When considering breast augmentation, my patients often wonder what types of breast implants I recommend. Each patient has unique needs, so it’s important to understand the pros and cons of different styles, textures, and sizes of breast implants before your breast augmentation procedure.

Saline Breast Implants 

Saline implants are made of a silicone shell filled with a sterile saltwater solution. One purported benefit of saline implants is that they can be filled with varying amounts of solution to achieve the desired breast size, shape, and firmness. There are different profiles of saline breast implants available. Some proponents of saline breast implants also note that saline can be harmlessly absorbed by the body if the implant ruptures. However, if a saline implant ruptures, there is a complete loss of volume in the breast.

Saline implants have dipped in popularity in recent years. In 2020 just 16% of all breast implants were saline, according to the American Society of Plastic Surgeons (ASPS). Some downsides of saline implants are that they are more prone to wrinkling, may have a less natural feel, and are more likely to rupture than silicone implants.

Silicone Breast Implants

Silicone implants are composed of a silicone shell filled with cohesive silicone gel. They have a more natural look and feel compared to saline implants, and are less likely to ripple or wrinkle. 

Silicone implants are also preferred by many active patients, who feel that they are more comfortable during high-impact activities like running. More than 84% of breast augmentations in 2020 used silicone implants, according to ASPS.

Whereas saline is dissolved by the body, if a silicone implant ruptures, the volume stays inside the implant capsule and doesn’t get systemically absorbed by the body. This can make it harder to detect ruptures but also means that the breast won’t entirely deflate in the event of a rupture.

Silicone implants are available in different shapes, profiles, and textures to accommodate different patient needs. These are the most common variations of silicone breast implants: 

Smooth Silicone Implants

I prefer to use smooth, round silicone implants when indicated by my patient’s anatomy and goals. Smooth implants tend to be rounded and form a thinner capsule around the implant. The capsule itself tends to be less palpable, giving the implants a more natural feel. Smooth silicone implants also conform to the patient more, whereas shaped implants force the patient’s anatomy to conform to the breast implant.

Textured Silicone Implants

Textured silicone implants have a coarse or dimpled outer shell. Early studies suggested that these implants may have less capsular contracture over time, but the impact is likely minimal and is negated by placing the implant in a dual-plane or submuscular pocket. Because the implant becomes more adherent to the capsule, it may move less with the patient and has a less natural feel. 

Gummy Bear Breast Implants

The gummy bear implants are textured, cohesive, and shaped implants. Composed of a denser gel that holds shape, these implants force the patient’s tissue to adapt to the implant. They’re designed to sit in a natural teardrop shape of the breast. A downside is that gummy bear breast implants can rotate if the pocket isn’t right enough or if there is capsular contracture, giving the breast an asymmetric or abnormal contour.

Hundreds of thousands of women in the U.S. get breast implants each year, according to ASPS. Breast augmentation surgery is consistently among the top five most popular cosmetic procedures nationwide and one of the most common cosmetic procedures we perform at our practice. 

Here are some potential benefits of breast implants that my patients have reported:

• Improved self-esteem: Many women say they feel more confident and positive about their appearance after breast augmentation surgery.
• Enhanced proportions: Women with naturally small breasts or asymmetrical breasts may find that breast implants balance out their overall body proportions.
• Reversal of post-pregnancy changes: Pregnancy, breastfeeding, and weight fluctuations can cause breasts to sag, lose volume, or become asymmetrical. Breast implants can restore a woman’s pre-pregnancy breast size and shape. Women who want to address breast ptosis or significant drooping of the nipples below the inframammary fold, may opt for a breast lift while getting implants.
• Reconstruction after mastectomy: Women who have undergone a mastectomy as part of breast cancer treatment can have breast implants placed to reconstruct one or both breasts.
• Correction of congenital defects: Women with congenital breast abnormalities, asymmetries, or chest wall deformities may also benefit from breast implants to improve their appearance and boost their self-confidence. 

It’s important to note that breast implants, like any surgical procedure, carry risks and potential complications. Before your procedure, we will walk through all of these factors with you and will ask you to sign a consent form provided by the breast implant manufacturer. 

One thing that I emphasize to patients is that breast implants are temporary devices, and studies show that approximately 25% of breast augmentation patients will have a revision at 10 years. At times, revisions are warranted due to changes in the implant pocket or breast tissue, or because patients desire an increase in implant size.

Some other potential breast augmentation complications include: 

• Capsular Contracture: Some patients develop scarring around the implant, which can distort the appearance of the breast or cause pain. Capsular contracture is usually resolved by a revision procedure. This occurs in approximately 12% of primary augmentation patients at 10 years. 
• Breast Implant-Associated Anaplastic Large Cell Lymphoma: This extremely rare form of cancer has been associated primarily with a textured implant manufactured by Allergan that is no longer in production and rarely used by surgeons today. In our practice, we do not use any implants that have been associated with this condition.
• Breast Implant Illness / Connective Tissue Disease: There has been speculation about a connection between breast implants and the development of systemic symptoms, including connective tissue diseases such as fibromyalgia or rheumatoid arthritis. The data available does not conclusively demonstrate an association between implants and these conditions, and research by the Institute of Medicine and the FDA strongly reaffirms that implants are overwhelmingly safe devices with a low likelihood of developing one of these conditions. Like any other implant or prosthetics, some patients’ bodies will have an adverse response to the presence of a foreign body, however, this is an extremely uncommon complication.
• Implant Leakage or Rupture: Breast implants are difficult to tear or rip, but ruptures can occur. Many implant manufacturers offer warranties and will replace the implant if a rupture occurs, and may assist with offsetting the cost of revision surgery.
• Weight Gain or Loss and Hormonal Changes: Pregnancy, weight gain, weight loss, and menopause can all alter the appearance, shape, and position of your augmented breasts over time.

To minimize the risks associated with breast implants, you must select a qualified board-certified plastic surgeon to perform your breast augmentation procedure. All active ASPS members have graduated from accredited medical schools, have completed at least six years of surgical training with specialty training in plastic surgery, and meet the highest standards of patient safety and ethics. Search the ASPS website based on your location to find a qualified plastic surgeon near you. 

If you’d like to learn more about breast augmentation, we’d love to bring you in for a consultation. Our team of board-certified plastic surgeons and experienced providers at Plastic Surgeons of Northern Arizona can answer your questions and discuss your goals.