Women considering breast augmentation surgery now have a remarkable range of options when it comes to breast implants. At my Chicago practice, I can customize the augmentation procedure thanks to the variety of implant shapes, profiles, and filler materials, in addition to different sizes.
When a patient comes in for a breast augmentation consultation, there are a number of factors to consider about breast implants. Most patients have a pretty good idea of what they want the final results to look like but aren’t sure what implants would produce those results. My job is to help them understand the benefits of the various options and how certain physical characteristics — such as their body’s frame or their existing breast tissue — would influence their outcomes.
Understanding the benefits of different implant options is a good place to start when making a choice:
- Implant filler: Most patients know implants are filled with either silicone or saline, but don’t necessarily understand the benefits of each. The main advantages of saline implants are that the saline causes less tissue reaction than the silicone gel over time. The newer silicone gel implants have less silicone gel bleed, and with their increased cohesiveness, the silicone will not migrate. However, some silicone gel bleed is inevitable over time, which causes tissue reaction and can lead to capsular contracture.
Saline implants are typically less expensive than silicone, and they require shorter incisions because they are filled after being inserted. This allows greater flexibility in placing incisions around the nipple or armpit without having the implant come into contact with the skin (a “no-touch technique”). There is evidence that silicone gel implants placed through a periareolar incision have a higher capsular contracture rate, presumably due to the inability to use the no-touch technique. On the other hand, the main benefit of silicone implants is that advances in technology have made them feel more like natural breasts, making them a good choice for women who have little existing breast tissue, in relation to the size of their implants.
- Implant shape: The choice of round or shaped implants is a complex decision. Patients with small to moderate-sized implants with some breast tissue will get a very natural result with round implants, and there is little reason to consider shaped implants. On the other hand, a thin patient who wants the most natural sloping appearance, where most of the implant volume is in the inferior pole (the lower portion), and wants a larger implant should consider a shaped implant. These have a teardrop shape and give a softer, more natural appearance. Another consideration is that shaped implants are firmer, and the edges can more easily be felt, which some patients find objectionable. Finally shaped implants are more expensive and require a slightly larger incision for placement.
This decision is typically based most on the patient’s preference for either dramatic or subtle results. Round implants provide more fullness in the upper portion of the breasts, resulting in more cleavage and a more dramatic transformation.
- Implant profile: A breast implant’s profile describes the projection from its base. A woman with a wider chest frame, for example, will usually choose lower-profile implants because they have a wider base than moderate-profile or high-profile implants. A woman who wants to emphasize fullness in the upper pole of the breasts may choose high profile implants. Because the relationship between implant profile and size can be complicated, I carefully explain the options to my patients after taking measurements.
Having a lot of implant choices is good, but it requires more discussion to ensure you find the right options for you. That’s why it’s important to choose a board-certified plastic surgeon who understands the benefits of the various choices. I can help you talk through each factor and prioritize the advantages that are most important in your life.
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