Interviewer: Let's roll into breast augmentation. I know breast implants have been out for the last 20 years or more. But what are the different types of breast implants that are available today to the patients?

Interviewee: Well, I'd say in the past five to 10 years, there's been sort of an explosion in technology in breast implants in this country, especially in silicone gel breast implants. So the two categories or types of breast implants you'll hear spoken of mostly are saline-filled breast implants and silicone gel-filled breast implants. Saline-filled breast implants are sort of fading out, I think, because they don't seem to perform as well. The silicone technology has advanced to the point we know they're safe, and they just produce a better result, in my opinion. So most people are getting away from using saline implants.

Interviewer: So I know there's a texture type of implant also. Is that texture implant actually proven to help prevent capsular contraction?

Interviewee: Yes. With both saline and silicone implants, we can put a texture on the surfaces, but the reason why we texture the implants is . . . One of the things that the texturing does is it helps prevent capsular contraction, which is where the scar tissue around a breast implant can tighten and shrink down and make the breast hard or firm or distort or change the shape of the breast.

Interviewer: So do you have a favorite implant that you use for most of your patients? I know sometimes many physicians do because maybe it makes a more beautiful look, or it's just more of a balanced fit for the general public.

Interviewee: Well, I will say there are three companies right now in this country that are approved by the FDA to sell breast implants. There's Allergan, Mentor, and Sientra. I like to use all of the companies' implants, and I like to use the different types of implants, shape, round, textured implants, based upon the individual patient, but I will tell you that I'm gravitating more towards textured implants, both round and shaped. I also really love using shaped implants, especially for those patients that want a more natural look, that don't want the fullness of the upper pull, the round, obvious implanted look. I think the shaped implants produce a beautiful result.

Interviewer: The shaped implant is kind of like a teardrop. Right?

Interviewee: It is.

Interviewer: Now, back when those were first came out, I understood that some of the complications of that shaped implant was that they could rotate. Is there anything that they're doing now that is keeping that from happening? Or was that just a myth?

Interviewee: No, that's not a myth. That's a great question because a shaped implant has obviously a long axis and a short axis. That's what makes it shaped. It's not round, where if it rotates, it really doesn't matter. But there are a couple of ways that we fight against that rotational thing. Personally in my practice, I haven't seen instances of rotation. One of those is the texturing. So in addition to keeping the capsular contraction rates under control, the texturing also provides some friction, so that that implant just doesn't slide around on the tissues. It actually is hard to move those things. When I'm putting these implants in, if I need to make an adjustment, it actually takes a little bit of an effort.

Then the second thing is how the surgeon makes the pocket where the implant goes. There's a little bit of a nuance in how you make that pocket when you use a shaped implant. Provided that you make your pocket appropriately, that should help keep rotation under control.

Interviewer: Now, does the patient get to pick their implant shape? Or is that something that you kind of help them decide or you decide, because of the anatomy of their body?

Interviewee: Well, from the standpoint of are we using a round or a shaped implant, that is something that I really rely heavily on the patients to give me input on. A lot of that depends on . . . Sometimes we're just asking questions like, "What do you want to accomplish?" You know? So we're not asking . . . We're not expecting them to come in and say, "I want a shaped implant," right off the bat.

Interviewer: Right. Right.

Interviewee: They may not know. But through a series of specially designed questions, we'll sort of elicit from the patients what type of look they're going for. Then we can help guide them into the type of implant that might be best to accomplish their goal. Some of the round implants . . . All of the round implants, I should say, come with different profile dimensions too. So that doesn't mean that they're teardrop shaped, but some may be broader and wider at the base and a little flatter in projection height, and some may be narrow at the base and more of a high projection. So you'll hear of things like high-profile or high-projection implants.


"Will a Shaped Breast Implant Rotate?" Your Popular Implant Questions Answered

Dr. Joseph Grzeskiewicz answers several popular questions about breast implants, addressing some points that you may not have even thought about.