Confusion about breast augmentation implants enlarged

The other day a patient came for consultation for breast augmentation. I have written extensively about these procedures in the past. Here are a few of those posts;

How to choose  the right breast implant size

How to choose between saline and silicone breast implants

Breast enlargement with implants

A great deal of confusion has arisen over the past 20 years with respect to breast implant sizes and types.

1. Saline vs Silicone

Initially there were just two types of implants;   Saline and Silicone. The shapes were the same; what we now call moderate profile implants.  Patients choose between volume they wanted and the type of material.

Then came new types of textures.

2. Smooth vs textured

Patients ( or rather their plastic surgeons) could now choose between smooth silicone implants and textured implants. The idea behind textured implants was to decrease the rate of capsular contracture or scar formation around the implants. There was no difference in shape of implants with textures…initially.

smooth-round-implants-

            siltex gel family plus ultra

3. Round vs Teardrop

Textured implants were noted not to move! So the breast implant manufacturers came forth with tear drop or “anatomic implants” which supposedly gave a more natural form to the implants. However it was noted that all implants in the body will have some tear drop shape due to gravity anyway. Also these anatomic implants sometimes flipped giving a very “un-anatomic” shape to breasts.

tear drop breast implants

4. Low, Moderate, Moderate plus, high profile implants

More recently there has been an explosion in breast implant shape options. The are now different profiles, or base diameters, for every volume of a breast implant. The same volume can now look very different indeed.

Breast implant profile

Here is an example of just a how different an implant of the same volume can look.

Given the huge choices that now exist in breast implant shapes, types, textures and volumes, things are now complicated. It is no longer enough to say i want a “350 cc implant”  . Let your board certified plastic surgeon choose the right implant for your body. That should be based on your

height,

weight,

size of hips

chest wall

amount of breast tissue

quality of the skin of your chest

experience of the surgeon

your preference for materials based on risks and upkeep, size of scars, just to mention a few of the variables.

Breast augmentation surgery with implants; It’s complicated.

These days, since 2018, there has been the new association of textured silicone implants with a low grade sarcoma can present years after the surgery. These are no longer used in my practice even though I barely used them in any case.

Morad Tavallali, M.D., FACS

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