Okay, so you’ve finally decided that you want to look flawless on the beach in that bikini and that you’re going to get a breast augmentation to help you get there. But now, as if that decision wasn’t hard enough, you have to decide which implant is best for you and your body.
Breast implants have been used for about 40 years. Millions, yes millions, of breast implants have been placed in women in the USA alone. And millions more were used in other countries.
Breast implants are, however, not guaranteed to last a lifetime, and future surgery may be required to replace one or both implants.
First, you must know that there are two types of fill for breast implants: silicone or saline. Feedback from some patients indicates silicone implants feel most realistic.
Silicone implants are ready before surgery, and they don’t need to be filled. Therefore, they require a slightly larger incision than saline implants.
Saline-filled implants come in smooth and textured shells and can be round or teardrop-shaped. Also, ruptures are easier and faster to detect.
Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an implant has been rigorously researched and tested, and reviewed by an independent panel of physicians for safety.
Many women want implants that provide the most “natural-looking” breast augmentation results during their initial consultation. Our certified surgeons will explain which natural breast implant option is best for you.
Saline implants were more popular back in the 1990’s and 2000’s. A lot of that popularity was because there was a temporary ban on silicone implants in 1992. However, over 7 years ago, the FDA approved silicone implants for use by all women ages 22 and older, and for some women under 22 given reconstructive purposes. Since that time, more and more women have undergone silicone breast augmentation.
Saline-filled implants were initially developed as an alternative to silicone gel implants. The implants consist of a silicone rubber shell that is filled with sterile saline (saltwater) solution. The saline is the same fluid that makes up the majority of the water in your body.
Saline implants offer a variety of advantages over silicone ones. The primary advantage is that saline implants are adjustable. Therefore, doctors can differentially fill implants to obtain near-perfect symmetry.
In case of an emergency leak, the saline implant collapses and the saline easily absorbs into the body and is excreted in the urine.
An adjustable saline implant, Mentor®’s Spectrum® breast implant, allows adjustments to the breast volume for up to six months after surgery. A small, removable fill tube is left temporarily attached to the breast implant after surgery.
The tube is accessible to the physician by injection through the skin, and in a simple office procedure, breast implant size can be varied until desired results have been achieved.
Once you get to your goal size, the fill tube is easily removed during an office visit. The Spectrum® breast implant gives you and your surgeon more flexibility and control over the end result of your breast enlargement procedure.
Silicone gel breast implants were the most popular breast implant type before the early 1990s. These also consist of silicone rubber on the outside, but the inside contains a semi-solid gel of silicone. What is silicone? It is a man-made substance that has many uses. In a breast implant, it closely resembles the look and feel of natural breast tissue, so it was an obvious choice when the first implants were created.
Concerns were raised in the early 1990s that patients with these silicone gel implants might develop systemic diseases (like lupus or arthritis). Several carefully conducted studies have demonstrated no difference in the incidence of these diseases in women with and without silicone gel implants.
Silicone gel implants were subject to a great deal of scrutiny and research during the 1990s and 2000s. On November 17, 2006, the FDA ruled that silicone breast implants are safe to return to the market for cosmetic procedures. FDA studies led researchers to conclude that silicone breast implants did not cause any kind of disease.
Studies showed that there was no greater incidence of any type of disease in women with silicone breast implants compared to the general female population. At this point, it is fair to say that breast implants are among the most studied medical devices ever, having gone through decades of research in thousands of women.
Feedback from some patients indicates silicone implants feel most realistic. Silicone implants are ready before surgery, and they don’t need to be filled, and therefore require a slightly larger incision than saline implants.
A new option for women is the Gummy Bear breast implant or the cohesive gel shaped silicone breast implant.
The term “gummy bear” is just a friendly nickname as these gel-based implants are superior at holding their shape over the other implant types made from silicone and saline. They are more solid than other silicone models and have the feel and consistency of a gummy bear when you cut into one. The Gummy Bear implant was just approved by the FDA within the past few years.
This type of implant may be more suitable for women who hope to achieve a more “natural appearance.” Or for women who do not have much breast tissue, to begin with. It has been created to maintain its shape over a longer period of time over multiple years versus the other round type of silicone implants. The implant is placed via the inframammary approach and it does require a slightly larger incision.
The advantage of this type of breast implant is that it doesn’t leak like traditional silicone implants if ruptured. The Gummy Bear implants were invented to create a longer-lasting implant that would retain an attractive and predictable shape.
One downside to the silicone or cohesive breast implant is the fact that these implants can NOT be inserted through the belly button via a transumbilical breast augmentation (TUBA). TUBA is a popular procedure because there are no noticeable scars since the incision is hidden in the navel.
Breast implants can have a smooth surface or a textured (rough) surface.
