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Silicone or Saline? Which Type of Implant Will You Choose?
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  Your First Choice, Choosing to have Breast Augmentation
  Breast Augmentation is technically known as augmentation mammoplasty. This surgical procedure is performed using breast implants to enhance the size and shape of your profile. Women choose Breast Augmentation for many varied and personal reasons. The most common reasons for Breast Augmentation include:
     
 
Enhancing breast size when women feel that their breasts are too small or
not in proportion with their overall body contour
Achieving a more proportionate breast symmetry in size and contour
Restoring breast volume and firmness for women after weight loss,
pregnancy, or breastfeeding
Improving breast shapes for women that have sagging or have lost skin
elasticity (a reason that frequently involves breast lift surgery, too)

“I had no idea how good I could look following my breast implant surgery.”

Jamie Strahl, Age 44
Teacher, San Antonio, Texas

   
  Of course, every woman's reasons are entirely personal. And once you know that Breast Augmentation is right for you, a consultation with a plastic surgeon will help you choose the right breast implant to accomplish your goal of an ideal profile.
   
Augmentation photos
  Pre Surgery: A-Cup. Post Surgery: A full C-Cup with 325 cc Silicone Gel-filled implants.

  Many women take an extensive look at before and after pictures to see what benefit they can realize from Breast Augmentation. In fact, plastic surgeons typically have before and after pictures of their work in their portfolios and feature them on their website. We recommend that you use the Find a Surgeon directory of Natrelle.com to select board certified plastic surgeons in your area, visit their website, and review their before and after pictures. When you see a board certified plastic surgeon's success that reflects your profile goal, it is easy to contact them through the directory.
   
 
   
   
  About Your Breast Augmentation Surgery
  Surgery planning begins with an overall evaluation to ensure you are healthy enough. The evaluation minimizes possible surgical risks. A complete history of all health disorders, medications, and allergies will be considered in pre-operative screening prior to surgery. Your plastic surgeon may wish to collaborate with your primary care provider for any additional information. Blood testing and a baseline mammogram for women over the age of 35 or those with a family history of breast cancer may be recommended prior to any breast surgery. It is important to recognize that similar to other medical devices, breast implants - saline or silicone gel - are not lifetime devices. It is possible that at some point in your life they will need to be removed or replaced, and you should talk to your plastic surgeon about this prior to surgery.

Pre-Operative Preparation
Your plastic surgeon will discuss the procedure in detail with you during your pre-operative consultation. This discussion should include an explanation of the surgical procedure, risk and possible complications associated with the surgery, and what to expect after surgery. Possible post-operative side effects, pain management, and pain medications should also be discussed as part of your preparation for surgery. You will be asked to sign consent forms to ensure and confirm that you fully understand the procedure and any risks and potential complications associated with your surgery. Your plastic surgeon may schedule surgery several days or weeks from the time of your consultation to ensure you have had enough time to understand and accept all aspects of the consent form. If you require further explanation, it is important to share your questions and concerns with your plastic surgeon, to ensure a truly "informed consent".
 

We also offer the Natrelle® Pre-Consultation Kit, so prior to your visit you have time to consider the primary aspects of Breast Augmentation and in particular, become comfortable with the size you may wish to set as your goal.

The breast aesthetic surgery consultation with your plastic surgeon should also include an evaluation of what would be the right breast implant size, placement and incision site for you based on your personal goals for surgery, and a thorough and realistic review of your expectations. Guidelines for eating, drinking, smoking, medications, and
exercise before and after surgery will also be reviewed. Before the day of your surgery, you should make arrangements for your aftercare and transportation post-surgery.

 

“The surgery went absolutely
fine. There were no problems.
My surgeon really guided me along. My only regret is that
I waited nine years to do it.”

Nicole W., Age 38
Personal Trainer

   


 

Incision Sites for Breast Implant Placement
Your plastic surgeon plays a pivotal role in explaining your options for surgery.
Breast tissue, body type and implant type and size will all be considered
before you and your plastic surgeon finalize a surgical plan. This is an overview of
the most common incision choices your doctor can offer.

Inframammary Incision
An inframammary incision is placed in the fold beneath your breast. This
location can accommodate every size and shape of implant, is often
concealed, and is known for fast recovery times. An inframammary incision gives your plastic surgeon the most precise access to where your breast implant will sit after surgery.

Periareolar Incision
The periareolar incision is performed on the border of the dark skin around your nipple.
It is known to have fast recovery times, but does not accommodate every size and shape of implant.

Transaxillary Incision
A transaxillary incision is well concealed in the armpit and more removed from the breast area, so it is less noticeable. Recovery times are a bit longer and not all implant sizes and shapes can be accommodated.

Augmentation drawing
     
   


  The Two Choices for Implant Placement
You can have your implants placed above the muscle (subglandular) or below the muscle (subpectoral). Your plastic surgeon will decide which placement location is best for you based on your goals, breast type and other factors. The location choice will be part of your surgical plan.
Subglandular drawing
     
     
 

Post-Operative Instructions
Instructions for recovery restrictions, activities, and follow-up appointments will be reviewed at the time of your pre-operative appointment and again when you are discharged from the facility where your surgery is performed. You will have plenty of time to review this information and to ask any questions.

