Your questions about breast augmentation and other cosmetic procedures are best answered by Dr. Wendy Gottlieb. To schedule a consultation or an appointment at the Reston or Arlington office, please call 703-668-9499.

What Gives the Breast Its Shape?

The breast consists of milk ducts and glands, surrounded by fatty tissue that provides its shape and feel. Situated beneath the breast is the pectoralis major muscle or chest muscle. Factors such as pregnancy (when milk glands are temporarily enlarged), rapid weight loss, and the effects of gravity as you age combine to stretch the skin, which may cause the breast to droop or sag.

What is a Breast Implant?

A breast implant is a sac (implant shell) of silicone elastomer (rubber), which is surgically implanted under your chest tissues.

There are two basic types of breast implants:

Saline-Filled Breast Implants

The saline breast implant is inflated with a saline (salt-water) solution through a valve. Saline is much like the fluid that makes up most of the human body. There are two types/families of implants filled with saline — one referred to as Saline-Filled and the other referred to as Spectrum™ implants. The Saline-Filled family of implants has a self-sealing valve located on the front (anterior) of the implant that is used for filling the device. The Spectrum™ family has a valve on the back (posterior) of the implant that allows saline to be added after surgery (postoperative adjustability). Mentor’s Spectrum implant is a saline-filled breast implant that lets your physician adjust the size of your breasts after your surgery. In a simple office procedure, your physician can change your implant size by either adding or removing saline for up to six months after your surgery.

Silicone Gel-Filled Breast Implants

A silicone gel-filled breast implant is filled with silicone gel, a soft-solid substance. At the present time, silicone gel-filled breast implants manufactured by Mentor are only available through Mentor’s Adjunct Study.

Participation in the study is limited to qualified patients in the U.S. who are having their breasts reconstructed following mastectomy. Also eligible for this study are patients with severe congenital deformities, such as pectus excavatum and pectus carinatum, or patients with severe ptosis who underwent mastopexy with associated replacement. Patients requiring revision of saline- or gel-filled implants who are not suitable for revision with saline implants may qualify if they have specific medical justification, as outlined in the clinical protocol, from their physician. If you want to know if you qualify, please ask your physician to explain to you the requirements for being included in the study.

What is silicone?

Silicone is derived from silicon, a semi-metallic or metal-like element that in nature combines with oxygen to form silicon dioxide, or silica. Beach sand, crystals, and quartz are silica. Silica is the most common substance on earth. Heating silica with carbon at a high temperature can produce silicon. Further processing can convert the silicon into a long chemical chain, or polymer, called silicone - which can be a liquid, a gel, or a rubbery substance. Various silicones are used in lubricants and oils, as well as in silicone rubber. Silicone can be found in many common household items, such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings, and chewing gum.

Are silicone implants safe?

Special studies have been done and have determined that much higher levels of silicone have been found in cows’ milk and commercially available infant formula than are found in the breast milk of women with implants. The Institute of Medicine concluded that ”There is no evidence that silicone implants are responsible for any major diseases of the whole body. Women are exposed to silicone constantly in their daily lives.”

Are Breast Implants Permanent?

Breast implants are not considered lifetime devices. You will likely undergo implant removal with or without replacement over the course of your life. Whether you are undergoing augmentation or reconstruction, be aware that breast implantation may not be a one-time surgery. You are likely to need additional surgery and doctor visits over the course of your life.

Many of the changes to your breast following implantation are irreversible (cannot be undone). Problems such as deflation, capsular contracture, infection, and shifting can require removal of the implants. Many women decide to have the implants replaced, but some women do not. If you later choose to have your implant(s) removed, you may experience unacceptable dimpling, puckering, wrinkling, or other cosmetic changes of the breast.

Deposits of calcium can be seen on mammograms and can be mistaken for possible cancer, resulting in additional surgery to biopsy and/or removal of the implant to distinguish them from cancer.

Are There Different Styles of Breast Implants?

Breast implants come in a variety of shapes, surface textures, and sizes. The implants are available with a textured or smooth surface shells. Mentor breast implants come in either round or contoured shapes. Mentor’s Spectrum implant is an adjustable saline-filled breast implant that lets your physician adjust the size of your breasts after your breast augmentation surgery. In a simple office procedure, your physician can change your implant size by either adding or removing saline for up to six months after your surgery.

Who is Eligible for Saline-Filled Breast Implants?

Breast Augmentation — This procedure is done to increase the size and proportion of a woman’s breasts. A woman must be at least 18 years old for breast augmentation.

Breast Reconstruction — This procedure is done to restore a woman’s breast shape after a mastectomy or injury that resulted in either partial or total loss of the breast(s), or to correct a birth defect.

Who is Eligible for Gel-Filled Breast Implants?

At the present time, silicone gel-filled breast implants manufactured by Mentor are only available through Mentor’s Adjunct Study. Participation in the study is limited to qualified patients in the U.S. who are having their breasts reconstructed following mastectomy. Also eligible for this study are patients with severe congenital deformities, such as pectus excavatum and pectus carinatum, or patients with severe ptosis who underwent mastopexy with associated replacement. Patients requiring revision of saline- or gel-filled implants who are not suitable for revision with saline implants may qualify if they have specific medical justification, as outlined in the clinical protocol, from their physician. If you want to know if you qualify, please ask your physician to explain to you the requirements for being included in the study.

Who is Not Eligible for Breast Implants?

Contraindications (inadvisable treatment) for breast implants include women who are currently pregnant or nursing, have an existing malignant or pre-malignant cancer of their breast without adequate treatment, or have an active infection anywhere in their body.

What are the Alternatives to Breast Augmentation?

- Accept your breasts as they are.

- Wear a padded bra or external prostheses.

You are advised to wait a week after reviewing and considering the information in this web site before deciding whether to have augmentation surgery.

Wendy R. Gottlieb, M.D.

In addition to an individualized approach to breast augmentation, Dr. Gottlieb performs reconstruction after mastectomy, breast reduction, and the latest breast “lifting” techniques. Botox®, skin care, facial rejuvenation, eyelid surgery, face lift, neck lift, body contouring, liposuction, tummy tuck, laser hair removal, laser face and leg vein removal, and much more are offered.

Dr. Gottlieb performs Reconstructive Surgery and Plastic Surgery in Northern Virginia, Dulles, Reston, Fairfax, McLean, Arlington, Tysons. Dr. Gottlieb also performs a full array of post weight loss surgeries including body lift, breast lift, arms lift and thigh lift.

To schedule a consultation or an appointment at the Reston or Arlington office, please call 703-668-9499. You may also send an email to us using the form below: