Types of breast implants
Introduction
Breast implants are used to make the breasts larger, firmer and fuller. They are used to correct breast asymmetry and for reconstruction after a mastectomy due to cancer or other health conditions.
They are available in a variety of types and sizes, and their shape is either “round” in profile and base, or oval shaped with an anatomical contour. They are usually made of an outer layer of silicone, filled with cohesive silicone gel. This is a soft gel which is highly elastic with the approximate specific gravity and feel of normal breast fat. Silicone materials have “memory” ie the shell and gel components of an implant can be stretched, and they will return to their normal state when relaxed.
It is important to choose the right type for the best aesthetic and functional outcome.
What are the breast implants filled with?
Saline and silicone breast implants both have an outer silicone shell. The implants differ in what they’re filled with and how they feel. Each has its benefits and drawbacks. Briefly stated, these considerations are:
- Saline implants are filled with sterile salt water. However, should they leak, they need to be replaced. In addition, they may feel unnatural, and they may cause a rippling of the skin of the breast, particularly in slim women with little breast tissue
- Silicone gel-filled implants provide a more natural feel to the breast, maintain the shape and are less likely to cause rippling. At present, most surgeons use cohesive gel silicone implants, which do not leak if the shell is damaged.
What are the different shapes of implants?
One of the more recent choices in breast enlargement involves the option of having either round or teardrop-shaped implants (also called anatomical implants as they resemble the anatomy of the breast).
Anatomical implants (teardrop shaped)
Anatomical implants are suitable for certain breast shapes. The importance of the anatomical implant shape relates to creating a natural looking breast and in particular the slope of the upper pole of the breast They can also help lift a breast that has a mild amount of droop. In patients who are slim, have little breast fat or in whom there has been some droop following children or weight loss the tear drop (anatomical implant) produces a more natural look which also gives more lift to the nipple.
Round implants
Round implants suit patients who are younger and have little or no droop in the breast and who also have a reasonable amount of breast tissue to start with. Round implants can sometimes give more upper pole projection: this means that the part of your breast above the nipple may be fuller. However, with a carefully chosen implant, a very natural and pleasing breast shape can be achieved with a round breast implant.
Interestingly, studies have shown it is impossible to determine whether an implant is round or anatomical (shaped) when analysing breasts that have been augmented.
What are the different textures of implants?
When we talk about implant texture, we’re referring to the outer shell of the implant. The various implants can have different surfaces and many different implant manufactures are available. The are two main textures available:
- Smooth /nanotextured breast implants have the softest feeling. They can move with the breast implant pocket, which may give more natural movement. However, smooth implants may have some palpable or visible rippling under the skin
- Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and become repositioned. These implants were originally created to reduce the risk of capsular contracture and to help maintain a specific breast shape. While textured implants may offer certain advantages, they also carry additional risks such as BIA-ALCL (breast implant associated anaplastic large cell lymphoma)
Breast implant profile explained
Dr Mackenzie uses predominantly Motiva SmoothSilk Ergonomix Implants. Motiva implant profiles are distinguished by differences in the width and height of the implant. Put simple, the higher the profile, the fuller the look. The implant will be narrower and project more (in a forward dimension, so the breast will look fuller from the front) than an implant of a similar volume with a lower profile.
Motiva implant profiles:
- Mini: The lowest profile option, offering subtle forward projection.
- Demi: A moderate-low profile, providing a balance between subtle and higher projection.
- Full: A moderate-high profile, designed for more projection and fuller cleavage.
How is the size of the implant chosen?
Suitable implant size is determined by breast dimensions, amount of breast tissue present, tissue laxity and desired aesthetic outcome. Some patients want as a natural look as possible, and others want a ‘breast augmented look’ with a fuller upper breast. This will also help determine implant shape and size.
If you are considering a large augmentation (defined by an implant over 350cc), it is important to appreciate the long-term implications. Over time the weight of the implant will have a greater effect on your breast tissue than a smaller implant. Your breasts will be at a higher risk of drooping with time due to the weight of the implant. Another effect of a large implant over time is the gradual loss of some of your breast tissue due to the implant placing a constant stretch on your tissue.
Determining the correct size (volume) of implant is one of the most crucial decisions to make. The best outcome is achieved when both you and Dr Mackenzie agree that the chosen operation and implant will achieve the goals and expectations. Dr Mackenzie will usually guide you towards a range of possible implant sizes, but ultimately the size will be your decision. If Dr Mackenzie feels that you have chosen an unsuitable implant, she will talk about this with you and explain why.
To confirm your choice of size, you will be asked to perform a rice bag test at home after the first consultation. This gives a good indication of how the breast implants will look on you and is something that can be done in the privacy of your own home.
From these discussions, measurement and rice bag test, Dr Mackenzie will recommend a range of implant sizes. This is routinely decided on at the time of the second outpatient meeting. You may try these implants in a soft bra, which will help narrow down the range. It is then usual for Dr Mackenzie to order several sizes of implants for the operation, one either side of the recommended size. This allows the final decision to be made during the operation, thus producing the best possible result.
Consultation and personalisation
The goal of breast augmentation is to enhance a patient’s natural proportions and create a more symmetrical, aesthetically pleasing breast profile which is long lasting. The exact procedure is tailored to meet a woman’s individual needs. Dr Mackenzie relies on devices from trusted manufacturers like Motiva – which offers an innovative alternative. Their implants feature a nano-textured shell – classified as smooth – designed to reduce inflammation without the risks associated with traditional texturing.
What you want + what I can deliver = our shared goal.
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