Silicone vs. Saline: Which is right for you?

When undergoing breast augmentation surgery in Pittsburgh with Dr. Capone, patients are empowered to choose their own implants with the support of their surgeon.  Dr. Avery C. Capone, M.D., performs breast implant surgery using all major FDA-approved breast implants.  His patients are provided with every opportunity to better understand their options in breast implants prior to their tailored breast augmentation surgery.

• Silicone: While all breast implants utilize a silicone shell, “silicone” implants are pre-filled with a cohesive silicone gel. They have a consistency similar to gelatin and hold their shape even if the shell is cut.  Silicone gel can vary in cohesivity and firmness.  Silicone gel may approximate natural breast tissue more closely.  Highly cohesive, "Gummy Bear Implants" are favored by those interested in more firm, responsive feel
• Saline: These implants also utilize a silicone shell but are filled with sterile salt water.  Saline breast implants can be inserted through smaller scars, and they are less costly.  Saline implants require less imaging and surveillance than their gel-filled counterparts.

During your breast augmentation consultation with Dr Capone, you will have the opportunity to examine and compare the different types of implants.  It remains Dr. Capone’s priority to help you feel empowered and confident in your selection of the very best breast implant to suit your specific goals.

Scar Minimization & Placement Options

Dr. Capone is experienced in all major techniques, meaning your incision location is based on your preference, not surgeon limitation.
Inframammary fold: the incision is placed on the underside of the breast, where the breast meets the abdomen.  With the scar situated in this natural crease, scars are well-hidden and visible from the ground-up view.

• Periareolar: the incision is placed along the edge of the dark nipple skin (areola).  Although centrally located on the breast mound, the scar is remarkably well-hidden at this junction of dark and light skin tones.  
• Transaxillary: the incision is placed in the armpit, well-hidden within the folds of the axillary skin, with zero scarring on the breast itself.  Dr. Capone utilizes endoscopic techniques to facilitate this approach to breast augmentation surgery.

During your breast augmentation consultation with Dr. Avery C. Capone, M.D. you will together explore the nuanced differences between these various options, their respective pros and cons.
Scar-healing is a process that spans 12-18 months.  Dr. Capone will take an active role in your own scar-optimization.  The best scars are the result of thoughtful scar planning, careful suture selection, meticulous surgical technique, and diligent aftercare with oversight.  Dr. Capone initiates a topical scar regimen for all of his patients 3-4 weeks after surgery, further optimizing their scar healing.  For patients who have had problems with scarring in the past, such as those with keloid history of hypertrophic scarring history, Dr. Capone employs further management strategies to contend with these issues.

Implant Placement: Above vs. Below the Muscle

Breast implants can be positioned in different tissue planes during breast augmentation, and Dr. Avery C. Capone, M.D. helps his patients to choose the plane that better meets their goals.

• Submuscular (below the muscle) dual-plane: in this approach, the breast implant is tucked under the pectoralis major muscle.  By lifting the pectoralis major atop the implant, the muscle may further camouflage the implant and its edges.  This plane provides additional fullness in the upper pole of the breast – a helpful advantage in thinner patients.  The additional work to lift the muscle may impart more soreness during early recovery.  When you flex your chest, there is more breast-movement as compared to subglandular implant placement.
• Subglandular (above the muscle): in this approach, the breast implant is placed directly behind the breast tissue, on top of the muscle.  When you flex your chest, breast-movement is less noticeable compared to submuscular plane.  The subglandular plane can accommodate larger implants, and may involve less discomfort in early recovery. 

Dr. Avery C. Capone, M.D. take time with you to compare the many nuanced differences between these options and help you to arrive upon a tailored surgical plan to maximize your confidence and best enhance your breast shape and profile.   

Recovery Timeline: What to Expect

Pain management: Dr. Avery C. Capone, M.D. utilizes evidence-based, multimodal pain management strategies in breast augmentation surgery.  These measures start even before your surgery, during the preoperative phase.  Dr. Capone takes additional steps intraoperatively to further reduce postoperative discomfort.  Dr. Capone provides his patients with an easy-to-follow, reliable medication guide after surgery that reduces discomfort and minimizes opioid use. 

• Down time: Patients will often take a week off of work in their recovery from breast augmentation, but many patients will return to desk-work after just a few days.  Responsible, adult accompaniment is necessary for the first day after surgery.  
• Activity limitations: After breast augmentation surgery, Dr. Avery C. Capone, M.D. instructs his patients to limit shoulder range of motion for six weeks. Most patients will be back to driving within 1 week.  
• Garments & Aftercare: Dr. Capone counsels his patients to wear a supportive surgical bra for about 6 weeks after surgery.  He may further advise his patients to pursue additional breast massage or garment exercises at home depending on their surgery.  

Your Safety is Our Priority

Breast augmentation surgery is safe and effective, and while immediate surgical risks are lower than other common elective procedures, efforts to mitigate those risks are the primary focus of Dr. Capone's care.  Safety in surgery begins prior to incisions, in comprehensive health assessment.  Together with Dr. Capone, you will identify those aspects of your health that could be modified to improve your surgical risks. 

Safety is further pursued in the operating room with evidence-based strategies in safety.  Smaller incisions are utilized wherever possible, and antibacterial irrigation thoroughly rinses the surgical pocket prior to implant placement.  A "no touch" technique is used whenever possible to further protect your breast implants at the time of placement.  Dr. Capone pursues multimodal strategies in meticulous hemostasis to reduce bleeding and minimize thermal tissue effects.

Comprehensive surgical aftercare further supports your safe healing, and Dr. Avery C. Capone, M.D., remains directly involved in this important phase of care.  During your recovery after breast augmentation surgery, you can expect Dr. Capone to be with you every step of the way.

While breast implants do not have an expiration date, they are not considered lifetime devices.  As time passes, the likelihood of needing follow-up surgery increases due to natural wear, shifting, or age-related changes.  Dr. Capone's breast augmentation patients are patients for life. In addition to comprehensive physical examinations, Dr. Avery C. Capone M.D. offers high-resolution, in-office ultrasound to better help you to monitor your breast implants during long-term follow-up.

With Dr. Avery C. Capone, M.D., safety in breast augmentation goes beyond just the surgery itself. During your consultation with Dr. Capone, you will have the opportunity to explore the risks and safety considerations relevant to your tailored breast augmentation surgery.

Composite breast augmentation with Dr. Avery C. Capone, M.D.

Dr Capone offers breast augmentation with simultaneous fat grafting in Pittsburgh.  This composite, dual augmentation approach (sometimes referred to as Hybrid Breast Augmentation) can impart a more natural feel to the augmented breast.  This composite approach to breast augmentation entails liposuction of fat from unwanted areas (abdomen, flanks, or inner thighs), processing and purification, then transfer of harvested fat to tissues surrounding the breast implant.  This composite augmentation technique offers several advantages, including improved camouflage and coverage of the breast implant, especially in thinner patients pursuing above-the-muscle breast augmentation.  While only 50-80% of transferred fat cells will survive transplantation, the fat tissue that remains is permanent and will enlarge or shrink as you gain or lose weight.  

Composite breast augmentation can be an especially powerful technique in secondary breast surgeries, adding contour and padding to specific areas of need.  Composite augmentation involves a second surgical site – the donor areas – which require special care in recovery.  Dr. Capone is excited to consider the role of composite auto-augmentation in your own breast surgery.  Schedule your consultation with Dr. Avery C. Capone, M.D. today to explore all options available at the forefront of breast augmentation surgery.

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