How are breast implants inserted during breast augmentation?

There are many patients who ask how the implant in insert in during the breast augmentation.

Today, I would like to briefly share about this process.

If someone judges just by looking at the breast augmentation, then he/she might think that the overall process was quick. But as always, what you see from the outside is not so important as to what is happening on the inside.
If the implant is to be put in properly without any contamination, there must be some principles that the surgeon must follow.

The first is a principle on trauma.



If the surgeon gets too tough during the breast augmentation and hurts the tissue cells, the skin and the tissue cells at the entrance point do not regenerate.

The incision part must be very clean and the skin tissue, epithelium, muscle and other parts must cared for with minimum damage for the cells to regenerate at the point of entry. This will lead to normal state of inputting the implant.

If there is much damage to the skin and entry point along with bleeding, we will not be able to open the entry point properly making it difficult to put in the implant.
Careful desquamation, non-damaging surgery, and clean insertion of the implant are mandatory in breast augmentation.

Second, we need to conduct desquamation accurately in size and direction. 

If we approach from the areola then we need to desquamate between the gland and the skin layer. The desquamation must be precise and enough. This makes a tunnel for the implant to come out.

If we approach from the axillary fold, then we need to make a path above or below the pectoralis muscle. This path must be big enough as well. The tunnel that the implant passes through to get to the pocket must be accurate and big enough.

This applies the same on inframammary fold as well. This is really basic stuff but if the desquamation is not accurate or big enough, we may face hard time putting in the implant which could also lead to implant damage, skin damage, scar and failure in putting in the implant. In the long term, all this could lead to implant collapse or capsular contracture.



Third is the no-touch technique.

The most concerning part about putting in the implant is the contamination. Implant is a foreign substance to the body therefore if pathogenic virus infects the implant that stays within the body for a long time; this could lead to bad results.

One of the worst complications is the capsular contracture. Then where does this infection source come from? It can come from the surgeon’s hygiene gloves, or the blood that gets on the implant as the implants goes into the pocket from the entrance, or the surgical equipment used or even from antiseptics. Also, the implant from the manufacturing plant might not be hygienic enough.

The source of infection cannot be seen by the human eyes. There is no way if there is any infection caused during the surgery therefore it is best that the surgeons be careful during the surgery and take preventive care.



No-touch technique means that we do not touch the implant with our hands. We use funnel-like equipment for insertion and squeeze out the implant. Nowadays we do not use the funnel that much, but use latex gloves called insertion sleeve.

Also, the implant must be unwrapped just when the desquamation is complete and when the preparation for the insertion is complete. We need to minimize the time that the implant gets exposed to the air. We also need to minimize the number of touches we make on the implant once it is inserted.

All the 3 factors of minimizing trauma, accurate desquamation, and no-touch technique are all applied by the surgeons in all clinics. These must be carried out in order to minimize the possibility of implant collapsing, getting infected, rotating, or leading to capsular contracture.

This is all for today, thank you very much.