Choosing your Breast Implants & Implant Surgery Options

Choosing your Breast Implants & Implant Surgery Options

Choosing the Best Breast Implants & Customised Implant Surgery for you

Selecting Your Breast Implant Filling, Shape and Texture

When I discuss implant surgery options for a patient I will always bear in mind that everyone is an individual with specific needs and desires, but they all want the best breast implant to achieve the best breast augmentation result. What you need to consider is the best result will depend on where you are starting from, what you want to achieve, the implant type, material, shape, size and location, as well as the plastic surgeon you choose.

Everyone is an individual with specific needs and desires and the best result for you will need a combination of implant type and location as well as size to create your desired breast augmentation result. Let’s start with the material and shape and in subsequent weeks we will consider other factors such as location and incision type.

Breast Implant Image - Dr Jeremy Hunt

1. Implant Filling Material – Silicone or Saline

Breast implant shells are filled with either saline or silicone. Saline naturally comprises most of the human body, so if the implant should leak (this occurs in less than 5% of implants) its fluid can be easily and safely absorbed. Silicone is one of the most intensively researched materials used in medicine and has been subjected to extensive safety testing. It has been scientifically proven that silicone gel implants carry no increased risk of:

  • breast cancer
  • autoimmune diseases
  • risks when breast-feeding

Silicone implants tend to create a more natural feel and look to the breast and most implants being used in breast augmentation today are silicone.

2. Implant Shape – Round vs. Anatomical or Tear Drop Shaped 

Breast implants come in two general shapes: round and anatomical, and there are benefits and drawbacks of each shape of implant that you may wish to discuss in detail with your breast augmentation surgeon prior to determining what type of implant is right for you. Read our blog Using Motiva Implants – Why Plastic Surgeon Dr Hunt uses Motiva.

Round Implants     

Round breast implants are shaped as their name suggests. Round implants are able to shift and move while in position without distorting the shape of the breast. Round implants are generally less expensive than anatomical implants. Available in both smooth and textured styles, round implants classically will give more upper pole fullness.

Some people claim that round implants produce a less-natural looking result than anatomical implants. This is because anatomical implants were designed to more closely resemble the shape of a natural breast. Critics of this claim state that round implants take the natural shape of the breast when held vertically into position in the body.

Anatomical Implants

Anatomical implants, also known as teardrop implants are bottom-heavy and designed to create a more natural look.  Anatomical implants, also known as contour implants, were originally developed for reconstructive breast surgery patients. Anatomical implants have also become very popular for cosmetic breast augmentation surgery. The tear-shaped, or bottom-heavy, design of the anatomical implant was designed to create a more natural look.

Anatomical implants must be placed precisely into their pocket by an experienced surgeon to prevent the risk of malpositioning or other complications. Due to the shape of anatomical implants, it is very important they are positioned appropriately in the body. The shifting or flipping of anatomical implants is much more likely to distort the shape of the breast. To mitigate this risk, manufacturers of anatomical implants have made them with textured surfaces only. Textured implants will adhere to the capsule where they are placed to reduce the risk of movement.

Read more about Round vs Anatomical Breast Implants.

Best Breast Implants Options

3. Implant texture – Smooth vs. Textured Implant Surface

The breast implant shell can be smooth or textured and there are benefits and drawbacks to both smooth breast implants move freely in their pocket and usually have thinner shells than textured implants, while textured implants have a reported lower rate of capsular contracture

Breast implants can be smooth or textured.  Smooth breast implants have the feel of a balloon while their textured counterparts feel more like fine sandpaper.  There are benefits and drawbacks to both surface types that a prospective patient may wish to discuss in detail with her breast augmentation surgeon.

 Smooth Breast Implants 

Smooth breast implants move freely in their pocket and usually have thinner shells than textured implants. Lower patient cost and less risk of rippling.

 Textured Implants

Textured implants were originally designed to reduce the risk of capsular contracture. Capsular contracture occurs when the scar around the breast implant grows and squeezes on the implant, causing the breast to harden.  The claim that textured implants do, in fact, reduce the risk of capsular contracture has not been conclusively proven in medical studies.  Textured implants have been found to have a higher rate of leaking and rippling of the breast after surgery.

Deciding Your Implant Surgery Incision Site, Position Location and Best Implant Size

When I discuss the best implant choice for a patient I will always bear in mind that everyone is an individual with specific needs and desires, but they all want the best breast implant to achieve the best breast augmentation result.

What you need to consider is the best result will depend on where you are starting from, what you want to achieve, the implant type, material, shape, size and location, as well as the surgeon you choose.

Let’s discuss the incision location and choices, the location of the implant, and the size of the implant.

4. Incision Site and Final Scar

There are three common choices for incisions:

  • Under the fold of the breast (the inframammary fold)
  • Around the nipple – Periareolar
  • Through the armpit – Transaxillary

Each of these incision sites have advantages and disadvantages in terms of how well the scar is hidden.  A scar not on the breast that is offered by the armpit incision may seem appealing, but it will be visible in a singlet top or bikini top. Incisions around the nipple may be well hidden but scars can fade and become paler than the nipple pigmentation and be visible, and can also alter and decrease nipple sensitivity

The commonest location is under the fold of the breast or the IMF position; the scar is hidden on a day-to-day basis and offers reliable surgical access with no alteration in sensation to the nipple.

Since everyone is different, you will likely prefer one incision site over the other.  It is your choice where the incision is placed. I will explain the pros and cons of each site and answer any questions you may have.

