Breast Implant Options
Breast augmentation surgery is one of the most common plastic surgeries performed every year. The American Society of Plastic Surgery survey showed over 280,000 breast augmentation procedures were performed in 2015. Whether because of genetics or from a life event, many women desire larger, firmer, and more defined breasts. As with many cosmetic procedures, breast augmentation surgery uses breast implants to achieve the size, shape, and firmness to achieve the look you desire.
Navigating the details of any cosmetic procedure can be confusing; here’s some information to help you better understand your breast implant options and thus allow you to make an informed decision on which breast implants are the best option for your individual needs.
*Individual Results May Vary
22-year-old female presents with breast asymmetry and hypomastia. Patient desires improvement in size and symmetry
Procedure: Bilateral breast augmentation with Mentor moderate plus profile silicone implants 250cc right breast and 200 cc left breast Implant placement – Subglandular ( under the breast tissue)Photo Gallery
What Are Some Reasons to Get Breast Implants?
Breast augmentation is a cosmetic procedure, which means that women undergo this surgery because they desire larger, fuller, or better-positioned breasts. Some of the most common reasons for this procedure include:
- Dissatisfaction with breast size and/or shape
- Asymmetry of the breasts
- Loss of breast size and/or shape from age, breastfeeding, or significant weight loss
- Loss of breast size from a previous procedure, such as a mastectomy
- Improved confidence in yourself and your appearance
Which to Choose: Saline or Silicone Implants?
There are three main types of breast implants: saline fill, silicone gel fill and structured breast implant (IDEAL IMPLANT®). The outer shell of the implant is still made up of silicone. There are advantages and disadvantages of all three types of implant.
The implant is a silicone elastomer balloon filled with saline. The saline implant does not have a natural feel because movement of the saline filler is uncontrolled, allowing rapid displacement with motion (like a water balloon). Also, because the implant shell is unsupported by the saline filler, the upper pole of the implant collapses when the woman is upright, resulting in significant wrinkles (see picture). However, the advantage of the saline implant is that the saline filler gives women peace of mind. In case of a rupture (deflation), the harmless saline is absorbed by the body. The woman can tell by simply by looking in the mirror whether her implants are intact or ruptured.
*Journal Plastic and Reconstructive Surgery( Plast. Reconstr. Surg. 142: 66, 2018)
This is a silicone elastomer balloon filled with silicone gel. Silicone gel implants have a natural feel because the viscosity of the silicone gel filler mimics breast tissue. The highly cohesive silicone gel (gummy bear) supports the implant shell, so there is less upper pole collapse when upright and less wrinkling compared with saline implant. With today’s 5th generation silicone gel implants, the implants are filled to 95 percent of cohesive silicone gel, which increases support for the implant shell and produces much less rippling than the older generation of silicone implants (see image), making it an ideal choice for breast reconstructions. The disadvantage of the silicone gel implant is that ruptures are silent, and can occur at a rate of 9.3 percent in 10-year studies. Silent rupture can be a concern for many women. The FDA recommends MRI scans to detect rupture every five years of the implant.
*Journal Plastic and Reconstructive Surgery (Plast. Reconstr. Surg. 142: 66, 2018)
Structured implant (i.e. The IDEAL IMPLANT®)
This implant is unique and different from saline and silicone gel implants. It has a round, smooth surface and is a saline-filled implant with an internal structure. It has two lumens within two nested shells that are connected to each other through a patch on the back. They are both filled with saline. Unattached and floating within the outer lumen is a baffle structure designed to restrict movement of the saline, thus limiting the water balloon effect seen with saline implants. The cutaway drawing of the structure implant showed a series of shells (baffle) within the implant. Since it is filled with saline, women can tell immediately if there is a rupture. However, the series of shells have enough volume to maintain the shape of the augmented breast. Furthermore, due to the structured design of the implant there is significant less rippling compared to saline implants.
Dr. Goldberg thinks the more information a patient has on all three types of implants allows her to make an informed decision on which implants are the best option for her. Aesthetically, Dr. Goldberg thinks both structured implants and silicone implants yield the best aesthetic outcomes for breast augmentation and reconstruction .
*Journal Plastic and Reconstructive Surgery (Plast. Reconstr. Surg. 142: 66, 2018)
What Specific Brands of Implant Are Offered?
