Striving for an ideal figure and aesthetic perfection is a natural desire of every woman. In search of a perfect body, they try various methods – diets and workouts, injections and cosmetic procedures. However, if we talk about breast augmentation, such methods will not give the proper result. The most effective and long-term solution is plastic surgery. Breast augmentation using implants not only helps to achieve the desired volume and shape but also has a positive effect on self-esteem and self-confidence. This approach is becoming increasingly popular as it allows you to change what cannot be corrected by other means. It is important to realise that the choice of implants and surgery are serious decisions that require an informed approach and careful consideration of all aspects. In this article we have collected complete information about modern breast implants – their varieties and features, methods of implantation, possible risks and recommendations on the choice.
Types of breast implants
Today there is a wide range of implants, allowing every woman to find the best option for herself. Modern plastic surgery also offers breast correction for men. Implants differ in the type of filler (saline or gel), shape (round or anatomical) and structure (smooth or structured). The choice of implant is based on the patient’s anatomy, preferences and goals.
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It is important to remember that the choice of implants is best entrusted to a professional plastic surgeon. An experienced doctor will take into account all relevant details to ensure the best outcome of the surgery and satisfaction with the result. Contact MediGlobus to find a mammoplasty clinic and make an appointment with a plastic surgeon without waiting in line.
What are breast implants made of?
Saline breast implants
Saline implants are filled with sterile saline solution, identical in composition to human plasma. This makes them safe and biocompatible. In case of damage to the implant, its contents are easily absorbed by the tissues and removed from the body naturally, without causing damage to health. With these implants, it is possible to give the breasts any volume desired. In addition, a smaller skin incision is required during implantation compared to silicone implants. They are predominantly chosen by women who want to achieve bigger breast size. However, asymmetry is more likely to occur with larger saline implants. There is also an increased risk of drooping over time and the lifespan of these implants is shorter than that of silicone implants.
Saline implants are FDA-approved for breast augmentation in women over the age of 18. There is no age restriction for reconstructive surgery.
Advantages:
Safety if the implant is damaged. The shell and fluid are naturally eliminated from the body.
Elastic and lush breast shape.
Any volume can be achieved.
Less scarring after surgery.
Costs less than silicone implants.
Disadvantages:
Less natural look and feel compared to silicone implants.
There may be visible asymmetry, especially if the implant size is large.
There is a risk of implant displacement.
Shorter lifespan than silicone implants.
Silicone breast implants
Silicone breast implants are filled with gel. It can vary in consistency from less dense to very dense. The denser the filler, the less likely it is to leak if damaged. Studies show that the risk of shell rupture is very low (from 1,1% to 9,3%, depending on the type and manufacturer). The weight of a silicone implant is less than a saline implant, and the structure is closer in feel to natural breast tissue. This option is suitable for active women seeking a natural appearance. In addition, silicone implants have a long lifespan. However, they require a longer skin incision. After implant placement, regular check-ups with your doctor are recommended to monitor the integrity of the shell and to prevent filler leakage.
Silicone implants are FDA-approved for women over the age of 22. There is no age restriction for breast reconstruction.
Benefits:
More natural feeling and appearance of the breasts.
Suitable for active women.
Very low chance of the gel leaking out into the tissue if the shell is damaged.
It is possible to choose different filler densities.
It is possible to choose different sizes.
Disadvantages:
Need for regular check-ups.
Low risk of damage to the sheath.
Longer incision for implantation.
More expensive than saline implants.
Gummy bear breast implants
‘Gummy bear’ is a new type of silicone implant that retains its shape even if the shell ruptures. It contains a very dense filler, which makes it more elastic than traditional gel implants. It has a characteristic pear shape that gives the breasts a natural look. Gummy Bear implants are limited in size, whereas traditional saline or silicone implants can give your breasts significantly more volume.
If the implant shifts (which is extremely rare), it can cause a change in the appearance of the breast, in which case a second intervention is required for correction. These implants require a longer incision in the skin.
Advantages:
Preservation of shape and retention of the gel inside if the shell is damaged.
Denser and firmer consistency.
Closer to natural breast shape.
Disadvantages:
Requires a larger incision for insertion.
Requires corrective surgery if the implant is displaced or rotated.
The most expensive option.
Bio breast implants and silicate implants
Hydrogel implants are filled with biodegradable filler and are considered environmentally friendly. They are aimed at women seeking more natural and biocompatible materials. However, they have a limited lifespan of about 10 years as the material is less resistant to wear and tear compared to other types. It is important to note that hydrogel implants do not yet have FDA approval.
