Breast Implant Choices
- Win Pound, M.D.
There are many choices in shapes and styles of implants these days.
You would think it wouldn't be so complicated since breasts come in
one basic shape themselves. Still, with so many options, choosing
the right implant for you can sometimes be very confusing. A quick
overview of the various choices may prove helpful.
Saline or Silicone Gel: Silicone gel implants more closely
approximate the look and feel of real breast tissue but they are more
expensive. Saline implants are basically a bag full of water and
ripples/wrinkles may be more noticeable with saline implants. The
upside to saline implants is that they are filled during surgery so
that the final volume can be adjusted, unlike silicone gel implants.
Also, should a saline-filled implant rupture, there is a noticeable
loss of volume within a few days. Not only is a rupture noticed
immediately but the saline is easily absorbed by the body. Because
the silicone gel in silicone gel implants is cohesive, a rupture may
go unnoticed for a long time.
Round or Shaped Implants: Shaped implants more closely approximate
the teardrop shape of a normal breast. Because they are shaped,
however, they must be placed very precisely. Shaped implants may
also be slightly more expensive. When round implants are tilted
upwards, they assume a teardrop shape. There is also less pressure
for precise placement. Round implants can turn inside the pocket and
still look good.
Moderate Profile, Moderate Plus Profile, or High Profile Implants:
Moderate profile implants are flat and wide. High profile implants
are narrower at the base and project more. Moderate Plus profile
implants are in between. The choice of which one to use depends on
which one will best fill the base diameter of the breast. If small
implants are being used, wider implants may be more useful than
implants with more projection. If large implants are used, it may be
necessary to use higher profile implants in order to have the base
diameter of the implant fit better with the base diameter of the
breast itself. Higher profile implants may also give more of an
illusion of a lift with their extra projection in cases where
patients are on the borderline of actually needing a breast lift
Smooth or Textured Implants: The textured surface on an implant was
proposed to decrease the risk of forming a capsular contracture, the
thick scar tissue capsule that can form around an implant causing the
breast to feel firm or distort the way it looks. Statistics show
that textured implants do indeed decrease the risk for forming
capsular contractures when implants are placed above the chest muscle
(sub-glandular) but the risks are the same as with smooth implants
when the implants are placed below the chest muscle (sub-muscular).
Decisions about which implant would work best for the patient should be made in consultation with a board-certified plastic surgeon who can examine the patient in person and determine which implant would best suit the patient's needs.