The first step in the breast augmentation consultation is to determine what type of procedure is appropriate after examining the breast size and the thickness of the subcutaneous fat around the breast.

In this article, I would like to talk about silicone bag breast implants among breast augmentation.

Currently, silicone bags approved by the U.S. Food and Drug Administration (FDA) consist of a bag made of a silicone membrane filled with silicone gel. The gel is cohesive, meaning that even if the bag is torn, the silicone gel inside will not leak out.

Silicon bags are available in a variety of sizes.
A 3D simulation is used to determine what size of silicone bag will be best suited for the desired breast volume.

The two most common sites for silicone bag insertion are under the mammary gland and the underlying pectoralis major muscle. There are also other options such as the submammary fascia. In the dual plane method, a portion of the silicone bag is inserted under the mammary gland and a portion under the pectoralis major muscle by partially separating the attachment area of the pectoralis major muscle from the bone.

If the amount of breast tissue is small, the silicone bag form is often chosen to be inserted under the pectoralis major muscle, as it is easier to see the silicone bag form from the body surface when inserted under the mammary gland. There is also the option of hybrid breast augmentation in combination with fat augmentation.
When silicone bags are inserted under the pectoralis major muscle, the shape of the bag is less visible from the body surface, but the skin may move with the contraction of the pectoralis major muscle, resulting in an unnatural breast shape.
In the dual-plane technique, the silicone bag is inserted under the pectoralis major muscle, but because the pectoralis major muscle is detached from its attachment, the silicone bag is unlikely to move due to contraction of the pectoralis major muscle.

The skin incision sites include the armpit (axilla), underbust (inframammary groove), and nipple, but very few cases are inserted through the nipple area.

I will continue with my next column on the precautions for silicon bag breast augmentation.