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You have decided to undergo breast augmentation surgery. Your head is buzzing with new information as you wait on your scheduled consultation with your doctor. Inevitably, you will consider the different types of breast implants available and what options are ideal for your breast implant goals.

Deciding to get your boob job presents a vast array of options regarding the size, composition, texture, shape, and incision site among others.

The majority of patients opt for breast implants in order to make their breasts bigger and fuller; however the reasons are not always solely cosmetic. Some patients require reconstructive breast surgery after mastectomy due to breast cancer, or other disfiguring life events, or after child birth and breastfeeding which can cause excess skin, droopiness and changes to feel.

The Food and Drug Administration imposed a minimum age requirement for breast augmentation patients of 18 for saline implants and 22 for silicone, since breasts can continue developing through the early 20’s.

Before the implant surgery takes place, patients typically have at least once consultation with the surgeon. This is the patient’s opportunity to convey their cosmetic goals with the surgeon and get their feedback, as well as ask any questions.

Breast Augmentation surgeries are typically performed as outpatient procedures, with the surgery itself taking a maximum of two hours. The surgeon makes an incision thought the areola, armpit, underneath the breast, or at the bellybutton, depending on the preferred incision site. A pocket is created either above or below the pectoral muscle in order to accommodate the implant.

Once the pocket has been formed the implant is ready to be placed and the incisions can be closed using sutures or medical tape. Once the patient is cleaned up, the breasts are wrapped in gauze. Some patients may have drainage tubes which are removed within a few days.

Breast Implant Composition

Saline? Silicone? Gummy bear?! As is the case with most implant composition, the outer “shell” is made of a silicone rubber elastomer with an additional coating to minimize the risk leakage in saline, silicone, and cohesive silicone gel, also known as “gummy bear” implants. All options of breast implant composition yield great results and both have their advantages.

Breast implants can be classified into two main categories: saline implants and silicone implants. During your first consultation, your cosmetic surgeon will explain in details the pros and cons of the different types of breast implants.

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Saline breast implants

Saline breast implants are popular in the world of breast enhancement procedures for two distinct reasons. First, because they offer a less invasive incision site as the implant shell is inserted empty, then filled with saline fluid once in place.

The second reason is the saline solution itself. A combination of sodium and water, saline breast implants are sterile. In the event of a rupture, it is immediately noticeable and perfectly safe, since saline is found naturally in the human body.

Saline implants are ideal for those patients concerned with visible scarring. Unlike silicone gel implants which are pre-sized, saline implants are filled once they are in place, allowing the implant shell to be inserted rolled up through tiny incisions. These ones up the incision site possibilities to techniques not available with silicone gel implants.

For example: the Transumbilical Breast Augmentation, AKA TUBA method. The TUBA method uses an incision made at the navel. The surgeon then tunnels up to the pectoral muscle and the implant shell is placed while empty, allowing for a much smaller point of entry. Once in place, the implant is filled with the sterile saline solution until the desired volume is reached.

Since saline implants can be filled to any size, they are sought after by patients who wish to correct asymmetry of the breasts, where breast are two different sizes. Since saline implants are adjustable, saline implants are ideal for correcting differently sized breasts.

No matter which point of entry is used, each implant can be filled once in place, and when performed by a skilled surgeon, each can be filled to different volumes resulting in much more symmetrical breast than prior to surgery.

Silicone Breast Implants

Silicone implants, the heavy hitters when it comes to breast augmentations. In 2015, silicone implants represented a whopping 80% of all breast implants and over 90% of implants used during breast reconstruction procedures. Accepted by the Food and Drug Administration for patients over the age of 22, silicone implants look and feel more like your natural breast tissue.

Prefilled to size with a soft “jelly-like” medical grade silicone substance, this kind of prosthetic is often recommended for petite patients or those with thinner breast tissue, who are generally more prone to rippling. Created to mimic body fat, silicone within the implant retains your natural body temperature, adding to the overall consensus that silicone implants are best for a natural looking and feeling breast enhancement.

Silicone implants greatly diminish the chances of breast implant rippling, the appearance of ridges on the outer perimeter of the breast, in part due to the silicone being able to retain its shape without the aide its shell.

