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 most suitable breast implant to achieve the breast augmentation result they desire. What you need to consider is a good 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 result for you will need a combination of implant type and location as well as size to create your desired breast augmentation mammoplasty result. Let’s start with the material and shape and in subsequent weeks we will consider other factors such as location and incision type.
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 mammoplasty 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 pros and cons of each shape of implant that you may wish to discuss in detail with your breast augmentation mammoplasty 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 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, 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 mammoplasty 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.
3. Implant texture – Smooth vs. Textured Implant Surface
The breast implant shell can be smooth or textured and there are pros and cons 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 pros and cons 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 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 On Your Implant Surgery Incision Site, Position, Location and Implant Size
When I discuss the 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 most suitable breast implant to achieve the breast augmentation mammoplasty result they desire.
What you need to consider is the 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.
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 mammoplasty – “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. This will then tell me what volume I need to add to the volume you already have to help 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 Patient Before Undergoing Breast Augmentation Mammoplasty
Having a breast augmentation mammoplasty 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 mammoplasty 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 optimal 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 a specialist 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 mammoplasty 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 right implant Surgery options & results…
Everyone is an individual with specific needs and desires and the result for you will need a combination of implant type and location as well as size to create your desired breast augmentation mammoplasty 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
- Choosing the Right Implant Size – Sydney Guide to Breast Implant Size
- Mini Boob Job – Natural Breast Augmentation with Smaller Implants
- Benefits of Mentor Implants and Why Dr Hunt Uses Them
- Using Motiva Implants – Why Plastic Surgeon Dr Hunt Uses Motiva
- Waterfall Breast Deformity after Implant Surgery
Breast Augmentation Past Patient before and after photo gallery
- Recovery After Breast Implant Removal
- Recovery and Exercising after Breast Implants
- Exercising after Breast Implants
About Dr Jeremy Hunt – Plastic Surgeon
Dr Jeremy Hunt is a specialist plastic surgeon performing breast, body, face and nose surgery in Australia. He is a member of FRACS & ASPS and has over 20 years of experience providing plastic surgery in Sydney.
Dr Hunt’s personal, one-on-one service and attention to detail has ensured that thousands of women and men from the Sydney & Wollongong NSW area and across Australia have received high quality surgical care.
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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- Find out more about pricing, medical payment plans and paying for your surgery
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- Make an Enquiry or Request a consultation with Dr Hunt