Many breast augmentation patients at my Toledo, Ohio, plastic surgery practice arrive at their consultations with questions about their breast implant options. That’s normal. Implant selection involves much more than size to get the desired result.
With that in mind, I put together a comprehensive guide to breast implants that helps patients make wise choices during pre-op planning. Because few textured implants remain on the market at this time, I’ll focus on the smooth, round implants made by the three implant manufacturers in the U.S. (Mentor, Sientra, and Allergan).
Silicone Gel vs. Saline Implants
Look & Feel – Things to Consider
Choosing between cohesive silicone gel or saline implants is really a question of personal preference in the look and feel of the implants.
Most believe that cohesive silicone gel implants feel more like breast tissue and look more natural, especially in women with less existing breast tissue and looser skin. Visible rippling is more prevalent with saline implants than the latest generation of silicone gel devices. This is less of a concern for patients with thicker tissue and skin.
Surgeons can make smaller incisions with saline implants because saline implants are filled after insertion, whereas silicone gel implants arrive already filled.
Which Is More Popular?
Even though silicone gel implants are slightly more expensive than their saline counterparts, about 85% of breast augmentation patients choose silicone implants.
Which Implants Last Longer?
Even the best plastic surgeons can’t promise that implants will last forever. Few medical devices come with lifetime warranties. Having said that, when properly placed, all implants can last a long time.
As patients age, breasts start to sag or change appearance due to weight changes. These are common reasons a woman may want to replace their implants with larger or smaller devices—or even simply remove them or get a breast lift.
What Happens If an Implant Fails or Ruptures?
Although rare, implants can fail. When this happens, the aesthetic effect is significantly different in saline implants than it is in silicone gel implants. In saline implants, the saltwater solution leaks from the shell and the breast appears deflated. The solution is biocompatible, meaning it’s naturally absorbed by the body and poses no health risk. If an implant filled with silicone gel breaks, the cohesive gel remains in the implant pocket. This is sometimes called a “silent rupture” because women may not even notice that the implant has failed. It’s one reason surgeons recommend getting regular MRIs or high-resolution ultrasound tests if you have silicone gel implants.
It’s important to note, however, that saline implants have a higher failure rate than silicone gel implants.
Although rare, implants can fail. When this happens, the aesthetic effect is significantly different in saline implants than it is in silicone gel implants. In saline implants, the saltwater solution leaks from the shell and the breast appears deflated. The solution is biocompatible, meaning it’s naturally absorbed by the body and poses no health risk. If an implant filled with silicone gel breaks, the cohesive gel remains in the implant pocket. This is sometimes called a “silent rupture” because women may not even notice that the implant has failed. It’s one reason surgeons recommend getting regular MRIs or high resolution ultrasound if you have silicone gel implants. It’s important to note that saline implants have a higher failure rate than silicone gel implants.
Why All Silicone Gel Implants Are Not the Same
Three companies make silicone gel implants in the U.S. and all of them produce excellent products. Key differences include the cohesiveness of the gel, the percentage of fill of the implant shell, and the number of sizes and profiles available.
Cohesiveness is a word to describe how “gummy” the implants feel. The latest generations of silicone breast implants (4th and 5th generations) use a more cohesive silicone gel that is a soft solid, so it maintains its shape better than saline implants and earlier generations of silicone gel implants.
The Right Implant Size for You—Getting Natural-Looking Results
Most breast augmentation patients focus much of their research on implant size. After all, the point of getting implants is to increase breast size, right? Well, yes and no. Increasing the size of the breasts is certainly one result, but the overall goal of cosmetic breast surgery is creating harmony of the breasts, meaning the relationship between the nipple, breast mound, and the crease at the base of the breast is aesthetically pleasing.
Implant size is part of that equation. The same size of implants can produce very different results even in patients of similar height and weight. The patient’s existing breast tissue and skin quality must be considered when choosing the right size of implants. Creating results that look proportional to the rest of the patient’s body—in other words, natural-looking results—is the goal most patients have.
Why Implant Profile Matters
It’s safe to say that breast augmentation patients think much less about the implant profile than the size of implants. The truth is that the profile matters just as much as size in the final outcome. An implant’s profile, or projection, refers to how much it projects from the patient’s chest when seen from the side.
Most cosmetic breast augmentation patients whose concerns don’t include breast asymmetry choose either moderate-profile or high-profile implants. (Implants come in several different profiles, ranging from low to ultra-high, and that broader range of options is used primarily for breast reconstruction or patients with significant asymmetry.) Moderate-profile implants produce the most natural-looking result.
Implants of the same size (cc volume) that have different widths will have different levels of projection. Implants with a smaller base width provide greater projection than implants with a wider base width.
The profile is also related to the implant’s dimensions—the volume and the width of the implants—and is a subject I discuss in great detail during the consultation as each patient has certain physical limits to the breast area that need to be respected. I don’t want to use an implant that is excessively wide for the patient’s chest area or an implant that has excessive projection or volume for the patient’s breast envelope.
Using VECTRA® 3-D Imaging to Choose Implants
Our VECTRA 3-D imaging system is incredibly popular with breast augmentation patients because it provides a realistic view of how implants of different sizes and profiles will look in the patient. Even though the simulated images aren’t identical to real-life results, they are very similar because the imaging is based on the actual breast implants we use in our practice. Using this system, we take a three-dimensional photograph of the patient, and then we create 3D representations of potential results with VECTRA’s software simulation tools.
As one of the leading breast augmentation specialists in the nation, Dr. Colville sees patients who travel from Ann Arbor, MI, and throughout the region to have him perform their procedures at our Toledo, OH, practice. If you’re thinking about getting breast implants, contact us using the online form to request a personal consultation with Dr. Colville or call (419) 534-6551 to schedule an appointment.