There is significant variation of the degree of softness and how breasts feel from person to person, even in those who have never had breast surgery. There are multiple factors in how the breasts will feel after an augmentation:
· 1. The fill material of the implant: Generally the feel of silicone is more natural than that of saline, especially in a person with very little breast tissue.
· 2. The amount of a person’s own breast tissue: If someone has a fair amount of their own breast tissue, then the feel of saline versus silicone is not as important because the existing breast tissue provides a thicker cover over the implant.
· 3. The position of the implant. Sub-muscular or sub-glandular: If an implant is under the muscle, there is additional tissue that covers the implant, usually resulting in a softer feel.
· 4. The configuration of the implant: Higher profile implants may feel firmer. Form stable implants also known as highly cohesive gel implants and commonly called “gummy bear implants”, which may be appropriate in some patients, are claimed to feel more natural, but are actually firmer than the other current types of silicone implants.
· 5. The implant covering: Smooth surface implants move more naturally than textured implants, so they feel more natural, especially when someone lies down.
· 6. Implant size. Very large implants usually do not feel or look as natural. Saline implants that are significantly over-filled definitely feel firmer.
· 7. Capsular contraction: Implants initially feel tighter and firmer and then get softer unless there is a tightening of the internal scar that forms around an implant which can make the breast feel firmer. It occurs in a lower rate with saline implants and in a sub-muscular position.
· 8. The plastic surgeon: It is not only the type and position of the implant that is important in achieving an outcome. It is also the plastic surgeon. To maximize the probability of having a pleasing result, have a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery and ideally a member of The American Society for Aesthetic Plastic Surgery and address your concerns .
Most patients who have undergone a breast augmentation are happy they did it.
Robert Singer, MD FACS
La Jolla, California