There are a variety of breast implant options available to women considering breast augmentation in the United States.
Saline Breast Implants
Saline breast implants come empty and are filled with sterile salt water once implanted into the body. Implant sizes come in a range versus one set size. The range allows the implant to be filled anywhere between the two sizes. This is helpful when there are asymmetries between the breasts, because one side could be filled more than the other to compensate for this difference. The incision is smaller with saline implants than silicone, because it can be rolled up and inserted through a tinier space. Saline is ideal for a peri-areolar incision, armpit incision, and belly button incision.
Saline implants can have visible rippling if there is little breast tissue and/or the implants are placed above muscle.
Should the implant rupture, it will deflate and the saline water will be absorbed and expelled by the body with no concern for health issues.
Saline implants are round and firm. They can be a good option for women with a substantial breast tissue, because they help to contain the tissue improving the overall shape and add upper fullness. Although the FDA has cleared silicone implants as safe to use, some women still feel uneasy about silicone, so saline would be a better option for peace of mind.
Saline breast implants are approved by the FDA for women 18 years of age or older
Silicone Breast Implants
Silicone breast implants are pre-filled with silicone gel. The gel feels closer to natural breast tissue than saline. Silicone implants come in a variety of set sizes and cannot not be altered. If there are breast asymmetries which need to be improved, your plastic surgeon may use a different size in each breast. The most common incision used with silicone implants is the inframammary fold (lower breast crease). An incision placed in the breast crease can better handle a larger implant size, because the incision can be made quite long horizontally and is well hidden.
If the silicone implant leaks, the gel may remain within the implant shell, or may seep into the breast implant pocket. A leaking implant filled with silicone gel will not collapse, so there is usually little indication anything is wrong. This is called a “silent rupture.” For this reason, the FDA recommends having an MRI 3 years after your surgery and then every 2 years from then on.
Silicone breast implants are FDA-approved for augmentation in women age 22 or older.
Gummy Bear Breast Implants
Form-stable implants are often referred to as gummy bear breast implants, because if the implant shell breaks, they maintain their shape due to the thicker cohesive gel inside. They tend to be firmer than traditional silicone gel implants and they are shaped as opposed to round. They have more projection at the bottom than the top. If the shaped implant rotates, it can result in a less than ideal appearance. Gummy bear implants are typically placed in the inframammary fold, because they require a longer incision.
Round Breast Implants
Most implants used today, saline or silicone, have a uniform round shape. They provide more upper fullness than shaped implants. Because round implants are the same shape all over, there is less concern about them rotating.
Anatomical implants are often referred to as “teardrop implants.” They are available in saline, silicone, and highly cohesive gel (gummy bear). Anatomical implants also come in varying sizes and profiles. Some women prefer the teardrop implant, because they mirrors the curve of a woman’s natural breast. They were originally introduced for breast reconstructive surgery, but have become more popular for standard breast augmentation as well.
Here is a picture of a round implant and anatomical “shaped” implant from Allergan
Smooth Breast Implants
Smooth breast implants are the softest feeling. They have some mobility within the breast pocket, which can provide a more natural look. Smooth implants can have visible rippling if there is little breast tissue and/or the implants are placed over the muscle.
Textured Breast Implants
Textured breast implants cause scar tissue to adhere to the implant. This helps keep them stabilized. Some surgeons use textured implants if a patient develops a capsular contracture with smooth implants and needs surgery to correct it. Textured implants may decrease the risk of another capsular contracture developing.
Breast Implant Profiles
Breast implants come in four different profiles: Moderate, Moderate Plus, High, Ultra High
Take a look at the width and projection of each profile shown below.
The moderate breast implant has a low profile and the widest base.
The moderate plus breast implant has a slightly higher projection, but has a very similar base.
The high profile breast implant has the more projection, but a narrower base.
The ultra high profile breast implants has the greatest amount of projection with the narrowest base.
The profile type is largely determined by your anatomy. If you have a wide chest, a high profile implant might be too narrow. If you are petite and have a narrow chest, high profile may be a good option. Your plastic surgeon will take a variety of measurements during the consultation, which will help narrow down which type of implant, size and profile is recommended.
During your breast augmentation consultation and physical exam, the appropriate implant type and size will be determined with the guidance of your plastic surgeon. The other decision that will be made is where the incision will be located.
Common Breast Augmentation Incisions
- Peri-areolar: in the crease of the outer edge of the areolar border
- Inframammary fold: located in the crease at the bottom of the breast
- Trans-axillary: located in the arm pit
- Transumbilical (TUBA): Upper inside edge of the belly button
Common Breast Lift Incisions
- Donut: around the areola
- Lollipop: around the areola with a line down the front center of the breast from the areola to the breast crease
- Anchor or Inverted T: same as a lollipop, but there is also a horizontal incision made in the breast crease