Incisions in the tummy button known as transumbilical incision do exist but can be fraught with difficulty and are only used if a saline implant is being used.

incision points in breast implant surgery
Incision points in breast implant surgery.

 5. Implant Location – Prepectoral, Retropectoral, In Front or Behind the Muscle

An implant can be placed in front of or behind the muscle and each location will achieve a different result.

The common locations are:

  • Retropectoral/ Submuscular –  behind the muscle
  • Prepectoral/ Subglandular – in front of the muscle

Generally speaking, in front of the muscle will create a more mobile breast and will give you more upper pole fullness. This may sound appealing but with little coverage at the upper pole the appearance of stepping onto the implant and the roundness of the implant can be visible.  For some, this is an appealing appearance and is more obvious that an implant is in place.

Placing the implant behind the muscle in the subpectoral plane will create a smoother transition from the chest onto the upper pole of the breast with a more natural ramp leading down to the nipple. This limitation of this location though is that when the pec muscle is flexed it will distort the shape of the breast. This is usually acceptable though depending on how physical your lifestyle is.

6. Implant Size & Volume – ‘Bigger Is Better – But Not Too Much’

It seems obvious that the larger the implant the bigger the result it will achieve and for some people this is their objective with breast augmentation – “big is better” For others though a natural proportioned enhancement is the key and “bigger is better – but not too much” often applies.

I use a sizing system preoperatively to allow you to add volume to a bra to achieve the desired result you want.  This will then tell me what volume I need to add to the volume you already have to achieve the result you desire.  It is what you see in the mirror that counts and what you call a full C cup others may call a large B or D cup.  The result you want is the ”look” you want and it is vital the volume is right to achieve this.  After all, what an implant looks like on a desk is irrelevant it is what that volume achieves when you are upright and wearing a bra that counts.

Six big decisions for the Best Breast Augmentation Surgeon Sydney results 

Having a breast augmentation is a big decision and most patients spend up to 18 months researching the procedure before seeking a surgical opinion. Patients are often very well-informed before they even get to their first consultation. This can be very helpful for their chosen surgeon when it comes to planning the implant surgical procedure, as the patient is already aware of what they want from the surgery.

There are usually 6 big decisions that need to be made before a patient has a breast augmentation and each has its own pros and cons.

Decision #1:  The final cup size – How big?

Patients will have an idea of what cup size they would like to achieve and it is often helpful to bring photographs to the consultation to convey this idea to the surgeon.

Decision #2:  Silicone versus saline implants

There will be advantages to silicone and advantages to saline implants in different patients, and this discussion needs to be had on an individual basis so patients achieve the best results.

Decision #3:  Round versus teardrop-shaped implants

Breast implants come in a series of different shapes, ranging from round to teardrop, and each variation will achieve slightly different results. Different patients’ tissue will respond differently to the shape of the implant and it is helpful to have an expert opinion to guide you as to which implant shape will achieve the result you desire.

Decision #4:  Implant surgery in front of the muscle or behind the muscle

The breast implant can be placed in front of, or behind, the pectoralis muscle and it will achieve a slightly different result in each case. During the consultation, it is helpful to review a series of before and after images to understand which location will achieve what result to ensure you achieve the look you desire.

Decision #5:  Implant surgery incision

To insert the breast implant an incision of approximately 5 cm will be needed and it can be placed through the armpit, in the fold under the breast or around the nipple. Each has advantages and disadvantages, and this decision needs to be made with the patient and the surgeon performing the procedure.

Decision #6:  Implant volume

Deciding whether a 300 cc implant or a 350 cc implant meets your needs is often challenging and different surgeons will use different techniques to estimate the final results of breast augmentation in a particular patient. Dr Hunt prefers to get patients to try different implant sizes inserted into a bra worn under a T-shirt. This gives the patient an idea of what result each size implant will achieve if a particular volume is added to a particular bra cup.

For the best implant Surgery options & results…

Everyone is an individual with specific needs and desires and the best result for you will need a combination of implant type and location as well as size to create your desired breast augmentation result.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health professional.

Further reading about Breast Implant Surgery

About Dr Jeremy Hunt – Plastic Surgeon

dr jeremy hunt

Dr Jeremy Hunt is one of Australia’s leading specialist plastic surgeons for breast, body, face and nose surgery. He is a member of FRACS & ASPS and has over 20 years of experience providing expert cosmetic and plastic surgery in Sydney.

Careful, considerate and honest, Dr Jeremy Hunt works with you to find a solution that is best for your body and your lifestyle. Every patient is unique and, through his expert guidance,

Dr Hunt’s personal, one-on-one service and attention to detail has given thousands of women and men from the Sydney & Wollongong NSW area and across Australia the confidence and body shape they desire.

Dr Hunt’s qualifications and education

Dr Jeremy A Hunt MBBS FRACS graduated with a Bachelor of Medicine degree from Sydney University in 1990 and is a Fellow of the Royal Australasian College of Surgeons and member of the Australian Society of Plastic Surgery. He completed a Fellowship at the prestigious University of Texas in the United States, where he learnt from some of the world’s very best plastic surgeons.

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About The Author

Dr Jeremy Hunt FRACS - Specialist Plastic Surgeon

Dr Jeremy Hunt is one of Australia’s leading specialist plastic surgeons. With over 20 years’ experience and thousands of happy patients, Dr Hunt is the smart choice for your plastic surgery or non-surgical procedure.

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