Patients who opt for silicone implants require MRI’s every two to three years to ensure ruptures resulting in gel leaks have not occurred. Because of the cohesive property of the silicone, should a rupture occur, it is virtually undetectable since the breast never “deflates”.

Gummy Bear Breast Implants

Made of a more viscous silicone gel, the gummy bear implant is slightly firmer to the touch than its older cousin, the traditional silicone implant. Cohesive gel breast implants are nick named Gummy Bear because the texture is solid, similar to that of a gummy bear and are “form stable” which simply means they have the ability to maintain their form, even outside of the shell. The ability to retain its shape makes the anatomical or “tear drop” implant another possibility for patients seeking a more natural, anatomically correct breast implants.

The "Gummy Bears" implants have existed for approximately three decades but in the last 5 years their use in the United States has been revolutionized. Since the date in which I enter the American market until today, the percentage of patients who use it for their breast augmentation has been growing.

But why? In Adore Plastic Surgery we explain it in a very simple way:

Visualize an implant filled with a cohesive silicone gel that would retain its shape if cut in half. How is this possible? Well, the silicone inside the implant has a greater amount of crosslinking. That means that this type of filling maintains its shape better, and most importantly, it does not wrinkle or ripple as much as the other implants.

So you increase the volume of your breasts, you will not see wrinkles or folds and if the implant were to break, the breast would maintain its shape and the gel would not leak to the body.

This last aspect is very important when deciding which type of implant is going to be used, because when the implants are broken, the leakage of the gel with which they are filled can present a complication and additional surgery is required.

At Adore Plastic Surgery we suggest you come to your first consultation and personally experience the texture of these Gummy Bear implants, the gel is usually soft and feels natural to the touch, although there are some implant manufacturers that make them more rigid ones that others.

Choosing the Shape of Your Implant

Round Implants

Oftentimes, a round implant behaves the most anatomically, even more so than the teardrop shape, which is widely believed to be the most anatomic breast implant option. Comparison studies have found when women are standing, the implants are similar. Unsurprisingly, teardrop breast implants assume an anatomic shape.

This is hardly a groundbreaking revelation. In an interesting plot twist, the same study found round breast implants also assume the anatomical tear drop shape.

Thanks in part to gravity, when a woman is standing, the implant is pulled down and, as seen in x-rays, both implants assume the coveted teardrop-shape and were found to be anatomic.

Round shaped implants respond to the forces of gravity and more closely mimics a natural breast. This is especially true when women with implants are lying down: round implants fall more naturally to the side similar to natural breast, much more so that the anatomic implant shape.

The round implant has the added advantage of having less of a framework than the anatomic implant, so that in the event that the implant rotates, there is no visible change to the shape of the breast.

Teardrop Breast Implants

Patients seeking a more subtle, natural look may consider anatomical breast implants, usually referred to as teardrop breast implants, due to their unique shape which is fuller at the bottom and gradually tapers towards the top, closely resembling the shape of a natural breast. Originally created for patients undergoing reconstructive surgery, the tear drop implant is recommended to patients with little breast tissue who would not achieve a natural look with a round implant.

Often enhancing the natural breast line, teardrop breast implants do not require any post-surgery massage. Doctors sometimes discourage patients from choosing teardrop breast implants because in the event that the implant rotates, the breasts become unnaturally distorted requiring re-operating the patient.

New trends in breast implants

Under the muscle, is not it?

Although breast augmentation is considered a major surgery, when performed below the muscle it is minimally invasive and, therefore, the healing period is less extensive. Our experienced plastic surgeons create a breast pocket for the implant with extreme precision, thus drastically reducing post-surgical bruising, bleeding, pain and swelling.

In addition, placement under the muscle generally produces more natural results, particularly when working with gel implants.

It has been discovered that patients who undergo a breast augmentation and place the implants under the muscle, need less analgesics than when the implants are placed on the muscle. It has also been proven that scarring is better and revision surgery is rarely done. There are, of course, some exceptions.

Breasts big or small?

Dr. Stafford Broumand, a board-certified plastic surgeon at 740 Park Plastic Surgery in New York, comments that breast augmentation appears to be the most popular surgical procedure of the previous year, and that he has seen a change in the size of the implants that the patients are requesting.

