WHAT ARE MY CHOICES FOR IMPLANTS?

Just as you must weigh the pros and cons of each incision location, your choice of implant must be discussed in depth with your surgeon.  There is no "one size fits all" solution and an implant that would look small on a tall woman may look very large on a petite patient.  The actual size of the implant you choose will depend on your ultimate size goal, what your chest wall will accommodate, the amount of breast tissue you start with and the type of implant you select.  Everyone's size goals are different and cannot be addressed in an article; you will need to see your surgeon to find out how best to suit your needs.  The implants discussed below come in many sizes and are the standard options from which to choose.

SMOOTH IMPLANTS VS. TEXTURED IMPLANTS

Smooth implants are only available as round shell implants (see below). Smooth implants have thinner shells, and tend to last longer. As a result, they are more popular than textured implants.  A smooth shell implant can move within the pocket that the surgeon creates behind the nipple.  When the patient is upright, the implant will move to the bottom of the pocket.  

A smooth implant makes the breast move and feel more natural than a textured.  Women find them more comfortable inside the breast pocket and they are available in high, moderate and low profile styles ("profile" referring to how far off of the chest wall they will project.)

The main risk with a smooth shell is a higher possibility of capsular contracture.  Capsular contracture occurs when the lining inside the chest pocket hardens and contracts excessively, due to the implant rubbing against the tissue, much like how a callus forms on the foot.  This excess firmness can push the implant out of position, changing the appearance of the breast.  The risk of capsular contracture is relatively small; if the implant is placed above the muscle, there is a 20-30% risk.  The risk decreases to less than 2% when it is placed below the muscle. 

Textured implants have a thicker shell and are generally firmer than smooth implants.  Textured implants were designed to help prevent capsular contracture.  Though widely studied, the findings have been inconclusive toward their effectiveness against contracture.  The idea of the textured surface is to prevent scar tissue fibers from laying down in a uniform, parallel pattern, which would cause the breast pocket to firm and tighten.

A textured implant can grab onto the surrounding tissue, causing less friction between the implant and breast pocket, thereby lowering the risk of capsular contracture.   It also gives the surgeon much more control over the ultimate shape of the breast.

Some women complain of temporary, mild discomfort, due to the textured surface sticking to the surrounding tissue. The overlying tissue can grab and pull on the implant surface, causing ripples or wrinkles.

ROUND IMPLANTS VS. ANATOMICAL IMPLANTS  (Teardrop Shaped Implants)

Round implants come in smooth and textured shells and are available in high, moderate and low profile styles.  They are chosen more often than anatomical implants and are less expensive.  Although round when held in your hand, if a round implant is held vertically, it takes on the same form as the anatomical implant.  A round implant can give you a rounder, fuller look. They are sometimes thought to produce a more "fake" or overly round and augmented look.  This is not true; a good surgeon can make the right implant for you look very natural.

If a round implant is under-filled, it can cause a "rippling" effect and allow the implant to move and change position inside the breast pocket.  It is very important to agree with your surgeon on the exact size that will satisfy your desires.

Anatomical breast implants were designed to create a more natural looking breast shape.  Originally for reconstruction purposes, they have become popular in general breast augmentation.  When you look at an anatomical implant from the front, it has an oval appearance.  Viewed from the side, it is larger at the bottom than at the top.  Most of the volume in anatomical implants is in the lower portion of the implant.    

All anatomical implants have textured surfaces to allow for a better integration with the surrounding breast tissue.  The implant may still flip or move, so your surgeon must be well versed with this type of implant.

An anatomical implant gives better forward projection of the breast than the round shell, with less volume at the sides.  It will also maintain it's shape longer.

Due to the texturing, the implant may occasionally make the surrounding tissue sensitive.  Also, because the length is greater than the width of the implant, smaller women may not have the chest cavity necessary to carry an anatomical shell.

When considering breast augmentation, there are many things to understand.  It is important that you research your choices carefully, always keeping an open mind to the options your surgeon recommends.  You should live your life to it's fullest and we're here to help you realize your dreams.  If you have any questions or wish to come in and talk to us in person, call (847) 853-9900.