Considering Breast Implants This Summer?

Breast augmentation with implants still reigns as one of the most popular cosmetic procedures around the world according to the American Society of Plastic Surgeons. Women choose to have this procedure for different reasons. Common goals of having breast augmentation with implants are often to restore lost volume post pregnancy or weight loss, to create symmetry due to deformities or underdeveloped breast, and breast reconstruction after a mastectomy. The number one reason we hear from patients during the summer season is the desire to look better in summer clothing and enhance self confidence. 

At New Image Plastic Surgery, Board Certified Female Plastic Surgeon Dr. Roberta Gartside answers some of the most asked questions in her practice regarding breast enhancement surgery. 

Silicone vs. Saline? 

It’s not unusual to be confused about the type of implants with the many options out there today. For the most part, you will probably find most plastic surgeons recommend silicone gel filled implants more often. The is because they feel more natural followed by a slightly reduced risk of seeing rippling through the skin. 

Saline implants are made of the same silicone shell as silicone but are filled with sterile saltwater. The only time I would recommend saline implants verses silicone to a patient is to offer adjustability for women who have asymmetry in the volume of one breast versus the other. Saline implants offer the ability to do more fine tuning and adjustments to the size. Additionally, since these implants are placed prior to being filled they can be inserted using smaller incisions, while silicone implants are pre-filled and require larger incisions. The biggest difference between saline and silicone is that if a saline implant ruptures, you will notice it immediately. If a silicone ruptures, it can be more difficult to detect and require imaging such as an MRI. 

What is the difference between Saline and the IDEAL Implants? 

All implants come with a silicone shell. Saline and IDEAL implants are both filled with sterile saltwater. When comparing the standard saline implant to the IDEAL saline implant, the distinct difference is that the IDEAL implant has an internal baffle system, which reduces the risk of rippling. This is more similar to the silicone implants in that they feel more natural than regular saline implants. 

Under vs. over the muscle 

I recommend the location of breast implant placement based on my patient’s physical examination and desired breast size. In general, the position under the muscle is favored as studies have shown a lower risk or capsular contracture, although that difference is very small. Under breast tissue may be recommended in extremely physically activity women to lower the risk of any muscle distortion as well as in women with borderline sagging or ptotic breast who choose not to have a breast lift. 

Best Incision site and why? 

There are generally three locations of incisions: the crease under the breast, around the areola, and under the arm near the armpit. I favor the crease under the breast (inframammary fold) for a number of reasons: it tends to be well hidden in the crease of the breast, allows access for any size implant whether it be silicone or saline, and may have a slightly lower risk of capsular contracture around the implant because there is less contact with breast tissue during insertion. 

How long do I need to take off work after a breast augmentation surgery? 

Typically, the recovery from breast augmentation surgery is quite quick. Within one week, most women can drive and return to work, depending on the nature of the job. Strenuous activities will be restricted for at least a month. 

How long do breast implants last? Do they need to be changed every 10 years? 

The general rule with breast implants is if they are not broken, don’t fix them. There seems to be a written myth that implants need to be changed every 10 years. I think this comes from the impression of the warranties associated with breast implants, which are for 10 years. Reasons to have your implants either exchanged or removed fall into a few different categories, such as rupture or leak, breast changes, and capsule contracture (formation of scar tissue). The lifetime of breast implants depends on a lot of factors, but in most cases it’s important to remember that they’re not intended to last a lifetime with no upkeep. You may need to remove, replace, or revise them at some point. 

Interested to learn more? Visit or call 703-742-8004 to schedule your breast implant consultation with Dr. Gartside today! 

Roberta Gartside
Roberta L. Gartside, MD, FACS is certified by the American Board of Plastic Surgery and with over 25 years in practice, Dr. Roberta Gartside is one of the most experienced and highly sought-after plastic surgeons in the area. In addition to offering patients a wide range of reconstructive and cosmetic surgery procedures, she also offers outpatient skincare treatments such as fillers, like Botox, and lasers, including the Gentle Waves Skin Fitness System™ - a breakthrough LED light treatment therapy that helps rejuvenate aging skin. While patients certainly appreciate Dr. Gartside’s vast experience and offerings, they also place great value in the time she and her gregarious staff take to explain each and every option available to them. Committed to upholding the utmost standards in her specialty, in addition to working on the medical staff at Fairfax Hospital, Fair Oaks Hospital and Reston Hospital Center, Dr. Gartside has served as Vice President of Membership and Communications for the American Society of Plastic Surgery and as a Board Representative of the National Accreditation Program for Breast Centers. She has also worked with Operation Smile and the Fairfax Skindeep Tattoo Removal Program in the past.