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 operation.
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.