Possible post-operative side effects, pain management, and pain medications should be reviewed again when you are discharged, preferably in the presence of the individual you have selected for your aftercare to ensure you capture all instructions. If you experience excessive pain or symptoms do not hesitate to contact your plastic surgeon's office. Whether you are having Breast Reconstruction surgery or Breast Augmentation, it is recommended that you take your husband, partner, close friend, or caregiver with you to both your pre- and post-operative appointments. This way, you'll have someone to support you and also another resource for taking notes and helping you remember the plastic surgeon's instructions.

What to Expect Post-Operation
You should discuss your recovery plan with your plastic surgeon prior to your Breast Augmentation and plan for your recovery period accordingly. Your plastic surgeon will inform you of your follow-up medical needs. As with any surgical procedure, you should arrange for a family member or friend to drive you home from the surgery and also to stay with you for at least the first night. You should plan to take at least a few days off from work to stay home and rest. It may be helpful to prepare your home for your recovery in advance. In addition to any specific instructions from your physician, you'll need the following:

 
     
  Ice packs
  Ointment or cream, as recommended by your physician
  Loose, comfortable button-down shirts
  Entertainment - Books, magazines or movies
  You will be advised to avoid any heavy lifting for about 4 weeks and to wait 6 to 8 weeks before resuming any exercise program.
     
 

Surgery planning, preparation, and recovery can vary according to the specific procedure you choose. Breast surgery, as with all
surgical procedures, carries some risks and uncertainties such as the effects of anesthesia, infection and bleeding. Find information
about breast implants at www.fda.gov/cdrh/breastimplants.

Breast Care and Health with Breast Implants
If you have saline or silicone gel-filled breast implants, continue your monthly self-breast exams, annual clinical breast exams, and age-appropriate mammograms. The mammogram procedure may be slightly different and the images more difficult to interpret in women with breast implants. For this reason, mammograms following Breast Augmentation are best done at a radiology center where the technicians are experienced in special techniques for imaging of breast tissue with breast implants. Additional angles may be required to allow for maximum viewing of as much breast tissue as possible. When you schedule your mammography appointments, inform the radiology center you have breast implants. When you arrive for your mammogram, also inform the technologist that you have breast implants.

In addition, a Magnetic Resonance Image (MRI) is recommended for women with silicone gel-filled breast implants three years after surgery and every two years thereafter. An MRI is a noninvasive, usually painless imaging test that helps physicians diagnose medical conditions. It is important to note that an MRI of the breast is not a replacement for mammography or ultrasound imaging. It should be considered a supplemental tool for detecting and staging breast cancer and other breast abnormalities. For more detailed information about breast implants, please read the complete patient information at www.Natrelle.com.

     
 
Financing your surgery -- How to get started today.
Many women are physically, mentally, and emotionally ready to go forward with Breast Augmentation, but can delay
because of the financial impact. The Natrelle® Collection can be right for you now. We have made special arrangements
with CareCredit®, the world's largest finance company for aesthetic procedures, to take good care of people choosing
Natrelle® implants. You can use this CareCredit® calculator and take a look at what you might pay monthly to get the
profile you want now.
Payment Calculator

Estimate your monthly payment. Enter the estimated procedure amount:
Not all practices offer every plan.
To find out which plans are available in your
provider's practice, begin with the Office
Manager or Financial Coordinator.
     
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Considering Your Breast Implant Options

 
  Volume Options: The Natrelle® Collection features a full variety of widths and volumes. The size and volume that's right for you is based on existing breast tissue, your body type and frame. The question of size is NOT just about picking a specific volume of breast implant. Your plastic surgeon will help you pick a diameter and projection of implant that fits your needs. For example, Natrelle® silicone gel-filled breast implants come in four different profiles, or projections: Moderate, Moderate-Plus, High, and Extra-High. Only Natrelle® breast implants are available with an Extra-High profile option. The Natrelle® Style 15 implant is the most common implant used in Breast Augmentation. The profile of the implant is an important factor in how far out your breasts will “project” after your augmentation. And each choice has a different volume. Try out the Natrelle® 3D breast simulator to explore different profiles. See the Natrelle® gel-filled breast implant examples below and notice how each one can deliver a distinctly different profile:

Natrelle volume options

Natrelle® Style 10
Moderate Profile

Diameter
(cm)

Projection

(cm)

Volume

(cc)

12.2

3.3

270

Natrelle® Style 15
Moderate-Plus Profile

Diameter
(cm)

Projection

(cm)

Volume

(cc)

11.9

4.0

304

Natrelle® Style 20
High Profile

Diameter
(cm)

Projection

(cm)

Volume

(cc)

12.0

5.2

425

Natrelle® Style 45
Extra-High Profile

Diameter
(cm)

Projection

(cm)

Volume

(cc)

11.9

5.7

500


 
Shell Options: There are two shell options available, textured or smooth. Your plastic surgeon can determine which option is best for you based on their technique and the shape of the breast implant that best fits your personal profile goal.
  Filler Options: Women in the United States currently have two distinct filler options approved by the FDA. The FDA has approved both saline and silicone gel-filled breast implants after determining that each is a safe and effective options for women undergoing breast aesthetic surgery, breast reconstructive surgery or revision surgery. Ultimately, it is up to you, along with your surgeon, to decide what breast implant option will provide the look and outcome you desire from surgery.
   


