Breast implants must be changed every ten years?


 False. There is no need for breast implants to be replaced every ten years. Breast implants should be replaced or removed when there is a problem with them such as a breast implant rupture or the patient changes her mind for any reason.


Saline breast Implants are safer than silicone ones.

False. The saline breast implants became popular due to a moratorium imposed by the FDA years ago when it was thought that silicone breast implants caused various diseases. The US became the main country where saline breast implants were used therefore.

When it was shown that silicone breast implants were NOT associated with any diseases then the rate of saline breast implant went down. Today plastic surgeons in the US prefer silicone breast implants as opposed to saline. Most female patients who have had saline breast implants and changed to silicone ones prefer the natural feeling of the silicone ones.

Saline breast implants can have an advantage in cases of breast asymmetry where different breast implant volumes must be used.


Under the muscle is better than over the muscle.

Not always true. The practice of placing breast implants under the pectoralis major muscle is mostly an American preference in breast augmentation. This started when saline breast implants were the main option in the US. Saline breast implants offer a more natural result when placed under the muscle due to extra tissue coverage. Saline implants are harder than silicone ones. In addition Saline implants cause less visible rippling and capsular contracture when placed under the muscle as opposed to over the muscle.

Silicone breast implants have a different biological behavior compared to saline ones. Silicone breast implants are softer and feel soft when placed over the muscle and directly under the breast. Silicone breast implant have a lower rate of capsular contracture and rippling compared to saline ones when placed under the breast itself.

Plastic surgeons in most other countries prefer to use silicone gel implants and place them over the muscle.

Each patient has individual and specific needs.


Textured breast implants cause less capsular contracture.

Not true. Textured means that the implant surface is rough. It has a feel like sandpaper. The rough surface causes a mild inflammation and helps the implant to adhere to the tissues. This was thought to decrease capsular contracture.  This has not proven to be the case.

Plastic Surgeons in the US use smooth surface implants preferably. Surgeons in Europe and South America prefer textured implants.

Textured implants provide no advantage against capsular contracture.


Breast implants cause cancer.

The information we have up to date does not support such claim.  The year 2012 is the 50Th anniversary since the first breast augmentation. If breast implants caused cancer we would know by now. There has been a recent report that a type of lymphoma was found on the capsule surrounding breast implants in some women with prior breast augmentation. This does not mean that in those people the lymphoma was associated with the presence of the breast implants. More investigation is being undertaken to investigate this issue.   Apart for this very recent report there has never been up to date any proof associating silicone gel or saline-filled breast implants with any cancer in the body. There is simply no cause and effect relationship between breast implants and cancer.  A typical cause and effect relationship is that which exists between smoking and lung cancer.


You cannot breast feed after you have a breast augmentation.

Not true. If the surgical incision and approach is under the breast in the inframammary fold and the implant is placed sub muscularly then there typically may not be any problem with future breast-feeding and nipple sensation.


I lose breast sensation if I get a breast augmentation.

Not true. If the breast augmentation is done via an inframmamary approach (a small incision about an inch and a quarter underneath the breast fold) then on the contrary women’s breast and nipple sensitivity is heightened. Most enjoy that as an added bonus of the surgery.


You need an implant to lift the breasts for a breast lift.

No. The breast lift operation (mastopexy, mastoplasty) has the ability to reshape and mold the breasts giving them a youthful perky look. The whole skill is in the surgical technique of molding. A well-trained plastic surgeon can do that without the need to rely on an implant. Some people do not want implants in their bodies and we must respect that.


Darker skinned people are prone to darker, thicker and more visible scars

False. Black, Latin, Indian and southern European patients often believe this to be true. While certain people may have a genetic predisposition to forming keloid or hypertrophic scars, the color of the skin itself does not affect the wound healing process and thus does not affect the eventual look of an incision.


Natural Breast Augmentation with fat is better.

While fat transfer techniques continue to advance, in my opinion it is not better than implant-based augmentation. Removing fat with liposuction from different areas of the body and then adding the fat to the breast by injections is indeed a way to enlarge the breasts. However some of that fat will die in the preceding 12 months and may form scar tissue and granulomas. Scar tissue and granuloma will be felt as a breast lump. Can you imagine the scare this patient will have? It will make her seek medical attention, many tests and even breast biopsy in order to rule out that those lumps are not cancer. In addition fat transfer to the breast can cause uneven breast skin contour.


John M. Anastasatos, M.D., FACS

The son of a Greek shipping executive, Dr. Anastasatos was born in New York during one of his father’s overseas assignments. In 2007 he moved to Beverly Hills and established his own private practice. Dr. John Anastasatos performs both cosmetic and reconstructive plastic surgery. That also includes revision cosmetic surgery of the face, breast, body and nose. You can connect with Dr. John Anastasatos on his Google Plus account.