Breast augmentation—a procedure designed to increase the size and/or improve the shape of the breast—can dramatically enhance the appearance of a woman’s breasts. However, there are many options for creating your ideal breast appearance, including implant size, style, and shape, implant material, implant position, and implant incision site. These decisions depend on several factors including your cosmetic goals and body type, and will ultimately be made along with your surgeon before you undergo breast augmentation, but we’ve created this helpful guide to inform patients about these important considerations.
IMPLANT MATERIAL
Silicone Implants
Silicone implants are made up of a silicone elastomer shell, filled with soft, cohesive silicone gel. Often considered to look more natural, silicone implants closely mimic the feel of breast tissue, and are available in a wide range of shapes and sizes. In our experience, on average, silicone gel implants will last 15-20 years or more.
Saline Implants
Saline breast implants have the same silicone elastomer shell as silicone implants, but are filled with sterile salt water during surgery. The look and feel of your breast will ultimately be determined by the size of the implant shell as well as the amount of saline that is used to fill it. Because these implants are inserted into the body while empty and filled once in place, saline implants may sometimes allow surgeons to use smaller incisions. In our experience, on average, saline implants will last 10-15 years.
IMPLANT SHAPE
Round Implants
Round implants add an equal amount of volume around the entire circumference of the breast, making them ideal for women looking for a boost in cleavage and fullness for a youthful final result. Properly sized, round implants can provide a natural breast contour. Additionally, if they happen to rotate, they maintain the same shape at any angle.
Shaped Implants
Shaped implants are sometimes called “anatomic” or “teardrop” implants, because they create results that mimic the shape of natural breast tissue with more fullness in the lower portion of the breast. These implants are typically used for women with smaller frames who still want to increase volume, or those who just want a more natural, anatomic look. These implants traditionally have a special texturing on their shell that limits rotation of the implant. This texturing has been associated with a rare but important new disease entity called anaplastic large cell lymphoma (ALCL). As a result, shaped implants are rarely used these days.
INCISION LOCATION
Inframammary Incision
This is our most commonly used incision and is made below the breast fold. This incision heals well and is generally well hidden. It also confers the lowest risk of internal scarring (capsular contracture).
Periareolar Incision
This incision site is typically the most concealed. It is associated with a higher likelihood of breast feeding difficulties than the other incision options because periareolar incision involves cutting through the breast tissue. This may also increase the chance that there will be a change in nipple sensation.
Transaxillary Incision
This incision is made under the arm and a small tunnel is made to create a pocket behind the breast. While saline implants are more easily placed through this incision, Dr. Somogyi and Dr. Jalil effectively place silicone gel implants through transaxillary incisions as well.
IMPLANT PLACEMENT
Submuscular Implant Placement (Under the Muscle)
The breast implants are placed partially or wholly under the pectoralis major chest muscle. Submuscular implants may result in a longer, more painful recovery than subglandular implants. Submuscular placement may result in less palpable implants and may reduce the risk of developing capsular contracture, as well as offer easier mammographic imaging of the breast.
Subglandular Implant Placement (Over the Muscle)
This breast implant location is between your chest muscle and your breast tissue (under the breast gland). Implants that are subglandular may be easier to see and feel through your skin and are only placed in this position if you have adequate thickness of overlying breast tissue. This placement may provide more upper fullness and even help slightly lift the breast.