Dr. Goldberg is proud to offer the following brands:
Natrelle® Implants (by Allergan)
Natrelle® implants are considered “gummy bear implants,” meaning they consist of a thick, cohesive silicone gel. This thick gel mimics the look and feel of breast tissue, allowing for natural-looking results. In the event of an implant rupture, the silicone gel will remain in place, increasing patient safety.
Mentor® silicone implants are available in a wide variety of brands and sizes and consist of a soft, cohesive silicone gel. Because of the highly cross-linked gel found in many Mentor® implants, these are among the softest gel implants available.
Sientra® silicone implants have a strong bond between their cohesive gel and shell, helping to ensure that the gel remains inside the breast implant in the case of a rupture. These implants demonstrate a low complication rate and offer an extended warranty against implant failure (for up to 20 years).
The IDEAL IMPLANT® combines the benefits of saline and silicone implants. This hybrid implant consists of silicone chambers that contain sterile saline. Because this implant is chambered, the saline cannot move as freely as it would in a traditional saline implant. Therefore, it will react and feel like silicone. This structured implant gives women the look and feel of a silicone implant with the safety of a saline implant.
What Other Implant Specifications Must Be Determined?
While the material of your implant is the primary choice when planning your breast augmentation, it is not the only choice. In addition to the brand of implant used, breast implants are determined by various other factors.
Smooth vs. Textured
Some silicone implants have a smooth texture that allows them to rotate freely inside the breast pocket. Others have a textured shell that adheres to the breast tissue, restricting movement. Due to recent increasing reports of breast implant-associated anaplastic large cell lymphoma (BIA- ALCL), Dr. Goldberg only offers smooth implants at her practice.
Round vs. Anatomical
Breast implants are available in round and anatomical shapes. Round implants provide equal volume to the top and lower pole of the breast. Anatomical implants are teardrop-shaped, meaning they are fuller on the bottom. Anatomical implants are susceptible to rotational deformity or movement of the implants within the pocket, leading to changes in breast shape. Furthermore, anatomical implants are textured implants and due to the reasons listed above, Dr. Goldberg only offers round implants at her practice.
Implants are measured in cubic centimeters (CC’s). All implant brands offered by Dr. Goldberg come in a variety of sizes, and you can tailor your implants to your aesthetic desires and body frame.
Implant profile describes the ratio between the base diameter of the implant and the projection of that implant. Implant profile is one of the most important aspects of a breast implant because it determines how the implant will sit and project from your chest.
The profile chosen is often based on your body frame and chest width. For instance, women with broader chest walls need an implant with a greater base diameter than petite women with narrower chest walls.
- Low-profile implants have a wide base but do not project much. This is ideal for women with wider chest walls.
- Moderate profile implants have a smaller base than low profile implants but project further from the chest. This is common for average-framed women.
- High-profile implants have a narrow base and provide the greatest projection. These are reserved for petite women with narrow chest walls.
There are also variations of profiles in between these sizes. Dr. Goldberg will review all of your options during your consultation.
Can Fat Transfer Be Used Along With Implants?
Yes. Dr. Goldberg offers breast augmentation surgery with fat transfer. This procedure is best used for thin women with smaller breasts who choose larger implant sizes. With fat transfer, Dr. Goldberg uses liposuction to take fat from one part of your body (usually the flanks, abdomen, or thighs) and move it to your breasts. This provides even more soft tissue coverage to the implants.
Will Implants Help My Sagging Breasts?
Implants will help you achieve the breast size and shape that you’ve always wanted, but they will not adjust sagging. To correct this issue, breast lift surgery (mastopexy) is necessary. However, many women choose to combine breast augmentation surgery with a breast lift.
How Long Do Breast Implants Last?
Though there’s no definite number to give, most breast implants last anywhere from 10 to 20 years. Some implants may need to be removed or replaced sooner due to complications or cosmetic concerns, though with a healthy lifestyle, your results can be long lasting.
Unfortunately, there is no way to prevent complications entirely. Please contact your plastic surgeon right away if you are noticing any changes to the look or feel of your implants.
How Much Do Breast Implants Cost?
As with any cosmetic procedure, breast implant costs vary for each individual patient based on a number of different factors, including breast implant sizes and brand. At your consultation with Dr. Goldberg, you will be given the price for the procedure. Additionally, financing is available.