What is the best type of breast implant?

My wife has seen numerous doctors and received conflicting recommendations. What is truly the most natural-looking and feeling implant? Round silicone? Form stable silicone? Ideal Implant?

Doctor Answers 10

Dr Kayser

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Thank you for your question. Each implant has its own characteristics and pros and cons. It would be important that you fully discuss the options of each implant with your plastic surgeon so that you can be thoroughly informed of the advantages and disadvantages of each. It is important to also understand the two basic tenants of implants: first, all implants will eventually leak and second, all implants will develop scar tissue around them, which is normal and is called a capsule. With that said, further distinctions then occur with regard to the type of implant you select.

Currently, there are saline and silicone gel implants. Saline implants are filled with salt water which tends to make them more rippley and artificial in feel and, although some surgeons make over fill the implant, this will actually make the implant feel firmer and less natural, and may also void the warranty by the manufacturer.  Saline implants offer the advantage of knowing exactly when the implant does deflate since it is filled with salt water and will be absorbed by the body within a day or two, which immediately reveal its deflation. The scar size of a saline implant also tends to be smaller since it is inflated after it is inserted into the breast pocket. Because of the difference in consistency between saline and silicone, there is also the possibility that the lifespan of the saline implant will be less than that of a silicon device. Saline implants are also less expensive which can be a consideration to patients as well.

Silicone gel implants have come a long way since their earlier generation counterparts. This has included both the improvement of the gel material and also improvements in the shell membrane which contains the silicon material itself. The consistency of the silicone gel material is referred to as cohesion which refers to the stickiness of the silicone. This can be adjusted to increase or decrease the firmness of the device to the point where silicone can actually resist deformation and maintain a better shape under pressure. Although all silicone gel has cohesive properties, the higher cohesive devices are what are referred to as the gummy bear implants. It is important to understand also, that making gel too cohesive - increasing its stiffness - can alter some of the implants natural feel. The latest generation of cohesive gel - gummy bear - implants can also help to retain the integrity of the implant should the shell rupture. The ultimate question, however, is not whether the implant leaks but whether or not it hurts you if it does. Multiple studies have shown that women with silicone implant devices are just as safe as those who have saline implants. Silicon has a more natural feel and also tends to have less rippling as compared to saline implants.

Both saline and silicone implants are available with either round or textured shells. Some believe that the texturing of the implant may help to decrease the abnormal formation of scar tissue which is referred to as a capsular contracture. It's important to realize that a shaped implant must necessarily be textured in order to allow it to stick to its surrounding tissue to prevent any motion or rotation  of the implant which can also result in a visible or palpable irregularity. Placing the implant under the muscle may also help to decrease capsular contracture, however, this can increase the gap between the breasts and also result in what is referred to as an animation deformity when the chest muscles flex or contract. For patients who have adequate coverage due to a larger breast size, implants can be placed above the muscle, however, there may be a higher risk of capsular contracture. In patients who are thinner, placing the implant above the muscle may result in more visible and palpable irregularitieirs as well

An exciting approach for women who desire an implant placed above the muscle, especially those who are quite athletic and lean, is the addition of fat that can be placed around the implants to add further volume and shape of the breast mound. Indeed, the ability to completely augment the breast with a patient's own natural fat is also an option. Using techniques not unlike liposuction, harvesting of fat from one part of the body to then place it into the breast can results and a breast mound that is completely natural. Fat is natural, yours, and has the potential to last a lifetime - so unlike an implant, which will eventually need to be removed - also incurring additional cost and surgery - fat, once integrated, will never have to be removed. Of course, all of this is a very in-depth subject and varies from patient to patient based on the desires and characteristics of each patient.

I would recommend a full consultation with the board certified plastic surgeon who is experienced in these matters. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Detroit Plastic Surgeon
5.0 out of 5 stars 43 reviews

It depends on who you ask...

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All implants have pros and cons.  The form stable implants are good, but they can rotate which is a problem because they are shaped like a tear-drop.  The "Ideal Implant" is ok, but it can still deflate.  Personally, I prefer round, smooth silicone implants because they are soft, have a low rupture rate, and look very natural on 95% of women.  The other 5% are the tough cases that are VERY thin with almost no breast tissue and likely wouldn't look much different even with a different implant.  

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

Best implant?

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I do not think that there is a perfect implant. There are many excellent choices, and a full discussion based upon your needs would be appropriate.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best type of breast implant

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The best type of breast implant is the one you decide is best. They all have benefits, they all have shortcomings. An in depth conversation with your Board Certified Plastic Surgeon who takes the time to discuss all your options: saline, silicone, textured, smooth, round, anatomic, profile... will make sure you have selected an implant that will give you the results you desire. 

Breast implants

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Hi John and thanks for your question. Breast augmentation is all about a healthy conversation between patients and their surgeons. I would recommend finding a plastic surgeon that really listens and tries to understand what your wife's goals are. Often times, the office can have sample implants to help you visualize what the implants look like (anatomic, round) and how they feel (textured, smooth, saline versus silicone). Best of luck! MMT

Best Implant?

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Thank you very much for your question.

As you are experiencing, there really isn't the "best type" of breast implant.  Surgeons pick different implants for different reasons depending on the patient, and the experience of that doctor with that implant.  I may place a form stable shaped implant in somebody, a smooth round in somebody else, and a saline implant in yet another person.  It all depends on the result the patient wants to achieve.

Sometimes there are trade-offs.  Sometimes the most natural looking isn't the most natural feeling, for instance.  You may need to prioritize what's the most important for you.

I would continue to talk with those surgeons, and ask them their opinions about what the other surgeons recommended.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon

Breast implant types

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Please watch the attached video. It may help to understand what goes into each implant a little bit better.
Best of luck!
Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 74 reviews

What is the best type of breast implant?

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  • Good questions. 
  • Generally speaking, much of the final look and feel achieved after breast augmentation surgery depends on several factors:
  • 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
  • 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's responsibilities.
  • I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
  • 3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
  • 4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc.
  • Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
  • I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

Best type of Implant

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Hello and thank you for reaching out. Unfortunately, there is one implant that excels over another type, each different one is made to enhance or correct a different issue or body type. As far as the most natural looking, silicone does look more natural than saline. There are different shapes and sizes, including form stable, high profile, moderate profile, etc. Those choices are made depending on what your current breasts look like, if you are considered a complex case, what you're looking for as far as end results, and all of these decisions can be made with your surgeon. Best Wishes.

What is the best type of implant?

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     Each patient has a unique set of goals to achieve with their breast augmentation.  For that reason, multiple types of implants exist. Person to person, there is a different perception of what feel or looks "natural".  Therefore, ii is impossible to recommend one type of implant to all.
      According to surveys, however, the smooth round silicone gel implant remains the most popular.  Part of its popularity centers around the perception that it provides the most natural outcome.  Discuss the options further until you are comfortable with an implant choice.

John Zavell, MD, FACS
Toledo Plastic Surgeon
4.9 out of 5 stars 40 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.