Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:

• To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
• To correct a reduction in breast volume and sagging after pregnancy.
• To balance a difference in breast size.
• As a reconstructive technique following breast surgery

Correction of these problems can greatly improve self esteem for many women.

There are many options that a patient should consider prior to having breast implant surgery, such as type of implant, placement of the implant (above or below the muscle) and incisions used to place the implant.  These options will be discussed with you during your consultation with Dr. Becker, at which time the optimal choices that best suit your body and desires will be determined.

Dr. Hilton Becker is best known for having developed the adjustable breast implant. 
He is now pleased to offer his patients the New Cohesive Gel (Gummy Bear – MemoryGel) implants.

“Results with these new implants are now better than ever.  The results look and feel     more natural.  Our patients that have received these implants are simply delighted”.

Dr. Hilton Becker has extensive experience using silicone gel breast implants.  He has been part of the FDA Adjunct Study of Silicone Breast Implants and has been using silicone gel implants since the study was started in 1992.

The FDA has approved Silicone Breast Implants after years of intense studies.  If you have had or are considering Breast Augmentation, here are some facts you need to know. 

Due to the firmer nature of the cohesive gel, a larger than normal incision is necessary; therefore, the inframammary (under the breast) incision is preferable for the insertion of these implants.  The gel implant may also be inserted through a breast lift incision or an abdominoplasty (tummy tuck) incision.

Saline-filled implants, on the other hand, are placed through a smaller incision, as they are not filled until they are placed in the pocket.

• More natural position, appearance and feel
• Less painful, quicker recovery

• Less tapered upper pole (less noticable with sub fascial placement)
• Possible increase in capsular contraction

• Gives more coverage and support to the implant, particularly in thin patients with small breasts
• More natural upper pole fullness
• Possible less interference with mammography
• Slightly less risk of capsular contracture

• More painful
• Longer recovery
• More movement with muscle contracture
• Possibility of visible step-off at muscle edge

• Very low leakage rate (cohesive)
• Lighter than saline therefore less tendency to cause sagging if placed above the muscle
• More natural feel
• Less chance of rippling

• Larger incision necessary

• Smaller incision
• Lower cost
• Slightly less incidence of capsular contracture

• Higher leakage rate
• Higher incidence of rippling
• Heavier than gel, therefore preferable placement is behind the muscle to avoid sagging

• Volume can be changed after surgery
• Patient has input into final size
• Better able to correct asymmetry
• Better able to treat complications following previous breast surgery i.e., irregularities in shape, capsular contracture, symmastia  (disruption of midline)

• Injection dome has to be removed (can be buried or externalized)
• If the injection dome is buried, a second minor procedure, performed under local anesthetic, is necessary to remove the infection dome.
• If the injection dome is exteriorized,no further surgery is necessary for removal.

• More natural feel
• Less incidence of seroma (fluid) formation after surgery

• May decrease capsular contracture (This has not been proven with the new cohesive gel implants)

• Smooth, round, moderate profile- plus cohesive gel implants, preferably placed above the muscle, under the fascia (sub-fascial).

• Adjustable saline implants with external injection ports
• If the patient wishes to ultimately have silicone gel implants, adjustable saline implants are used to expand and adjust the pocket above the muscle.  These can subsequently be replaced with silicone gel implants, usually with local anesthetics.

• Submuscular saline implants are removed, the muscle is returned to its original position and new silicone gel implants are placed above the muscle (it is usually not necessary to remove the capsule unless it is calcified)

The most common breast problem seen after a woman has had one or more children is sagging of the breasts, combined with a loss of volume.  This condition is best treated by combining a breast lift procedure with a breast implant.  However, by combing the two procedures, the risk of complications are increased since the breast lift procedure results in tightening of the breast skin, while the implant enlarges the breast, resulting in increased tension on the scar.  It is for this reason that the sub-areola technique and the adjustable implant is beneficial when combining mastopexy with augmentation. Dr. Hilton Becker uses the adjustable implant, known as the Mentor-Becker implant, which he developed and pioneered in 1984.  Use of this implant, either saline or a combination of gel-saline, reduces the risk of scarring and complications associated with the mastopexy augmentation procedure.

If the adjustable saline implant is used it is placed under the muscle, the silicone gel implant is placed above the muscle.

A minimal amount of saline is placed in the implant at the time of the surgery.   Saline is added slowly over a period of 5-10 days to allow for healing of the incision.   When swelling has subsided and the implants are filled to the desired volume, the fill tubes and domes are then removed.  The implant seals itself with a self-sealing valve.

If a vertical scar is warranted, due to excessive ptosis (sagging), use of the adjustable implants greatly improves the shape and symmetry of the breast, while reducing the amount of scarring.

The new Silicone Cohesive Gel (MemoryGel –Gummy Bear) implants have been used with excellent results in combination with a sub areola mastopexy procedure.

Dr. Becker has lectured and performed live surgery at several national and international plastic surgery meetings on these techniques.  He has written two chapters in plastic surgery text books and has published three articles on this topic, including:

1. The Adjustable Breast Implant – Plastic Surgery Journal 1992
2. Augmentation Mastopexy using Adjustable Implants with External Injection Domes Aesthetic Surgery Journal – November 2006

Now that silicone gel implants have been approved for use by the FDA, women have the option of having the most natural form of breast enlargement available.

When Silicone gel implants were not available in the United States, woman had only two options available to them:

1.      Use saline implants placed above the muscle - Due to the weight of the saline implant they would tend to sag excessively, resulting in an abnormal shape, commonly known as Rock-In-The-Sock.   Rippling was also problematic.

2.      Place the saline implant under the muscle.  Although this technique reduced sagging, muscle contracture resulted in abnormal distortion of the implant.

Patients, who have previously had saline implants and are dissatisfied with their results, can now have their saline implants replaced with the New Cohesive Gel (MemoryGel – Gummy bear) implants.

It is of my opinion that the most beautiful and natural results in breast augmentation are seen with Smooth Silicone Gel implants, placed above the muscle.
Our patients who have received these implants are happier than ever.