  Natrelle photos Be sure to hold both a Natrelle® silicone gel (left)
and saline implant (right) in your hands before
making your choice. There is a measurable
difference in the feel you achieve with each
of these choices.
     
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  Silicone Gel vs. Saline  
 
 
Silicone - Gel Breast Implants
 

Natrelle® silicone gel-filled breast implants have experienced acceptance for more than 25 years in over 60 countries.
They were approved by the Food and Drug Administration (FDA) for use in the US in November 2006.
A Gel-filled breast implant has an elastic silicone rubber shell and is filled with cohesive silicone gel.
The safety of Natrelle® silicone gel-filled breast implants meet one of the most rigorous standards of all medical devices.
 
Saline Breast Implants
 
Saline-filled breast implants were approved by the FDA in May 2000.
A Saline-filled breast implant has an elastic silicone rubber shell and is filled with sterile saline (saltwater).
 
     
 
A further look at the Safety of Silicone Gel-Filled Implants
Like many other medical devices on the market today, silicone gel-filled breast implants have evolved substantially over the
last two decades. Today's Natrelle® silicone gel-filled breast implants have an advanced technology and enhanced safety profile
thanks to several refinements in product design and manufacturing. The most significant advancements available today include a
more cohesive silicone gel and a thicker, yet supple shell with an additional barrier layer that is distinct from earlier breast
implant devices.
   
     
 
  Low long-term rupture rates: To assess the long-term safety of Natrelle® breast implants, Allergan conducted
extensive clinical studies both in the United States and in Europe. These studies show that silicone gel-filled
implants have low long-term rupture rates. In fact, the results of the European research found that after 11 years,
92 percent of implants were still intact.*

*Data on file
     
  Rigorous testing: Today's breast implants in the Natrelle® Collection undergo thorough testing and meet the very high
standards of Allergan quality. They are backed by an unsurpassed warranty that reflects the Allergan commitment to quality.
     
  Ongoing research: Through ongoing research Allergan is constantly assessing the impressive long-term safety
record of our full line of elegant silicone gel-filled breast implants.
   
 

Natrelle® silicone gel-filled breast implants are one of the most studied FDA approved medical devices in existence. There have been hundreds of peer-reviewed studies and published reports involving silicone gel-filled breast implants, including robust epidemiological studies supporting their use*. The Institute of Medicine of the National Academies (IOM), concluded in its landmark report (IOM, 1999)
that "a review of the toxicology studies of silicones and other substances known to be in breast implants does not provide a basis for
health concerns." More information about the safety of silicone gel-filled implants can be found in the IOM report
at www.iom.edu/CMS/3793/5638.aspx.

For safety data on implants go to www.fda.gov/cdrh/breastimplants and please read the complete patient information at http://www.allergan.com/labeling/index.htm.

   
 

The Natrelle® Collection for Your Desired Profile
The Natrelle® Collection from Allergan, Inc. is a complete collection of silicone gel-filled and saline-filled breast implants; the two options available to women in the USA approved by the FDA. They range in volume, shape and texture, providing you and your plastic surgeon an array of options to achieve a result that is in line with your personal goals.

Every Natrelle® breast implant is backed by the Allergan total commitment to quality and offers a guarantee unsurpassed by any other breast implant you can choose. Visit www.cppwarranty.com for complete details on our outstanding warranty.

   
 

Find information about breast implants at www.fda.gov/cdrh/breastimplants.

   
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  Questions to Ask Your Plastic Surgeon about Breast Augmentation
 
     
  Are you board-certified and, if so, by which board?
  Do you limit your practice to plastic or aesthetic surgery?
  How long have you been in practice?
  Do you specialize in breast aesthetic surgery and/or breast reconstructive surgery?
  May I see your "before and after" photos?
  Can I talk to previous breast implant patients to learn about their experiences?
  How many breast implant surgeries do you perform a year?
  Where are your hospital privileges?
  What is the overall cost of my Breast Augmentation?
  Have you completed a certification training program like the ALLERGAN ACADEMY® specific to
products such as silicone gel-filled breast implants?
  Where will my surgery be performed, in a hospital, outpatient surgery center, or in the operating
room in your practice?
  What type of anesthesia will be used?
  How long will my recovery take?
  What aftercare will be required?

This list of questions is not all inclusive. Each patient is responsible for determining what questions are appropriate to ask.
   
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*Inamed Corporation's PMA P020056: Silicone Gel-Filled Breast Implants, FDA Presentation from April 12, 2005, slide 11, http://www.fda.gov/ohrms/dockets/ac/05/slides/2005-4101s1_Inamed-P020056.pdf. Only round gel-filled implants are included. Style 153, anatomical, dual lumen implants are excluded.

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