Breast implants are made in different shapes, with different surfaces and with different filling. It can be a daunting task to understand which is best for you. Even for a Plastic Surgeon, it is not always and easy task. Breast implants can either be round or teardrop (anatomical) and both of these are made in low, medium, high and extra-high profiles or projections. The choice of shapes will be determined by you specific anatomy, breast size, drooping, skin elasticity, fat layer (under skin). So a guide to this is the following :

Breast Information from LBPS

The important determinant of implant size is the width of your breast. In most instances, the implant size should match this width. In a small number of women, the breast width is abnormally narrow, so the implant size will be the desired width rather than the actual width.

Implant projection should be determined by the harmony of your desire, your existing breast size and your skin laxity. The more skin laxity and the fuller you desire to be, the more projection is required, and conversely, the less skin laxity and the smaller you desire to be, the lower the projection required.

One of the key developments in breast implants over the years has been in the surface of the implants. Early breast implants were smooth allowing the implants to move easily within the breast. However, capsular contracture (hardening) was a major risk (affecting up to 30 – 40%) with early implants and efforts were made to reduce this by changing the surface. Textured surfaces were developed in an attempt to reduce the risk of capsular contracture with significant positive benefit. Hardening was reduced to about 15%. However, at the same time, the purity and quality of the silicone fill improved (See below), so it is likely that the surface texture had less of a benefit in reducing capsular contracture. There is very little evidence presently to support any benefit of textured implants over smooth implants. Thus, many surgeons still use smooth breast implants. One other development which has been demonstrated to dramatically reduce capsular contraction has been the use of polyurethane foam coating. This coating has reduced hardening to as low as 0.5% in several long term studies. No other modern implant has yet achieved such a low rate of hardening.

Breast implants are either filled with saline (salt water) or silicone gel. Both have advantages and disadvantages and you should be fully aware of these before you decide what is right for you. Saline implants carry no risk of silicone leaking and feel very soft. However, all implant shells (bag) are made of silicone and saline implants can deflate over time necessitating surgery to remove or replace them with the inherent risks of any operation. Many patients who have saline implant do not like the “water bag” feeling of these implants. Modern medical silicone gel (filling) is a soft cohesive gel which is similar to a jelly. This silicone gel does not have any liquid component, so has minimal if any leakage even if the shell ruptures. Many silicone gel implants now use what is referred to as a form stable silicone, which means that it feels soft but maintains its normal shape – like a jelly.