B-Lite silicate implants are made with added silicate. They are 20-30% lighter than traditional silicone implants. When used, they reduce stress on the breast tissue and spine, which is especially important when choosing large sizes. These implants last up to 20 years. Their cost is 20-30% higher than their analogues. Silicate implants also do not yet have FDA approval.
Which breast implants are better – round or anatomical?
Round breast implants
This is the classic and most popular type of implant. They all have the same diameter, giving the breasts a more lush and voluminous look, and creating a ‘push-up’ effect. Breasts with this implant become firm and dense to the touch. Because round implants are uniform over the entire surface, the risk of rotation and displacement is greatly reduced. They can be either smooth-surfaced or textured.
Advantages:
A more lush and voluminous breast shape.
Different implant sizes can be selected.
Less risk of displacement.
Disadvantages:
Less natural appearance compared to anatomical implants.
Anatomically shaped implants
Anatomical implants, also known as ‘drop-shaped’ or ‘pear-shaped implants’, mimic the natural shape of the breast. They can be used for cosmetic correction as well as for breast reconstruction after mastectomy. They have a textured surface, which favours better adhesion to the tissue and reduces the risk of displacement.
The implants come in different heights (low, moderate and high). This makes it possible to take into account the individual anatomical features of the patient. For example, women with an elongated chest wall are better suited to high implants to achieve the desired fullness in the upper chest.
Anatomical breast implants also have their disadvantages. The main one is the risk of rotation. If the implant rotates, it can cause the shape of the breast to become uneven, in which case a second surgery is required to correct it.
Advantages:
Mimic the shape of a natural breast.
The textured surface provides better adherence to the surrounding tissue, which reduces the risk of implant movement.
Ideal for restoring breast shape after mastectomy.
Disadvantages:
If the implant rotates, it can cause deformation of the breast shape, requiring a correcting surgery.
Placement of anatomical implants requires a longer skin incision compared to round implants.
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Differences between implants by structure
Smooth breast implants
They are characterised by their softness and pleasant tactile sensation. They move freely within the pocket, allowing for more natural breast movement during activity. However, they have a higher risk of displacement than textured ones.
Advantages:
Softest to the touch.
More natural breast movement during physical activity.
Disadvantages:
Higher risk of displacement.
Textured breast implants
Due to their special texture, these implants are firmly anchored in the breast tissue, which reduces the risk of displacement and capsule formation. The breasts feel denser than with smooth implants.
Some studies have found an association between textured implants and the development of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). However, the risk of developing this complication is extremely low. Therefore, given the numerous benefits, many surgeons recommend this method of breast augmentation.
Advantages:
Secure fixation and less risk of displacement.
Less risk of a dense capsule forming around the implant.
Disadvantages:
May be stiffer to the touch.
Smaller risk of complications.
Which breast implant size should I choose?
Selecting the size of your future breast is an individualised process that takes many factors into account. Typically, breast implants range from 125cc to 700cc, but if necessary, an implant with individual parameters can be made. The new breast must harmonise with the body, so not only the patient’s wishes are taken into account, but also the features of their physique, weight, height, etc. To choose the optimal size and visibility, the surgeon may suggest trying on a special bra with different shapes and cup sizes or 3D modelling on a computer, which will help visualise the future result.
What are the risks of breast augmentation with implants?
Breast augmentation with implants is a surgical procedure, so there is a risk of complications. However, the risks are less common and many of them can be easily managed with appropriate therapy. Before deciding on surgery, it is important to discuss all the nuances with your surgeon and weigh the pros and cons carefully. The doctor should talk about the potential risks and complications, as well as methods to prevent and treat them.
Possible complications:
Allergic reaction to anaesthesia;
haemorrhage;
infections;
changes in nipple or breast sensitivity;
lactation problems;
seroma formation (fluid accumulation);
problems with implant positioning;
perforation or rupture of the implant;
pain;
scarring.
Capsular contracture
Capsular contracture is a hardening of the scar tissue that forms around the implant. It is a natural process whereby the body creates a protective ‘capsule’ around the foreign body. However, if this capsule becomes too dense, pain and breast deformity can occur. Contracture can develop at any time after surgery, most commonly within the first year, but sometimes the process takes years. To reduce the risk of contracture, implants placed under the muscle and regular check-ups with your surgeon are recommended.
