Breast Implant Surgery

in Denver, Colorado

What Types of Breast Implants Are Available?

There are many choices of implant type, shape and surface available. Each type of implant has its strong and weak points, and there is no one implant that is the perfect choice for every patient. This is where your surgeon's expertise and experience will be of great benefit.

In the United States, saline filled implants are currently the only implants available for most patients. Silicone implants are still available in certain situations such as for breast reconstruction, augmentation in combination with breast lift and in cases where saline implants have not produced acceptable results. Dr Squires is an investigator in the Silicone Adjunct Study and is one of a select few plastic surgeons in this country who can provide silicone implants when indicated.

Implant shape: The most commonly used implants are ovals of varying projections, although they are commonly referred to as "round". The standard shape is known as a "moderate profile" implant and has been in use for many years. "High Profile" implants are used where more projection is desired and they are often used in larger size implants to not have them appear too wide for the chest. Conversely, "low profile" implants can be used when less projection is desired. When placed under the muscle, these oval implants impart a very natural shape to the breast and do not look "round".

"Teardrop" shaped implants were designed with the hopes of producing a more natural shaped breast. The down side of these implants is that they needed to be held in position so they do not turn sideways or upside down. This was accomplished by using an aggressively textured surface on the implant that the tissue grew into like Velcro. This produced a breast that was very firm, didn't move easily and tended to stick up in the air even when you were lying down. (see: "surface texturing" below) For these reasons, most surgeons do not use these implants.

Surface Texturing: Implants come with either smooth or textured surface. Texturing was developed as a way to decrease capsular contracture that was a problem in silicone implants placed above the muscle. Textured surfaces come in coarse and less aggressive forms. The coarse, aggressive texturing is used in the Inamed (McGhan) BioCell implants. This type of textured implant results in tissue ingrowth and a firm feeling implant. Mentor Siltex is a less aggressively textured implant that produces no tissue ingrowth and a very soft breast. The fine Siltex textured surface appears to reduce capsular contracture even more than the Biocel implant and is my choice when using a Silicone implant especially when above the muscle. Textured implants above the muscle may show rippling in very thin women. In general if the soft tissue pinch test in the upper chest is greater than 2 cm, these implants are well tolerated.

Saline: This implant is an inflatable shell that is filled with normal IV saline. An advantage of this is the implant can be inserted through a smaller approximately 1-inch incision then inflated with saline. It has a very low rate of capsular contracture especially when placed under the muscle and early massage is performed. It has a higher incidence of rippling than silicone implants. This is helped by placing the implant under the pectoralis muscle, but in very thin women, rippling can sometimes be felt on the outside and under the breast.

Soy (Trilucent): These were recently taken off the market in Europe because of allergic reactions.

Saline with polysaccharide (Hydrogel): This implant was developed in France and has been reported to feel softer than saline implants. Clinical trials have yet to be performed In the United States.

Cohesive Gel (Gummy Bear): This is a type of silicone implant in which the silicone gel has been made into a much more viscous "cohesive" material with a consistency much like a gummy bear. If the implant shell breaks, the silicone will not leak out. This implant was conceived back when there was still concern that liquid silicone could cause disease. The downsides of this implant are that it is much firmer than a normal silicone implant and it needs a much larger incision to be inserted. This implant is marketed heavily by the implant companies but is unlikely to become popular due to its firmness and the large incision necessary for insertion.

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