The saline implant can be placed above or below the pectoral muscles, depending on the position of the patient's breast, with minimal post-operative hardening or distortion. The complication rate of saline implants, which are filled with a sterile salt solution, is very low, and they are considered safe for all forms of augmentation.

Saline implants have also proven to be durable. They normally do not need to be replaced even if a leak occurs. The sterile solution used to inflate the implants is absorbed by the body without harm. If replacement is necessary, the surgeon uses the original incision to insert the new implant, in a simple procedure with rapid healing.

In a mammaplasty, or breast augmentation, implants are inserted in a deflated state through minimal, inconspicuous incisions. The route of insertion will depend on the shape of the patient's breast and how large an implant she has chosen. The type of incision is discussed in detail during a thorough pre-operative consultation. The surgeon takes "before" photographs of the patient's breasts. These images help the patient better understand the various possibilities for aesthetic enhancement and the likely outcome of the surgery. Whether the incision is located under the arm or at the edge of the nipple complex, the ultimate goal is to achieve a natural-looking breast.

The most natural results occur when the augmented breasts are based on the shape of the original breasts, and the implant is used to fill out the skin to its natural volume. Patients who are forty or more pounds overweight may not be good candidates for breast augmentation, as the volume of their pre-surgery breasts may be artificially enlarged by the excess fat.

Asymmetrical or drooping breasts may require modifications to the skin and the position of the nipple in order to achieve the ultimate symmetry and balance. Several consultations with the surgeon may be necessary for the patient to fully grasp the options and likely outcome, and for doctor and patient to settle on details of the augmentation.

PRE-SURGERY
Patients with a history of cysts may be required to have a mammography. Anti-clotting medications should be stopped at least one week prior to surgery.

POST-SURGERY
A post-surgical garment -- a support bra -- should be worn for the first five days post-surgery. Surface sutures, if there are any, will be removed after five days. For the next six to eight weeks, the patient should avoid wearing an underwire bra. Strenuous arm lifting and sports such as tennis or golf should be avoided for four weeks post-surgery. After that, the patient should always wear some type of support garment when active.

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