Anaplastic large cell lymphoma
The risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is present with textured implants. The disease is not breast cancer, but a rare type of immune system cancer that can develop in the fluid and scar tissue around the implant. Although the risk of developing the disease is extremely low, it is important to be aware of its existence. According to the meta-analysis, which included data from 17 studies and 525,475 patients, anaplastic large-cell lymphoma associated with breast implants was diagnosed in 254 people. The median time to disease development was 13 years. The risk of disease ranged from 0 to 1 case per 1,000 implant patients (0,048%), with a significantly higher risk in textured implant wearers than in smooth implant wearers.
The FDA strongly recommends regular breast implant examinations after implant placement. MRI or ultrasound examinations to monitor the status of silicone implants should preferably be performed 5-6 years after surgery and every 2-3 years thereafter. These routine examinations are necessary to check the integrity of the implants and to detect possible complications. Even if there are no symptoms, it is important to follow the examination schedule, as some women may not feel any signs of implant rupture.
Are there breast implants for men?
Breast augmentation with breast implants for men is used to add muscularity to the chest or in transgender transition to create a more feminine figure.
Specialised pectoralis muscle implants are used to create a muscular chest contour in men. They have a different shape and dense texture and are placed under the pectoral muscle. Male pectoralis muscle implants are more durable because they are designed to withstand increased physical stress.
In the case of transgender patients, the breast augmentation procedure allows for a more rounded shape to achieve a harmonious silhouette and make the appearance more in line with the desired gender. Soft silicone implants similar to traditional implants are more commonly used here.
Do I have to remove an implant with a damaged shell?
The mandatory removal of a ruptured silicone implant depends on whether the contents have leaked out of the shell and capsule. Implant ruptures are divided into two types: intracapsular and extracapsular. Intracapsular ruptures usually do not cause noticeable symptoms and can only be detected by ultrasound or MRI. They are often left alone because the silicone stays inside the capsule formed by the body around the implant.
While it is theoretically possible to leave intracapsular ruptured implants alone, it is still recommended that they be removed to prevent potential complications and improve the accuracy of follow-up examinations. In any case, it is important to discuss all the nuances with your surgeon and make a decision based on their professional advice.
However, over time, such a rupture may progress to an extracapsular rupture, where the silicone extends beyond the capsule and penetrates the surrounding tissues. This can lead to the formation of painful seals, scar tissue, or even open sores. Silicone leakage can also affect the accuracy of mammography, which can make it difficult to detect breast cancer in a timely manner.
How long do implants last and when should they be replaced?
The approximate lifespan of implants is approximately 10-15 years. However, today modern manufacturers produce breast implants with a lifetime guarantee. Many plastic surgeons recommend not to change the implant if it does not bring discomfort, does not cause complications and satisfies the woman.
The main reason for replacement is changes in the size or shape of the breast caused by weight fluctuations, pregnancy or age-related changes. Surgery is also required if capsular contracture develops or if the shell ruptures and the silicone filler leaks out.
Modern implants made with cohesive silicone have a low probability of rupture. According to international studies, third-generation implants retain 98% integrity after 5 years of use and 83-85% integrity after 10 years, with the risk of rupture increasing after 6-8 years of use. Regular check-ups will help to identify possible problems with the implants, which will also help to determine the need for replacement.
Which surgical method of implantation should I choose?
The method of implantation is chosen depending on the anatomical features and the desired result of the patient.
Implants are placed under the muscle or the gland.
The method of positioning breast implants under the muscle is called submuscular placement. This method is used in about 75% of cases because it reduces the risk of capsular contracture and facilitates mammography. Submuscular placement is more often recommended for thin women or those who want a significant increase in breast volume. However, this method has a disadvantage – the recovery process can be more painful and longer.
An alternative method is to place the implant behind the breast tissue, or sub-glandular placement. This option is better suited for women with naturally drooping breasts. Recovery after implantation is less painful and faster. However, this method has disadvantages – the risk of capsular contracture is higher, and in women with thin skin, the implant may be more visible.
As for access options for implant insertion, one of the most popular is an incision in the crease under the breast. This allows the surgeon to place the implant as accurately as possible, and in most cases, the scar remains hidden beneath the natural curve. This access has minimal impact on the mammary glands, which reduces the risk of lactation problems.
An axillary incision is also possible, in which the implant is inserted through the armpit using an endoscope. The advantage of this method is that there is no scarring of the breast itself. At the same time, symmetrical placement of the implants with this approach can be more difficult, and an additional incision on the breast will be required if adjustments need to be made. In addition, a scar in the axillary area may be visible when the arms are raised.
