Implant Overview

What types of implants are there?

Breast implants were once said to last a lifetime but, they do not. You must expect to replace your implants at least once in your lifetime or perhaps more often than that, depending on your age. Most breast implants last between 10 and 15 years.

Only two companies market approved breast implants in the United States, Allergan and Mentor Corporation. Allergan bought the McGhan line of breast implants a few years ago. You still see the McGhan name occasionally in discussions of breast implants, but implants are no longer made under that name. A third company, Silimed, is conducting clinical trials of high-strength cohesive silicone breast implants in the United States, as well as Allergan and Mentor.

We are going to confine this discussion to the two basic types of breast implants approved in the United States, silicone-filled and saline-filled. Both silicone-filled and saline filled implants come in several variations.Textured versus smooth shells, round versus anatomical shapes, and different types of profiles. We will discuss the pros and cons of all these options.

Silicone vs Saline Breast Implants

Both silicone-filled implants and saline-filled breast implants have an outer shell of a substance called silicone elastomer. Silicone elastomer looks like a clear or translucent rubbery plastic. This shell is basically a flexible envelope that contains the implant filling and, in the case of some anatomically shaped implants, gives them shape. Some models of implants have a "double lumen". This is an elastomer envelope inside of another elastomer envelope, sort of like double-bagging your groceries. The double lumen is thought to reduce the risk of rupture.

Round or Contoured?

Contoured implants (also called anatomical, teardrop, or biodeimensional) are implants that are shaped like a natural breast. They create a natural sloped shape when placed over the muscles. For some women, round implants may be too spherical and look less natural than they want, so contoured implants can be a better choice.

In general, contoured breast implants are more expensive than round ones. One disadvantage for contoured implants is the possibility of them flipping over or inverting themselves if the surgeon did not form the pocket correctly. This would result in a misshapen breast. If a round implant flips or rotates, it still looks the same. A textured contoured implant may be less likely to flip in place.

Smooth or Textured?

Breast implants come in shells that are either smooth or have a slightly rough texture. There is much disagreement in the cosmetic surgery community as to whether smooth is better than textured.

Textured implants are thought to reduce the incidence of capsular contracture. The idea is that the texture allows the body to bond with the texture of the shell. However, even the implant manufacturers say there is no evidence of a difference between incidence of capsular contracture between smooth and textured implants.

Smooth implant shells are slightly thinner than textured shells. They are thought by some to be stronger because there are no intentional defects like those created in the surface of the outer shell for textured implants. Textured breast implants are thicker to compensate for their intentionally rough surface.

One problem with textured implants is that you are more likely to be able to feel them, especially if you have thin skin or have small natural breasts.

Another disadvantage with textured breast implants is that if a patient develops capsular contracture, the texture is less likely to make the implant difficult to remove from the scar tissue. However, there is a lot of controversy and many different opinions on this subject, just as with other aspects of breast augmentation. Your surgeon may have his or her own opinion

High Profile Breast Implants Versus Low or Moderate

Both Allergan and Mentor make breast implants in different profiles, usually low, moderate, and high. The profile of an implant is how far from the chest wall the implant will project. If you are a woman with a smaller chest wall, using a moderate or high profile implant will result in what appears to be a larger implant. Similarly, if you want larger breasts, but still want them to look very natural, the choices in profiles allow you and your cosmetic plastic surgeon to choose the one that is exactly right for you.

When you factor in saline or silicone-filled, smooth or textured, round or contoured, and the different profiles and sizes, each of the implant makers has dozens of different implants. The implants you receive, combined with the amount of breast tissue you have naturally will give you results that no other woman on the planet will have. Breast augmentation is truly individualized to you.