Which implant is least likely to migrate laterally in pectus carinatum, saline or noncohesive?

Silicone gel implants migrate less because on average the capsule is thicker than with saline due to silicone gel bled which occurs to some extent even with cohesive gel implants.  With pectus carina when lying down gravity tends to push implants laterally.  Textured implants move much less.

The surface of the outer shell of breast implants can be smooth or textured
and either can produce good cosmetic results.. There are pros and cons of each
and the best implant for any particular patient depends on many factors
including individual anatomy and desired outcome. Smooth implants usually have
thinner shells and move more freely in their pocket than their textured
counterparts. Many plastic surgeons believe that the thinner shell allows
smooth implants to feel more natural. Implants with smooth surfaces are less
likely to ripple. Textured implants were designed to lower the risk of capsular
contracture, but whether it achieves that is open to debate. The textured
implants tend to migrate laterally less but may have a greater chance of leakage or deflation. One type of
implant, known as the anatomical or teardrop-shaped implant
("gummy-bear" or form-stable), is only available with a textured
surface, because this surface helps keep these contour shaped implants in
position and diminishes the risk of rotation and distortion. Some of the
differences of the implant surface characteristics depend on whether the fill
material is saline or silicone gel. Textured implants also have a potential
greater risk of developing an extremely rare tumor,  Anaplastic Large Cell Lymphoma (ALCL) around
the implant.
Currently, most plastic surgeons in the U.S. prefer smooth implants. You should
discuss your concerns with your plastic surgeon, who should be certified by the
American Board of Plastic Surgery and ideally a member of the American Society
for Aesthetic Plastic Surgery (ASAP). Robert Singer, MD FACS La Jolla, California

Hi Nurturing3696,

The two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages.

The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.

On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery