Dr. Smita Ramanadham

Dr. Smita Ramanadham

August 30, 2020

So, you are thinking about breast augmentation?  The next logical question is what type of breast implant.  There are some common questions that come up during your breast implant consultation.

If this pertains to you at all then this blog is for you!

  • What are the two main types of implants?  Silicone and Saline are the two main categories of implants. Under these two umbrellas, there are different options which we can get into later.
  • What is the main difference between the two? Is one safer?  The difference between these implants is the material used to fill them.  Both have an outer silicone shell, however, the silicone implant is filled with a highly cohesive silicone gel, while the saline is filled with saltwater, essentially.  Both are safe and approved by the FDA for breast augmentation.
  • Which do you recommend as a board-certified plastic surgeon?  Since both are safe options, this is a personal decision that I leave to the patient. The main difference that might push you in one direction versus the other is when it comes to rupture. When a saline implant ruptures, the water leaks out so you will know when that happens.  It will need to be replaced surgically if and when that occurs. The saline is safe and is just reabsorbed by your body.  A silicone implant does not leak out when ruptured. Since the gel is so tightly adherent to itself, when the implant ruptures, the gel remains intact and contained within the implant.  It’s like cutting into a gummy bear rather than a chocolate filled with caramel, which will ooze out. Additionally, the saline implants tend to feel a bit more unnatural and feel heavier in your chest than a silicone implant.
  • Are both implants safe for all ages?  Both can be used in all ages; however, the silicone implants are only FDA-approved for women over the age of 22.
  • Do implants cause cancer?  While implants do not increase your risk of breast cancer (invasive ductal carcinoma or invasive lobular carcinoma) they are associated with a rare form of lymphoma, called Anaplastic Large Cell Lymphoma.  This is a very low risk, on the order of <1% and only associated with textured implants.  Most implants used today are smooth implants.
  • What is a smooth versus textured implant?  This refers to the outer shell of the implant.  The smooth implant is smooth, shiny, and has a glossy appearance.  Textured implants have a rough surface and look dull even. The texture allows for better scarring and adherence of your tissues to the implant. This is especially useful in shaped (anatomic) implants so they are more adherent and rotate less in the breast pocket.
  • What is a shaped versus round implant?  A shaped implant is more tear-drop shaped.  This means that the upper portion of the implant has less projection than the bottom portion to recreate the natural shape of the breast with a gentle slope at the top and curved fullness at the bottom. They also can have a different height and width.  A round implant is just that.  It is completely round so the height and width are equal, their projection is highest in the center and tapers off on the sides.  The most commonly used implants are round.  In fact, when you hold these implants vertically recreating their placement in the breast, they assume a tear-drop shaped appearance anyway.
  • What brand of implant is the best?  There are three main companies that supply breast implants in the U.S.  These are Mentor, Allergan, and Sientra.  They are all great companies with great products. All are FDA-approved.
  • How do I choose the implant that is best for me?  This is multifactorial. First, we should have a good understanding of your overall goal.  Do you want natural vs. unnatural, a gentle boost or a dramatic augmentation?  Then we measure your actual breast dimensions and thickness of your breast tissue to make sure that the chosen implant will safely fit within your breast.  Finally, we choose the implant.  The implants all differ in their projection (how far they will stick out from your chest wall), their width (will they fit in the width of your breast), and their volume (how well do they fill out your breast).  We take all of this into consideration when choosing the right implant for you.
  • What if I choose an implant that is too big?  Typically, when this happens, the implant can stick out laterally so you feel it when you put your arm down or can almost cause a “uni-boob” type of appearance. People tend to look top heavy as well with implants that are too large.  More importantly, this can cause complications down the road.  The pressure from the implants as well as gravity, can ultimately cause issues that will result in complex revision surgery in the future.

I hope this blog helps clarify some of the common questions about breast augmentation and breast implants.  While our office consultation will go into more depth about implants, complications, expectations, etc. these are some of the most common questions that come up.  Have any more questions? Set up a consultation with us or see New Jersey board-certified plastic surgeon Dr. Smita. She will be able to educate you well on this topic with a free consultation!