Second only to the decision to actually book a breast-enhancement surgery, picking an implant size is often the biggest challenge for many women. You know you want larger breasts, but perhaps you’re not sure what size will look and feel the best on your frame.
Typically your plastic surgeon will work with you to help you find the implant size that best suits your body, taking into consideration the width of your torso, current breast size, height and many other factors. You’ll have a chance to see what your breasts will look like post-surgery by experimenting with implant inserts in your bra, worn with and without clothes. Many doctors will ask you to bring photos of breasts that you like and don’t like to help ensure you get the post-surgery breast size that you want.
If after going through the sizing process you’re still nervous about the new ones you’re picking, you may want to opt for adjustable breast implants. These implants have been on the market for more than 20 years and can be made 20 percent bigger or smaller post-surgery through a simple procedure.
Who might benefit from adjustable breast implants?
Adjustable breast implants work best for patients who:
- Can’t decide what she wants pre-op and wants to control the result herself (you perfectionists may fall in this group!)
- Have an asymmetry (uneven breasts)
- Have experienced previous problems with implant size and needs to control the new size
- Want a significantly larger size that would be better to increase gradually
- Have already undergone a breast lift (that tightened the tissue) and in whom the stretching of an implant would be better done gradually
- Had a mastectomy and are undergoing breast reconstruction
How do adjustable breast implants work?
During the surgery, the implant is inserted as usual along with an internal valve, says Richard P Rand, MD, FACS, in Bellevue, Washington, who estimates that he uses adjustable breast implants on 3 to 5 percent of his patients. Post-surgery, the surgeon can make the implants larger or smaller by putting a small butterfly needle in and injecting or withdrawing the saline fluid.
“The valves can be left in for an extended time, though the manufacturer recommends taking them out at six months,” says Dr. Rand. At the end of that period, the valves are removed under local anesthesia during a 20-minute procedure and become regular saline implants.
What are the downsides to adjustable breast implants?
The major downside to adjustable breast implants is that they are only available in saline, not silicone. A few of the advantages of silicone breast implants are that they look and feel more natural, are less prone to rupturing and have a smoother appearance, says Grant Stevens, MD, a board-certified, Los Angeles plastic surgeon and the medical director of Marina Plastic Surgery Associates. Dr. Stevens says that 99 percent of his patients chose silicone implants.
There is a type of adjustable implant that has an adjustable saline inner envelope and an outer silicone implant and gives the feel of silicone gel but the post-op adjustability of saline, reports Rand. The implant is no longer available in the United States, however.
The other con to adjustable breast implants is that there is a “very slight elevation of infection rates because of accessing the implant with a needle through the skin,” says Rand. When that happens, the implant must be removed, and the augmentation process will need to be started again.
Whichever type of implant you choose, be sure to work closely with your surgeon to get the breast implant size you desire.