As a natural reaction to any device placed in the body, a shell of scar tissue will form around the breast implant surface, creating a capsule. In some women, the capsule can tighten and squeeze the implant. This occurrence is called capsular contracture. The texturing of implants was originally introduced in silicone gel implants to reduce the incidence of capsular contracture around the implant. This does appear to be effective when the implants are placed beneath the breast gland and over the muscle of the chest wall. Textured implants have never been shown to provide any advantage over smooth implants when placed beneath the muscle of the chest wall.
But, textured implants do have their own disadvantages. Textured implants have a slightly thicker and stiffer shell which makes the implant more visible through the skin and more easily felt when the breast is touched.
A smooth implant will settle into the breast more quickly and easily than a textured implant and may be less likely to show wrinkling. Because of textured implant disadvantages and because most implants are placed in a submuscular plane, the great majority of breast implants used today are of the smooth variety.
A specialized type of textured implant is the “Anatomical” or “Teardrop” implant. These implants are not round and must be textured to keep them from turning the wrong way. These implants have a width that is different from the height and may be helpful in special situations to better simulate the shape of the natural breast. However, the final shape of the breast is determined by the breast and muscle tissue, rather than the implant. The implant is not strong enough to hold against the force of the tissue.
Anatomically-shaped implants must be placed in exactly the right position and leave less room for error. If an anatomically-shaped implant moves around, it will cause a very unnatural profile.
Until recently, most patients never discussed breast implant profile with their plastic surgeons. If you chose a certain size implant, you received a determined amount of forwarding projection from that size implant. Now, you can choose an implant size AND the degree of projection.
This works well for certain body types. For a woman with a very narrow frame, a low or moderate profile implant may be too wide and carry the implant too far to the cleavage and underarm. By using a high profile implant, this patient can get the larger volume that she desires. By the same token, a wide-framed patient may find that in order to adequately cover the natural diameter of their breast size, the desired implant would have far too much projection. A low or moderate profile might work better. Depending on the shape of your chest, our surgeons will advise you as to the best type of implant for your body.
Low Profile Implants – These breast implants have less projection for a given base diameter than a moderate profile breast implant.
Moderate Profile Implants – This breast implant profile is usually used and provides a moderate degree of projection for a given base diameter.
High Profile Implants – These breast implants have more projection per measurement of base diameter than a moderate profile breast implant.
Choosing the right size of your implant is generally the most important decision that you have to make. Because of this, our plastic surgeons will take several approaches to help you make the best decision based on your anatomy, personal preferences, and the appearance you wish to achieve.
First, the Newport Beach plastic surgeons examine your breast tissue and skin, and take appropriate measurements of your breast characteristics in reference to your chest. These measurements provide the doctors with an idea of a suitable implant that will help you achieve the size you want post-operatively.
An ideal implant will correspond to and cover the base of your breast. Thus, the diameter of your breast will provide the most important measurement and a good starting point to select your implant of choice.
Choosing an implant that is smaller than your natural breast envelope will not provide the proper cleavage and shape following the procedure. Similarly, choosing an implant that is too large for the amount of breast tissue is more likely to give you an unnatural appearance. Inappropriately large implants may be visible through skin or the implant may be more easily felt. Also, breast implants that are excessive in size may enhance the effects of gravity on your chest, which may cause your breasts to prematurely droop or sag.
Your breast size after surgery depends on two main factors: your breast size before surgery and the volume of implant inserted. The volumes of the breast implants are measured in CCs (30 cc= 1oz). Everyone is built differently and bras are not manufactured to a set standard, but it is expected that a cup size is approximately 200cc in a person of average height and build. If tall or broad-shouldered, that number to be slightly higher. Similarly, if shorter or narrow-chested, that number will be slightly lower.
During a consultation with our surgeons, the patient will try actual implants of different sizes by placing them in her bra. This will help make the decision about the implant size. Make sure that the bra is not a push-up or padded bra on the day of the consultation.
Although a desire for a certain cup size is helpful to our plastic surgeons in guiding in the selection of the proper implants, it is more helpful to focus on the shape and appearance that is wished to achieved. The most popular implant sizes are about 275 to 350 CCs in our practice.
There are several different companies that offer breast implants in the United States that include Allergan, Mentor, and Sientra; Allergan and Mentor offer both silicone and saline implants, and Sientra only offers silicone implants. All 3 of them have FDA approval to provide implants to the United States for different types of implants.
Feeling overwhelmed? Do you have any questions? Please feel free to contact us in order to make sure you are satisfied with your surgical selection. Our main goal is your happiness. But don’t forget, being realistic and following your doctor’s recommendations is very essential for the best result possible, too.
More about Dr. Siamak Agha
Dr. Siamak Agha is a renowned breast surgeon who is pleased to perform breast augmentation, breast lift, breast reduction and more at his Newport Beach practice in California. In addition, he is a top Newport Beach body contouring surgeon who performs procedures such as abdominoplasty, liposuction and mommy makeover. To learn more, or to schedule a consultation, contact his practice at 949-537-2177.