In preparation for augmentation or reconstruction with implants, it is important to understand the implant options available. Implants vary in their shell, fill material, and shape. Each implant has pros and cons. Although there is not a “perfect” implant, it is our goal to find the implant that most satisfies your preferences. This resource reviews the different implant options so that you can make an informed decision regarding the implant that is right for you.
All implant shells are made out of silicone, but can be smooth or textured. Smooth implant shells tend to feel softer and are more able to move within the space created for them on the chest. This means that they will move more like a natural breast. They can be pushed into a different position with a bra, for example, to create the appearance of more cleavage. Less commonly used in our practice are textured implants. Textured implants feel slightly more firm and are relatively immobile after being placed. Textured shells become adherent to your internal tissues, so cannot be pushed into a position to increase cleavage.
Implants can be filled with silicone (gel) or saline (salt water). Silicone is softer and feels more comfortable and natural than saline, and, in general, is less likely to show rippling through the skin. It also has a lower rupture rate than saline. If saline ruptures, your implant will deflate over time and eventually go flat. This is because saline can be reabsorbed by the body. If silicone ruptures, you may not notice at all, or you may experience a change in the way the implant looks or feels, but the volume will stay the same.
Patients often ask about safety related to silicone implants. In the past, silicone implants were taken off the market due to concern that they were somehow connected to significant health problems. This claim was very intensely researched, and no connection was found between silicone implants and the reported health issues. Despite the many benefits of silicone implants over saline, however, some patients do still chose saline due to their personal worry about their safety. In general, we counsel patients to choose saline if the idea of silicone makes them nervous despite all evidence suggesting they are safe.
Recently, a new silicone implant has been released that is slightly overfilled. This means that for the same shell size, it is filled with more silicone. Although the silicone is not necessarily more cohesive, the overfill does contribute to a slightly more firm feel. The major benefit of this type of implant is that it reduces rippling and could potentially contribute to more upper pole fullness.
In general, implants will appear more round and full at the top than a natural breast. Although this is often desirable, it is less natural in appearance. Shaped implants were designed to provide a more natural shape. These implants are tapered, so they are flatter at the upper pole, and more full at the bottom, similar to the shape of a tear drop. They are often also filled with a more cohesive gel, so feel more firm, but have less chance of contributing to visible rippling. Keep in mind that all tapered implants must be textured so that they will remain in the correct orientation; texturing reduces natural appearing mobility. Despite texturing, there is still risk for rotation. For most people, the supposed advantage of a more natural shape may not actually provide the desired result. This is best discussed on an individual basis.
Implants Used in Our Practice:
In our practice, the most common implants used are smooth round silicone implants. We offer Mentor Gel and Allergan Inspira implants. Smooth round silicone filled implants optimize comfort, longevity, and natural feel, and create a shape that is most commonly desired.