Breast Implant Options

breast-implants

Breast Implant Types: Saline, Structured, and Silicone

Breast implants were originally brought onto the plastic surgery scene several decades ago, and after years of research and evolution in implant characteristics, women now have hundreds of possible choices for breast enhancement. The volume, projection, shape, fill material, and shell surface structure variations allow for hundreds of different permutations, which offer women the possibility of finding a truly unique look to fit their desired results.

In the U.S. today, breast implants are available in 3 main types: saline filled implants, structured saline implants, and silicone gel filled implants. All implants consist of an outer, solid silicone shell, but the internal component is what primarily differentiates the many types of breast implants:

  • saline implants are round, consist of a single outer shell, and are filled with varying amounts of saline solution;
  • structured implants are round, contain a layered system of nested shells, and are filled with a variable amount of saline solution;
  • silicone gel implants contain a single outer shell, and are pre-filled with either liquid or cohesive silicone gel in a specific volume; cohesive gel implants are available in both round and tear drop shaped styles.

All currently available breast implants used for plastic surgery in the U.S. have been subjected to extensive research and clinical studies, and have all been cleared by the FDA as safe and effective medical devices that may be safely used for both breast reconstruction and aesthetic breast augmentation.

Saline Implants

For women who are considering breast augmentation, saline filled breast implants may be used to increase breast volume and produce a fuller chest. Saline filled implants are round implants composed of a pliable smooth silicone outer shell and filled at the time of breast augmentation surgery with a variable amount of sterile saline solution. They are available in a wide variety of sizes and projections, which allow for providing an individualized approach to each patient’s anatomy and desired results.

Saline breast implant

Saline breast implant

Saline implants may be placed in either one of the following locations:

  • subglandular – directly under breast tissue
  • subpectoral – underneath the pectoralis major muscle

Saline implants may be inserted using any of the following access incisions:

  • inframammary – under the breast
  • periareolar – around the nipple
  • transaxillary – via the armpit

Additionally, these implants may be inserted through the incision used to perform a tummy tuck if an abdominoplasty is performed concurrently. All incisions will result in a scar in the area, but the scar is very short, usually an inch or less, because the implants are inserted deflated and are subsequently instilled with saline once they are in the proper location.

Advantages of using saline implants include:

  • very short incision
  • adjustable volume at time of surgery
  • filled with saline, which in case of implant rupture is resorbed by the body

Potential disadvantages of saline implants include:

  • feel more firm than natural breast tissue
  • only available as round, not anatomically or tear drop shaped

All surgery carries the risk of complications and untoward results. Potential complications of breast augmentation surgery with saline implants include bleeding, infection, unsightly scars, capsular contracture, asymmetry, implant deflation, palpability or visibility. In some cases, revisional surgery may be necessary.

Most breast augmentation surgery with saline implants is performed under general anaesthesia for patient safety and comfort. Dr. Hutchinson performs breast augmentation in the safety, privacy and comfort of the AAAASF certified Operating Room in her office in New York City. Surgery usually lasts 1 to 1.5 hours and patients go home after their surgery. Recovery requires restriction of strenuous physical activity for 2 weeks after surgery.

Structured Implants: the “Ideal Implant”®

The new, Structured Ideal Implant®, is the latest alternative to saline filled breast implants. Developed by a plastic surgeon in order to provide a more natural feel to saline implants, it comes without some of the risks associated with silicone gel implants, such as silent rupture and silicone gel leaking. In addition, unlike traditional saline filled implants which consist of a single silicone shell, the Ideal implant has several layers of built in baffles that create a softer, more natural feel. In clinical studies, it also has a lower risk of capsular contracture and lower rupture rate than silicone gel filled implants.

IDEAL Toolkit_ Implant Image

Ideal Implant

Structured implants may be placed in either one of the following locations:

  • subglandular – directly under breast tissue
  • submuscular or subpectoral – underneath the pectoralis major muscle

Structured implants are inserted empty of any saline and subsequently filled with an adjustable amount of saline once they are inserted in the proper location under the breast or pectoralis muscle. Since the fill volume is adjustable at the time of surgery, asymmetry in appearance of the breasts, whether in size and shape, may be addressed by using different amounts of saline. In addition, the implants may be filled to either “high” or “maximum” volume, which also changes the shape of the implant and how the breasts ultimately look. With a “high” volume fill, the implant is more conically shaped, with more central projection, whereas with the higher “maximum” volume fill, the implant assumes a rounder shape with more lateral fullness on the sides:

idealimplant

Ideal Implant: High fill volume (left) – Maximum fill volume (right)

Structured implants may be inserted using either of the following access incisions:

  • inframammary – under the breast
  • periareolar – around the nipple

Regardless of which incision is used, a short scar will be located in that area. This scar is usually well hidden, and most often measures less than an inch.

