Breast Implants


Breast implant strength is one of the most pressing concerns of women who consider undergoing breast augmentation surgery. To shed light on the issue, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos in order to demonstrate how durable this artificial prosthesis can be.

 

In the first trial, Dr. Smiley asked a 125 lbs. woman to step on two breast implants, putting all her weight on them (one was saline-filled, while the other was silicone-filled). No leak or rupture occurred after the experiment.

 

In another trial to assess breast implant strength, Dr. Smiley asked one of his assistants to throw saline and silicone implants out the window four stories high. When picked up and closely observed, again, no rupture was seen.

 

To further demonstrate how strong [FDA-approved] breast implants can be, Dr. Smiley conducted another trial in which he literally ran his car over saline implant, then silicone implant. Both prostheses remained intact; the only sign that showed they were subjected to extreme load was the tire mark.

 

breast implant strength

The weight of this large sedan is not enough to cause implant rupture.

To further take it to the next level, he asked one driver of an SUV to pullover and run over saline implant, which instantly burst. Simply put, it would take about 4,200 lbs. of force or weight before the breast implants rupture or “explode.”

 

Dr. Smiley posted these trials on Snapchat to bust common myths about breast implants.

 

* The changes in air pressure during flight will not cause the implants to instantaneously explode.

 

* Weight lifting, strength training, rigorous aerobic exercises, and the likes will not affect implant durability.

 

* Modern breast implants have impressive durability that in the event of replacement, leak only accounts for a very small percentage. More common reasons for breast revision or replacement include capsular contracture, implant displacement (e.g., sagging), wrinkling, and wanting to downsize/upsize.

 

In an attempt to preserve the results of breast augmentation or at least minimize the revision rate, the celebrity plastic surgeon said he makes all the efforts to prevent capsular contracture, a condition in which the scar capsule around the implant becomes copious due to the over-production of collagen (scar tissue).

 

The body is believed to produce excessive scar tissue around the implant when the latter comes into contact with microbes and other “irritants.” Hence, Dr. Smiley said he utilizes all techniques to reduce risk of implant contamination at the time of surgery.

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While breast augmentation trends come and go, there are universal guidelines that help surgeons achieve natural-looking results and minimize risk of complications, particularly relating to aesthetic issues such as sagging or bottoming-out, and rippling.

 

Leading Inland Empire plastic surgery expert Dr. Tarick Smiley, who performs over a hundred breast augmentations every year, has provided basic explanations of the current breast augmentation trends.

 

breast augmentation trends

 

Although many trends and new technologies have paved way for safer, longer-lasting implants, Dr. Smiley says the ideal choice still boils down to patient compatibility, meaning that one’s underlying anatomy and aesthetic goals must be in line with her implant type, design, and size.

 

  • Breast implants that “acknowledge” and “respect” patient lifestyle

 

Patients who participate in sports and fitness programs generally seek breast augmentation to achieve a more balanced figure, instead of having a “cup size” that will be the focal point of their physique. For this reason, they choose the conservative route—i.e., breast implants not bigger than 350 cubic centimeter or cc.

 

While cc is not directly correlated to the final breast size (due to variables such as pre-existing tissue, chest shape, and other anatomy), patients with an active lifestyle typically ask for a full B or small C cup result, or simply want to restore the lost volume in their upper breast pole following pregnancy.

 

  • Gummy bear breast implant

 

This is a marketing term used to describe fifth generation silicone implants. But instead of a “runny” silicone gel, it uses solid silicone whose molecules have stronger crosslinks and so it is highly cohesive just like a gummy bear candy.

 

The solid silicone will keep its form when cut in half and so the risk of rupture is markedly low, with one study suggesting it is only 2.6 percent within a nine-year period.

 

  • Fat injection

 

While fat injection is a growing trend in buttock augmentation surgery, it is rarely used as a primary method to reshape and increase the breast size. Unlike the butt area, the breast can only “take” a lower volume of fat.

 

Nonetheless, fat injection—which involves liposuction as a way to collect unwanted fat, and purification prior to re-injection to achieve a high survival rate—can serve as an additional soft tissue coverage to prevent or minimize risk of rippling and palpability.

