Liposuction, tummy tuck procedures and breast augmentations are some of the most common forms of cosmetic procedure to be performed in Hawaii. A plastic surgeon there should be certified by the American Board of Plastic Surgery (ABPS), the only body recognized in the field by the American Board of Medical Specialty.
One of the most often performed procedures is breast augmentation. Saline (saltwater filled) or silicone gel implants are the most common types. Additional choices and considerations are whether the implant is placed above or below the pectoralis muscle, and whether the incision will be below the breast, around the nipple, or axillary (under the arm). Generally the surgeon will discuss all the options with the patient so that optimal results are obtained.
There are some advantages to saline implants, and there has in the past been a lot of concern about complications from silicone implants. Saline implants are empty when they are implanted in the patient. Saline (salt water) is injected into the implant after insertion. This means that a smaller incision is required.
Saline implants were more common in the United States during the 1990s because of restrictions with silicone implants, but they are not used much in other countries. There can be cosmetic problems with saline implants, such as wrinkling and rippling, and they may be rather more noticeable than silicone. Often silicone is the preferred implant for patients who have very little breast tissue, or who require reconstruction after mastectomy.
There are many generations of design for silicon implants, and some of the early types had a number of problems. These led to lawsuits against manufacturers in the US. New generation designs have been developed since then.
The fifth generation designs have been used in other countries since the mid 1990s, but are still at a preliminary evaluation stage in the United States. The improved design should remove the problem of silicone migration. Surgeons will normally discuss all the pros and cons of different implant types with their patients.
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