone implants come with a warranty which can help with the costs of a replacement or revision breast surgery.

If you have silicone implants, the FDA recommends having an MRI – which is 95 percent accurate – three years after surgery and then after every two years.

But the picture is muddied a bit by the chances of capsular contracture, a common complication. Saline has about a 15 percent chance.

But with silicone, it is only five percent.

Like choices everywhere, it’s six of one or a half dozen of another!

Actually, there’s nothing unusual about that – at least when it comes to celebrities.

In the world of cosmetic breast augmentation, the most common reason for new patients having a breast revision surgery is because they did not like their final size after healing and wanted to go bigger.

But as women get into their 40s and beyond, they often go back under the knife for smaller size implants.

You’ve already read our recent blog about Denise Richards’ breast reduction after spending many years with a larger size that did not fit her general body build and delicate bone structure.

She’s not alone! The list of other celebrities opting for a smaller breast implants now include:

• Victoria Beckham
• Demi Moore
• Courtney Love
• Jennny McCartney

According to various news reports (Rolling Stone, US Magazine and AwfulPlasticSurgery.com) the commonly accepted story seems to be that Britney talked her mom into allowing her, Britney, to get breast implants as a teenager.

Sure enough, as Britney grew, her breasts continued growing also and the size became too large and unflattering for her body and, especially, for a dancer.

(Note: If you want the new silicone gel implants, you must wait until you are at least 22 for precisely that reason – teens may grow a while longer!)

Solution? Out with the large breast implants!

Many dancers, especially ballet dancers, consider larger breasts an unwanted hindrance to balance and graceful movement.

Nobody has mentioned it, but if Britney also nursed her two boys – which she claims to have done — she may have been a good candidate for a breast lift, too.

Nursing often deflates the breasts because they swell and fill during pregnancy and then droop after childbirth and nursing.

Read more about breast implant explantation, the surgical process that removes or exchanges breast implants for a different size.

Since then, silence.

What ever happened? Short answer: they are still being studied!

The Gummy Bear, the most solid type of silicone breast implant,  got its nickname name when a plastic surgeon giving a television interview sliced into the implant to show its inside has the consistency of a piece of gummy Bear candy.

The idea was that this more solid breast implant could not leak into the patient’s body because the silicone was much more cohesive and more stable than silicone gel which can leak out if the implant envelope tears.

Only several hands full of U.S. plastic surgeons in about five states are authorized to offer the semi-solid gummy bear implants to patients.

If you want Gummy Bears, you must be:

• At least 18 years old
• Willing to enter the FDA study on Gummy Bears
• Able to take part in follow-ups

Several U.S. manufacturers offer the cohesive gel, Gummy bear implants — but only as part of the FDA studies. Three separate studies are going on.

Driving the studies is the notion that some consumers still fear silicone leaks although the National Institutes of Health has been unable to find in many studies any connection between silicone and disease.

Proponents say that gummy bears have a more natural soft feel and look and are not very likely to ripple, fold and leak or change shape. Some saline breast implants slosh if not filled completely or can make the breasts look too hard if overfilled.

Because of their size, the incision must be a little longer and is almost always in the crease at the bottom of the breast, a location known as the Inframammary fold.

So it may be a couple of years before the semi-solid, cohesive gel, Gummy Bear implants are more widely available in the United States.

Nonetheless, those implants have been used overseas in eight nations for about 15 years. In addition, one plastic surgeon/researcher blogged that the usual reoperation rate for silicone and saline breast implants is between 13 and 20 percent over three years.

However, 50 gummy bear implant test patients had zero reoperations over three years. (More about the gummy bear breast implant study.)