 

  • Postoperative breast massage

 

A 2016 survey conducted among active members of the American Society of Plastic Surgeons has shown that more than half of the 1,067 respondents recommended postoperative breast massage, which basically requires pushing the implants into the outermost corners of the pocket.

 

The idea is to retain the thinness and softness of the scar tissue sac encapsulating the implant, which in turn prevents capsular contracture and high riding implants.

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Crescent lift with implants basically involves slight elevation of the areola and a simultaneous breast augmentation. It is important to note that it only suits patients who do not require an actual breast lift.

 

Breast lift surgery, in the truest sense of the term, elevates the breast tissue with internal sutures. At the same time, the nipple area is repositioned higher, making sure that it lies above the submammary fold, to achieve more proportionate, perkier results.

 

crescent lift with implants

Meanwhile, a crescent lift does not involve actual elevation of the breast tissue. Basically, it just raises the nipple area slightly with the creation of a concave shaped incision at the upper border of the areola; hence, the resulting scar precisely lies at the dark-light skin junction and is almost invisible when completely healed.

 

Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to demonstrate crescent lift with implants.

 

The patient shown in the videos has no “real” breast ptosis (sagging), which is medically defined as having a nipple area drooping below the submammary fold. However, she could benefit from a slight elevation of her areola and so Dr. Smiley performed a simultaneous crescent lift.

 

Some surgeons are hesitant to use the crescent lift due to the perceived risk of areola distortion (it may appear asymmetric, wider, or elongated after surgery). However, Dr. Smiley said in the video that poor results generally arise when excessive tension is put on the skin.

 

In the video, Dr. Smiley is seen closing the concave shaped incision with the use of absorbable suture. But instead of “picking up” the skin, all the stitches were made “inside” or beneath the skin layer.

 

Meanwhile, the skin’s edges were simply allowed to “kiss other” so the scar will remain thin and inconspicuous as it lies precisely at the areola’s border.

 

“Favorable or invisible scar can be achieved if there is no or very little tension on the skin. We simply respect the skin during wound closure,” he said in the Snapchat video.

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One of the latest breast implant trends involves “combination procedures,” allowing surgeons to give additional volume and achieve optimal breast shape at the same time, as explained by leading Beverly Hills plastic surgery expert Dr. Tarick Smiley.

 

For patients with good or decent breast symmetry and shape (i.e., no sagging appearance or downward-pointing nipple), in most cases breast implants alone can provide impressive results.

 

breast implant trends

However, patients with noticeable breast ptosis (sagging), suboptimal areola position, enlarged nipple area, and conspicuous asymmetry (one side larger or more pendulous than the other) will need some type of ancillary procedure to achieve optimal results from breast augmentation.

 

Dr. Smiley says that failure to address the aforementioned “issues” can lead to unnatural breast contour, implant displacement, imbalance, and other surgical stigmata.

 

The celebrity plastic surgeon has explained the most common breast implant trends and “combo methods.”

 

  • Breast lift

 

Breast lift, which basically elevates the sagging breast tissue (not just the skin), is a great complementary procedure particularly in women with ptosis in which the nipple area falls beyond the submammary fold.

 

Patients with mild or pseudo-ptosis in which the areola is positioned slightly lower, although still above the submammary fold, can also benefit from a modified form of breast lift. For instance, a donut lift slightly elevates the nipple by creating incisions at its border; therefore, the resulting scar blends into the background.

 

  • Areola reduction

 

There is an uptick in the number of patients seeking smaller breast augmentation (i.e., B and C cup, which is often achieved with the use of 300-350 cc implants). Complementing this growing preference is the smaller nipple size, which is basically achieved with the creation of incisions around the areola’s order.

 

  • Simultaneous fat transfer

 

Fat transfer as an alternative to breast implant is rarely used because of the limited results: Most patients can only expect about a cup size increase since the breast only allows a relatively small amount of grafts. Too much injection and the surgeon runs the risk of low survival rate and less than optimal results.

 

But as an ancillary procedure of breast implant surgery, fat transfer can be an excellent option for patients who are susceptible to implant rippling and palpability.

 

It is important to note that thin and athletic patients are at an increased risk of rippling in which the outline of the implant is visible beneath the skin. However, this can be minimized by fat transfer in which the goal is to add an extra layer of fat between the prosthetics and the breast tissue.

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The Benelli lift with breast implants basically accomplishes two things: create an “illusion” of a perkier appearance, and provide more breast volume.

