Choosing the Breast Implant that’s Right for You!

I am frequently asked which implant is the most natural and the best one to use for breast augmentation. The truth is that we should not think of one implant as better than another, but as the best implant for a particular individual, given differences in breast shape, …the breast tissue available to cover the implant, asymmetries, individual concerns about implant wear, and of course the ‘look’ desired after augmentation. Implants do share one thing in common; they all have a silicone rubber shell which holds the fill, saline or silicone gel. Over time, the shell does wear causing the implant to leak. Implants last 10, to perhaps 20 years, or longer.

The saline implant will ‘go flat’ so the detection is very simple. Patients can wear the implant to the very end and replacement is straightforward. The lower cost, small incisions, and relative softness over time, with this low hassle factor, make the implant a good choice for some. Why not all? The saline implant needs a good cover to hide the edges and the ripple which might be detected under and to the side. In larger sizes, they may ripple all the more, and breast projection might be limited. Some just want a gel as the safer bet against a ripple and cohesive feel.

Silicone implants have made a strong comeback with an improved shell and a more cohesive gel. Of course, the cohesiveness comes at a price of softness. Still, with a fuller implant, and less tissue to cover, or a looser breast envelope, the silicone gel can be the better choice. The leak is a tricky issue, in that the wear or leak is silent unlike the saline. The FDA recommends an MRI study after the implants have been in as long as five years to help find leaks, though replacement at 10 years of so might be an option. The gel is soft and resists folds and ripples better than saline, and we like the gel when a lift is needed, again the loose breast envelope. The more cohesive gel holds shape better than saline. Remember, water seeks its own level. Breast asymmetry might work out better with a gel.

So if shape is so important, why not the gummy bear for everybody? For those who have not seen the gummy bear yet, as they are not generally available, the implant contains a highly cohesive gel which we refer to as form stable. Yes, just like gum drops they hold their shape. Cohesive gel is leak resistant, though leaks still occur, and remember the cohesive gel comes at a cost in softness. For the most natural breast augmentation, the implant should fit into the breast hand in glove, and move and flow with the breast as one. The gummy bear is a good choice for augmentation, though we view the implant as a problem solver. In particular, very thin breast cover might do best with the gummy bear as it folds and ripples least of all, and asymmetry can be improved with an implant shaped for the demands required. Finally, they can hold up better to capsular contracture issues because of its stable form.

When considering breast augmentation, focus on the ‘look’ you want, without being overwhelmed by implant choices You can be assured with the choices available, there might not be a ‘best’ breast implant, but there will be one that is best for you.