Advantages of using structured implants include:

  • natural feel, closely resembles normal breast tissue
  • adjustable volume at time of surgery
  • filled with saline, which in case of implant rupture is resorbed by the body
  • short scar in imperceptible location

Potential disadvantages of structured implants include:

  • feel slightly firmer than silicone gel filled implants
  • only available as round, not anatomically or tear drop shaped

All surgery carries the risk of complications and untoward results. Potential complications of breast augmentation surgery with saline implants include bleeding, infection, unsightly scars, capsular contracture, asymmetry, implant deflation, palpability or visibility. In some cases, revisional surgery may be necessary.

Most breast augmentation surgery with structured implants is performed under general anaesthesia for patient safety and comfort. Dr. Hutchinson performs breast augmentation in the safety, privacy and comfort of the AAAASF certified Operating Room in her office in New York City. Surgery usually lasts 1 to 1.5 hours and patients go home after their surgery. Recovery requires restriction of strenuous physical activity for 2 weeks after surgery.

Silicone Implants

Silicone gel filled breast implants are used for breast augmentation to increase breast volume and produce a fuller figure. These implants are available in a wide variety of options including size, shape, and type of gel used for the inner fill. The outer shell is composed of either smooth or textured silicone, and the inner gel is either cohesive or highly cohesive (“gummy bear”) gel. Silicone implants are available in a wide variety of sizes, shapes and projections, which allow for providing an individualized approach to each patient’s anatomy and desired results.

Silicone smooth shell implant

Silicone smooth shell implant

Silicone gel textured shell implant

Silicone gel textured shell implant

Highly cohesive silicone gel shaped implant

Highly cohesive silicone gel shaped implant

Silicone gel implants are also available in a more cohesive gel which maintains an anatomical tear drop breast shape. These implants are highly cohesive silicone gel implants, often referred to as “gummy bear” implants. Originally used for breast reconstruction only, they were recently cleared by the FDA for aesthetic surgery and are now also an option for cosmetic breast augmentation patients over age 22. Many alternatives exist with variations in height, width, projection, and type of tear drop shape of the implants allowing for matching the implant to each patient’s unique characteristics and goals.

Silicone implants may be placed in either one of the following locations:

  • subglandular – directly under breast tissue
  • subpectoral – underneath the pectoralis major muscle

Silicone gel filled implants may be inserted using any of the following access incisions:

  • inframammary – under the breast
  • periareolar – around the nipple
  • transaxillary – via the armpit

Additionally, these implants may be inserted through the incision used to perform a tummy tuck if an abdominoplasty is performed concurrently. All incisions will result in a scar in the area, and although the incision is made as short as possible, larger implants require longer scars for implant insertion. Advantages of using silicone implants include:

  • closely match feel of natural breast tissue
  • available both as round and anatomically shaped
  • highly cohesive gel does not spread in case of implant rupture

Potential disadvantages of silicone implants include:

  • require slightly longer incision for insertion
  • highly cohesive gel feel somewhat firmer
  • may undergo “silent” rupture that is not visible and requires MRI for diagnosis

All surgery carries the risk of complications and untoward results. Potential complications of breast augmentation surgery with silicone gel filled implants include bleeding, infection, unsightly scars, capsular contracture, asymmetry, implant rupture, palpability or visibility. In some cases, revisional surgery may be necessary.

Most breast augmentation surgery with silicone gel implants is performed under general anaesthesia for patient safety and comfort. Dr. Hutchinson performs breast augmentation in the safety, privacy and convenience of the AAAASF certified Operating Room in her office in New York City. Surgery usually lasts 1 to 1.5 hours and patients go home after their surgery. Recovery requires restriction of strenuous physical activity for 2 weeks after surgery.

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If you are interested in learning more about our services or would like to schedule an appointment with Dr. Hutchinson, please contact us or call us at 212-452-1400.

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