"Throughout my career, in the last 20 years, I have seen an increase and a fall, forgiveness for the pun, in the size of breast implants, in the 90s and 2000, for my practice, sizes of the implants were larger, patients requested larger breast implants, and today patients' requests have moderated a bit"

Dr. Stafford Broumand

Type of breast implant most common today

The "Gummy Bear" implants lately have been the most requested. While it is true that the incision that is required is a little larger, they represent less risk if they are broken. Its longevity is greater and its appearance is very natural.

At what age are women more likely to have a breast augmentation?

In 2016, statistics indicate that women between 19 and 34 years of age had more breast augmentation procedures than the others.

Breast Augmentation Statistics by Age

Breast Augmentation - Statistics by Age

How know what Type of Breast Implants is the Best

Choose what is best for you

At this point, we hope you have realized that to decide what type of breast implant you want, there is much more to consider than simply "wanting a cup C". It is necessary to assess the shape of your body. And from that point: the constitution, weight and initial size of the breast before choosing the type of breast implant that is right for you.

It is important that you accurately convey to your surgeon what you define as ideal results, and have your mind open to suggestions on what size and shape will work harmoniously with your body. Also consider your lifestyle; Patients who lead a more active lifestyle should assess which type of implant is the strongest, and which has the least chance of breaking.

Form: Now that you have an idea of the types of breast implants available, we will explore the different options available. Today's patients can choose between round or anatomical implants, also known as teardrop, as well as choosing between low, moderate or high profile options.

Consistency: Both saline and silicone implants have their advantages and disadvantages. The best way to determine which is best for you is to reduce your preferences. For example, patients with moderate-sized breasts can choose both types of implants, but patients who do not have as much breast tissue can benefit more from silicone implants, since they provide a more natural appearance and less chance of breaking. Our surgeons will warn you about the mammary implants that are closest to the constitution of your body.

Do you know what brand of breast implant is better?

At Adore Plastic Surgery we are very careful when choosing the prosthesis with which we perform breast implants. While it is true that they are usually all made of silicone, the cover is very important. Based on our experience and search for a career, there is a brand with which we prefer to work. Allergan: Made here in the United States and with a history of good recommendations and high longevity.

Allergan is known because it has a good guarantee, because there is no tendency for it to break, because it has a wide range of samples of different types of implants in terms of shape, texture, size; and although it is true that its price is not the cheapest, the relationship between price and quality is very good.

These are the most recognized and reliable brands in the market:

It is time for you to do your own search, you will know that Adore Plastic Surgery works with one of the brands with more tradition and guarantee of the entire cosmetic market; Allergan.

Breast implants comparison

The composition of breast implants depends a lot on the results you want. Anticipate the pros and cons of each possibility, and ask your surgeon any questions you may have.

SiliconeSalineGummy Bear
Minor age that the patient must have22 years18 years22 years
Type of materialSilicone gelSaline solutionCohesive silicone gel
Filling Pre-filledStuffed after placedPre-filled
Breast Implant IncisionPeriareolar, Inframammary, TransaxillaryInframammary, Periareolar, Transaxillary, TransumbilicalPeriareolar, Inframammary, Transaxillary
Breast Implant Placement optionsSubglandular or submuscularSubglandular or submuscularSubglandular or submuscular
AppearanceNatural feeling with little chance of undulation Sensation strong to the touch and with a high probability of ripple Most natural breast shape with little chance of wrinkling or bending.
Longevity15- 20 years 7 - 10 years15- 20 years
RuptureThe body does not absorb it, it is kept inside the bag that covers the breast implantIf the implant collapses the saline solution is absorbed by the body. If there is a break, the material does not filter, it does not even lose shape.

The final results will depend directly on the type of breast implant you choose. For that reason, patients must understand the various options available that will help them make a solid decision.

At Adore Plastic Surgery our experienced surgeons have performed breast implant surgeries to people from all corners of the world. We can help you achieve results that are natural and in order with your needs.

An informed patient is a happy patient. The more you know when making the decision for surgery, the more likely it is that the result of your breast augmentation procedure will exceed all your expectations!

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