 

The term “illusion” is an appropriate way to describe the effects of Benelli lift, which unlike the standard breast lift, does not manipulate and reshape the actual breast tissue. It simply relies on repositioning the areola higher on the breast.

 

benelli lift with breast implants

 

Meanwhile, a standard breast lift actually “lifts” and re-anchors the sagging breast tissue.

 

For this reason, the Benelli lift only suits patients with pseudo or fake breast ptosis or sagging—i.e., the upper breast pole appears “empty” but the areola has not yet sagged below the breast fold.

 

To demonstrate the effects of Benelli lift with breast implants, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos involving the technique.

 

The patient shown in the video had enlarged areolas, which were positioned lower than ideal, although they had not yet drooped beyond the breast crease. Moreover, her breast size was disproportionately small for her body and thus she requested for a simultaneous augmentation surgery.

 

Dr. Smiley started off the surgery with the creation of a smaller areola. He used a round cookie-cutter device to make an imprint of the new areolar complex. Then, he created an oblong-shaped incision outside of the same cut.

 

With the aforementioned incision pattern, Dr. Smiley was able to remove some of the dark pigmented skin of the areola, ultimately reducing its size. Of course, he lifted it a few centimeters from the breast crease to achieve a perkier, more youthful appearance.

 

According to studies, the ideal distance between the nipple and the sternal notch (visible dip between the neck and the collarbone) is between 17-21 cm. But if there is a larger gap, the breasts are perceived to be saggy.

 

After improving the shape, size, and placement of the areola, Dr. Smiley positioned the implants to give the patient more breast volume. These prostheses are propelled into their pockets through the previously created incision around the nipple area, thus avoiding additional scar.

 

The resulting scar from the Benelli lift, meanwhile, lies precisely at the dark-light skin junction and so it will blend into the background after six to 18 months, Dr. Smiley said in one of his Snapchat videos.

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Capsulectomy breast implant exchange is the best solution for capsular contracture, a complication in which a thick scar capsule forms around a prosthetics, as explained by leading Beverly Hills plastic surgeon Dr. Tarick Smiley on his recent Snapchat posts.

 

In a series of Snapchat videos, Dr. Smiley presented a patient whose right breast had capsular contracture, leading to the implant to ride higher; it also resulted in hardness of the breast tissue. The left breast, meanwhile, had no such problem although it appears pendulous.

 

To achieve good results from capsulectomy breast implant exchange, Dr. Smiley also performed areola reduction and wise breast lift technique.

Capsulectomy Breast Implant Exchange

After and before photos of a patient who have had revision breast augmentation to correct her capsular contracture

In the videos, the celebrity plastic surgeon is seen removing the entire scar capsule, which has encapsulated the implant.

 

“It is important to remove the entire capsule to prevent the problem from recurring. In primary breast augmentation, the capsular contracture rate is 4 percent, but in revision it goes up to 15 percent,” he said.

 

“However, removing the entire capsule and with the use of meticulous techniques, we can lower the capsular contracture rate to 4 percent,” he added.

 

Aside from lowering the risk of recurrence, Dr. Smiley said that removing the entire scar capsule also allows for smoother, more natural results from revision breast augmentation.

 

“The thick scar capsule squeezes the implant inside sometimes to the point that it becomes deformed, with some of its edges showing through the skin as bumps,” he said.

 

To further reduce the risk of capsular contracture recurrence, Dr. Smiley always irrigates the implant pocket with antibiotic solution, and only performs his surgeries in accredited surgical facilities.

 

“One of the main causes of capsular contracture is implant contamination at the time of surgery. However, this can be minimized since our accredited surgical facilities have air ventilation system designed to curb contamination. Also, they are fully equipped with sterilization devices,” he further explained.

 

Moreover, Dr. Smiley requires all his patients with smooth round implants to perform breast implant massage everyday to maintain the “thinness” and softness of the scar capsule, which naturally forms around any implanted device.

 

“Capsular contracture is made up of excess collagen fiber. We could prevent this from happening with daily breast implant massage in which the idea is to push the prosthesis into the outermost corners of its pocket,” he added.

 

Meanwhile, Dr. Smiley finished off the surgery by performing a breast lift, which corrected the patient’s pendulous breasts.

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