Breast Implants

There are many different types of breast implants available today for breast augmentation. No breast implant type is suitable for every augmentation patient. The decision about which breast implant type to use is based upon many factors. Both the plastic surgeon and patient together should choose which type of breast implant to use and which method of augmentation to employ.

Types of Breast Implants

Saline & Silicone
Saline Breast Implants - Advantages

The majority of breast implants that are used for augmentation today are comprised of a silicone shell which is filled with saline. The implants come from the manufacturer filled with air. The air is removed prior to placement of the implant during breast augmentation and the implants are filled with saline once they are in place. This allows for very short incisions to be used for the augmentation. There two main advantages of the saline breast implant for breast augmentation. First, there is no controversy surrounding the use of saline breast implants. This is as compared to silicone gel breast implants (discussed below) which are controversial for breast augmentation (although this controversy is lessening). Second, if a saline breast implant ruptures, or leaks, after breast augmentation, the patient knows about it. The body absorbs the fluid (there is no risk as it is the body's natural fluid) and the breast gets smaller than it had been after augmentation. Essentially, this second advantage is th at if a leak occurs, the patient knows about it.

Silicone Gel Implants - Advantages

Silicone gel breast implants consist of a silicone shell filled with silicone gel. These are the type of breast implants which were initially introduced by plastic surgeons in the 1960's and have been in use ever since. Controversy developed surrounding the use of these devices for breast augmentation. The controversies were whether or not these breast implants ruptured and if so, how often. Further, if these silicone gel filled breast implants ruptured, would a patient know about it. Further still, if a silicone gel breast implant ruptured and the woman did not know the implant had ruptured, would there be any adverse affect on her health.

It was precisely these questions which lead the FDA to suspend routine use of silicone gel filled breast implants for routine primary breast augmentation. Following this suspension, silicone gel filled breast implants were available as part of an on going FDA study. Dr. Bernard Shuster is an investigator in the FDA's silicone gel breast implant study. The goal of the study has been to answer the questions regarding the use of the implants for breast augmentation in order to determine the rupture rate of these implants and whether gel filled breast implants posed a potential health hazard.

To date significant scientific work has been done by experts in various fields of medicine regarding the issues surrounding the uses of gel filled breast implants for breast augmentation. Their findings suggest there is no health hazard related to the use of gel filled breast implants. The greatest advantage of the silicone gel filled breast implant is its natural feel. This is especially noticeable when compared to saline filled implants. There is nothing that feels quite as natural as a silicone gel filled breast implant. This is in comparison to saline filled breast implants. This is even further evident when saline filled breast implants are "over inflated". There is a common trend amongst plastic surgeons to "over inflate" saline filled implants for breast augmentation. Some plastic surgeons will state the implants are less likely to produce 'rippling' or give better projection when over filled. The only definite result of over filling a saline filled breast implant is a breast implant that has ta ken on a spherical shape and is much firmer than necessary.

Breast implants do not have to be as hard and firm as many have come to think of them. Dr Bernard Shuster uses both of these types of breast implants. Most of the augmentations he performs involve saline breast implants. Dr. Shuster does offer silicone gel implants for those who are appropriate candidates. That being said, except in the rarest of circumstances, Dr Shuster does not over fill saline breast implants when he uses them for breast augmentation. Saline breast implants that are filled to the minimal fill volume are also quite soft. In his hands, Dr Shuster feels silicone gel breast implants are only 10% to 15% softer than an appropriately filled saline breast implant.

On the other hand, there are disadvantages to the silicone gel filled breast implants. The implants can, and do, rupture. The issue is a patient does not know if this has happened to them. Various imaging methods have been used in an effort to develop a non-invasive method of detecting whether a silicone gel breast implant has ruptured. These have included, MRI scans, ultrasound and, mammograms. None of these have proved very effective in evaluating implant rupture for breast patients.

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Round and Anatomic Shaped Breast Implants

Breast implants for augmentation come in a variety of shapes. In general, these are round or anatomic (tear drop) shaped. No one design is best for every augmentation. Rather, each augmentation patient should be evaluated individually regarding which breast implant design is best for them.

Anatomic breast implants, also called tear dropped shaped breast implants, have more volume along the lower portion. The concept behind this is that this type will have an appearance more natural. While this works well for a select group of patients undergoing augmentation, it has not become widely used. The draw back with this design is that anatomic breast implants have a distinct vertical orientation. If the implant rotates following augmentation, it distorts the appearance; not an ideal outcome. However, some patients benefit from this design making the tear drop shape the correct choice.

Round breast implants are by far the most popular style used for augmentation today. An advantage of the round breast implant, as compared to the tear drop shaped breast implant, is that if the implant rotates it is of no consequence. This type of breast implant is round and therefore has no vertical or horizontal orientation. Another important point to consider is that when a round breast implant is in place and a woman stands up, much of the filler settles in the bottom portion of the breast implant as a result of gravity. This creates a profile quite similar to that of the anatomic breast implant but avoids the risk of visible distortion following breast augmentation.

High Profile Breast Implants

Smooth round implants for breast augmentation come in various sizes and styles. The profile of these implants is the view of the implant from the side. This is called the projection of the breast implant. Breast implant manufacturers are now making these breast augmentation devices with a variety of projections. They are called "Moderate Profile", "Moderate-plus" Profile, and "High Profile". For any given breast implant width, the higher the profile the more the projection. The Moderate Profile Implant provides for a more conservative breast augmentation. The High Profile implant provides a more voluptuous breast augmentation. The selection of which style to use depends in large part upon a woman's body type and on her personal preference.

Cohesive Silicone Gel Breast Implants

Cohesive gel implants are the newest advances in breast augmentation. What is so innovative about these breast implants is that if the shell were to rupture or tear, the gel is thicker and thus less likely to extrude from the shell and enter the tissues. These breast augmentation devices are textured and have an anatomic shape. The Cohesive gel breast implants have more of a firm feel which has lead to them being called "Gummy Bear" breast implants. While there is much interest in these implants, they are relatively new to the breast augmentation market. The main advantage of silicone gel implants for breast augmentation is the soft natural feel to them. As the Cohesive gel implants have a firm consistency, it differs from the traditional gel filled breast implants in this regard.

Dr. Shuster and his staff are committed to his patients' care and well being. Dr. Shuster sees his patients frequently in the postoperative period and continues to follow their progress for an extended period. Should a question or concern arise, please call our office at any time.

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