Breast implants: your options

Surgeons are able to offer patients a wide choice in breast implants to suit many body types and desired results. We take a look at the types of implants available and the differences between them.

Breast implants on the market today come in a variety of shapes, surface textures and sizes to suit every individual. Their design and manufacture has been progressively refine and improved to reduce risks such as capsular contracture, gel diffusion and implant rupture.

The choices of both saline and silicone gel implants are now available in Australia and are produced in round and teardrop (anatomical shapes), with a smooth, textured or polyurethane foam-covered silicone elastomer envelope.

Fill: Saline vs Silicone

The vast majority of implants in Australia are silicone.

Saline and silicone implants both have an outer silicone shell, however they may differ in material, consistency and techniques used for placement. Both types of implants have their own advantages and risks.

Saline-filled implants both have an outer silicone shell, however they differ in material, consistency and techniques used for placement. Both types of implants have their own advantages and risks.

Saline-filled implants use a medical grade saltwater solution, which makes the implant feel like a water-bed. This can be controlled to an extent by the volume of fill in the implant. If implant rupture occurs, the saline is absorbed by the body. However, saline implants feel firmer than silicone implants and have a higher risk of visible folds and ripples.

Unlike silicone gel implants, saline implants can be filled through a valve during surgery. because of this, the insertion of the implants generally requires a smaller incision than that associated with silicone gel implants. The amount of fill can also be adjusted after surgery, which is not possible with fixed silicone gel implants. Additionally, saline implants can be pre-filled to a fixed volume during manufacture, which doesn’t incorporate a valve for filling during surgery.

Silicone gel-filled implants contain a cohesive gel, designed to mimic real breast tissue. It has a slightly firm, non-runny consistency, which can give a more natural feel. As the gel is not liquid, the risk of dispersal if the implant ruptures is minimised. It also typically maintains its shape better than a saline implant, especially in the upper part of the implant.

The implants are filled before they are inserted into the breast, which requires slightly longer incisions than those required for saline implants. The length of the incision depends on the size of the implant to be inserted.

Silicone is regarded as one of the most compatible materials for implanting into the body and is often used in medical devices and medicines.

SHAPE: Round vs Anatomical

The two basic forms of breast implants are round or teardrop (anatomical) shaped. Round implants, depending on their fill, can achieve a defined round shape or assume more of a teardrop form when the patient is upright. They tend to provide more upper pole fullness than anatomical implants, which are fuller in the lower pole.

Anatomical implants more closely resemble the natural shape of a breast. however, they demand a greater degree of accuracy in positioning and if they shift after surgery, the shape of the breast may be distorted.

Anatomical implanted can also provide greater projection in proportion to the size of the base, making them particularly suitable for women with little natural breast tissue.

The choice of projection is to large extent a personal one. A woman with adequate breast tissue and a shape she is happy with may opt for a low-profile implant that will simply increase the size of her breasts. Another patient seeking to create cleavage, or a patient with some degree of sag, may prefer a high-profile implant that can help achieve these results.

SHELL: Smooth vs Textured

Implant shells can be smooth or textured. Smooth-she;;ed implants are easy to insert and make the breast move and feel more natural than a textured shell. However, they have increased risk of capsular contracture (hardening of the breast), which is a common reason for re-operation.

Textured implants have a thicker shell and the very nature if their surface means they can grab onto and adhere to the surrounding tissue, causing less friction between the implants and breast pocket and therefore helping to reduce the risk of capsular contracture. Many surgeons also believe it offers them greater control over the ultimate shape of the breast.

Round implants come in smooth and textured shells, but anatomical implants have textured surfaces to allow for better integration with the surrounding breast tissue. The implant may still flip or move and distort the appearance of the breast, so the surgeon must be experienced with this type of implant.

The polyurethane foam coated implant gained approval for use in Australia in 2008. Used in South American and Europe since the 1970s, it was designed to significantly reduce rates of capsular contracture.

With the foam coating, the collagen fibres that surround the implant are not lined up, but sit in a circular pattern around the foam structure. This means they are less likely to slide over one another and contract. There are differences in technique with this type of implant, such as the pocket size used to accommodate the breast implant needs to be typically bigger than usual.

Regardless of the type of implant women choose, the shape, texture and size can be customised to reflect her individual body type and aesthetic goals. During your consultation your surgeon will measure your chest and breast and advise you on the most suitable implant size and style for your individual anatomy.