Breast implant shapes and textures

Every so often I still have a patient ask me which shape of breast implant is best for them and what the differences in breast implant shapes and textures actually are. This topic can get a bit confusing, so bear with me while we plow through it in a condensed format.
Breast implant textures
There are two different types of coverings for breast implants, be they silicone or saline.
Smooth breast implants
Smooth breast implants are typically used for cosmetic breast augmentations and have a smooth silicone shell that allows for easy gliding of the implant under the breast tissues. These are currently the most-used implants in the US.

Textured breast implants

A few decades ago, in an attempt to decrease the occurrence of breast capsular contracture, implant manufacturers came up with the idea of creating a texture made of lots of microscopic silicone pegs on the outside of implants. Both saline and silicone implants were made in this way, and many were used for both cosmetic breast augmentations and reconstructive surgery. It didn’t work. Some people still like them, but I  have found them to be useless and in some cases troublesome, as they adhere to the surrounding tissues and do not freely move like a natural breast.
 These implants have recently been associated with large cell anaplastic lymphoma and I no longer use them.
Breast augmentation with contoured implants vs. round implants

Contoured breast implants

A few years ago, the implant companies came up with the idea of “contoured breast implants,” primarily for breast reconstruction patients. They then tried to move this product to the cosmetic field, advertising a “more natural shape.” An ideal breast shape, after all, is supposed to be a gently sloping upper breast area and a full and round lower half—sort of like a dutch shoe. The contoured implants, which were all textured so that they would stay in position—were hence narrower at the top and fuller at the bottom. However… A classic plastic surgery study showed that all round implants will have a “contoured” shape as long as we are on this planet; gravity has that effect on all implants, irrespective of how you mold them.
I think the companies that came up with this idea got sued for misrepresentation. In any case, these implants are no longer available as far as I know for cosmetic breast enlargements.

Dutch shoe

A Dutch shoe

Round breast implants and breast profiles

Round breast implants are as advertised: round or spherical implants. Unlike the contoured breast implants, there is no artificial or manufactured narrowing of one end of the implant. Round implants come in three different “profiles,” or heights.

High profile implants

High profile implants are round implants with a narrower base, leading to more projection or “sticking out” of the breast. I am always reminded of Madonna’s bra in the early 90s when I see this shape. These implants are ideal for patients who have narrow hips and for whom a moderate profile implant would be too big and make them appear top-heavy.

High profile breast implants remind one of Madonna’s bra

Moderate profile implants
This is the profile I use in the majority of cases for my cosmetic augmentations. The diameter of the implants is a little wider for the given volume compared to the high profile implants, and this is better suited for women who have larger hips in relation to their chest. Many women fall into this group and need the wider implants to balance their bodies into proportion.

Low profile implants

This type of profile is for… well, I have never used them, as I have to yet see a patient who says they want flat but wide breasts. But companies still make them.
In summary, whether you want saline or silicone breast implants for a cosmetic augmentation, you should decide on the profile of your implant based on the size of your hips and chest so you become proportioned. I  use neither a textured implant nor a contoured one. Your cosmetic plastic surgeon may have other ideas, but do have them write me to convince me otherwise if they do.
Let the plastic surgeon help you make the choice of implant, and don’t get too worked up about trying to figure out which is best for you—that’s why you go to an experienced cosmetic plastic surgeon in the first place.
Need more information on breast surgery? Find it at: Breast surgery