Another option is periareolar access, where the incision is made along the edge of the areola. This allows the scar to blend in with the natural pigment of the skin. However, this method can increase the risk of decreased nipple sensitivity and make breastfeeding more difficult because the incision is made close to the mammary glands.
The TUBA method involves inserting the implant through the navel. It is less common and is only used to place saline implants under the breast tissue. In this case, an incision is made in the navel area and the implant is transported to the breast with the help of an endoscope.
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Best breast implants from global manufacturers
In 2024, several well-known brands stand out in the breast implant market, which have gained the trust of patients and surgeons due to the quality of their products and a high degree of safety.
Allergan (Natrelle series)
Allergan is one of the market leaders in breast implants. The most popular is the Natrelle range with a wide variety of shapes and textures. Allergan breast implants with TrueTexture technology make the breasts as natural to the touch as possible after augmentation.
Motiva (Ergonomix series)
Motiva attracts the attention of patients and surgeons with innovative solutions in the field of mammoplasty. The Ergonomix implants adapt to body movements, which gives the breasts a more natural appearance and increases patient comfort. Motiva uses SilkSurface technology, which minimises the risk of inflammation and other adverse reactions. These implants are highly durable, and reliable and come in many variations of shapes and textures.
Mentor (MemoryGel and MemoryShape series)
American breast implants from Mentor are characterised by their natural shapes. The company produces both silicone and saline implants. The products are actively used for aesthetic mammoplasty, as well as reconstructive surgeries. The brand’s technologies include MemoryGel and MemoryShape, which provide a natural feel and ideal breast contours. Mentor MemoryGel breast implants are soft and pleasant to the touch, mimicking natural breast tissue as closely as possible, while MemoryShape with its drop-shaped shape gives a more natural contour.
Polytech (Microthane Series)
Polytech is a company from Germany. They manufacture implants with a Microthane coating. This coating reduces the risk of capsular contracture, making these implants one of the safest and most stable. The company’s range includes several shapes and sizes.
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Summary
Saline implants are filled with a sterile solution that is safe for the body, but they can provide a less natural feel. Silicone implants, on the other hand, provide a more natural look and feel, although they cost more and require regular integrity monitoring.
For breast augmentation, the FDA recommends silicone and saline breast implants. Which ones are best to choose depends on the patient’s goals, the characteristics of their body, and the surgeon’s recommendations.
Round-shaped implants create a more lush and voluminous look but may look less natural, while drop-shaped breast implants give a more natural look.
Smooth implants provide softness and natural breast movement but have a higher risk of displacement. In contrast, textured implants are firmly anchored in the tissue, reducing the chance of displacement and capsule formation, but may feel more rigid.
Breast augmentation using implants has certain risks because it is a surgical procedure. Possible complications may include infections, bleeding, changes in breast sensitivity, risk of implant rupture, capsular contracture, etc. breast sensitivity, risk of implant rupture, capsular contracture, etc.
The average lifespan of breast implants is around 10-15 years, however, modern manufacturers are making implants that can last significantly longer.
Breast implants need to be replaced if they rupture or shift; or if the shape or size of the breast changes due to age or pregnancy. In addition, as the implants age, there may be a risk of capsular contracture, which will also require replacement.
Today, the market offers different types of breast implants. The companies are Allergan, Motiva, Mentor and Polytech. They offer a wide range of shapes and textures and guarantee natural-looking and long-lasting results.
If you are planning a mammoplasty abroad and want to choose a trusted clinic, contact MediGlobus. Experienced specialists will help you choose the best medical centre, arrange consultations and support you at every stage of your transformation.
Sources:
- 1. American Society of Plastic Surgeons: What types of breast implants are available?
- 2. American Society of Plastic Surgeons: What are the steps of a breast augmentation procedure?
- 3. U.S. Food and Drug Administration: Types of Breast Implants
- 4. U.S. Food and Drug Administration: Breast Implants
- 5. NHS: Breast enlargement (implants)
- 6. MedlinePlus: Breast augmentation surgery
- 7. Hillard C, Fowler JD, Barta R, Cunningham B. Silicone breast implant rupture: a review. Gland Surg. 2017 Apr;6(2):163-168. doi: 10.21037/gs.2016.09.12. PMID: 28497020; PMCID: PMC5409893.
- 8. Elameen AM, AlMarakby MA, Atta TI, Dahy AA. The Risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma; A Systematic Review and Meta-Analysis. Aesthetic Plast Surg. 2024 May 9. doi: 10.1007/s00266-024-03956-9. Epub ahead of print. PMID: 38724638.
