Breast Implant Options

Choosing the right implant is a personal choice. At your breast surgery consultation, we will have a variety of implants for you to feel and ask questions about so you can make an informed choice. The most popular companies that make implants include Allergan, Mentor, Sientra, and Ideal Implant. All conventional breast implants have a medical-grade silicone shell, with two types of filling to choose from: saline or silicone gel. Whether you choose saline or silicone implants, it is important for you to self-monitor your breasts and implants and to follow-up with your plastic surgeon for appropriate checkups.

Below is a general overview of the types of implants we provide. Implant manufacturers occasionally introduce new styles and types of breast implants that may slightly change the shape and feel. We are all about adopting new technologies to make your outcomes better and safer. To get up to date on the latest options for your breast surgery, schedule a consultation with us at Bay Area Esthetics Plastic Surgery.

Silicone gel filled implants have been used since the 1960s, but are far safer now than they were in the past. They are popular because they can provide a feel that is more natural than traditional saline-filled implants. They come in a range of gels from slightly cohesive silicone gel (softer) all the way up to form-stable silicone (firm, “gummy bear” implants).

If the implant ruptures or leaks, the silicone remains within the implant shell or just outside within the breast implant pocket and is not absorbed by the body. Therefore, the breast does not collapse like a ruptured saline-filled implant. This “silent rupture” associated with silicone breast implants can be found on magnetic resonance imaging (MRI) or ultrasound. If you choose silicone-filled implants, the FDA recommends surveillance MRIs 3 years after placement and every 2 years thereafter. Silicone-filled implants are FDA-approved for breast augmentation in patients 22 years or older.

Saline breast implants still have a silicone shell but are filled with sterile saline instead of a silicone gel. Traditional saline-filled implants have a uniform firmness that can feel less natural to some women. They are filled with saline during surgery, so they can be rolled up and placed through smaller incisions than silicone gel filled implants. They are also preferred by patients who do not want to worry about monitoring their implants with imaging down the road. That is because if the saline leaks, it is naturally absorbed by the body and the shell will collapse. You will notice your breast flatten when the implant ruptures (no silent rupture), and replacing a ruptured saline implant can be easier to manage than a ruptured silicone-implant. Saline breast implants are FDA-approved for augmentation in patients 18 years or older.

Structured saline implants have a structured silicone shell to make the implant feel more natural when it is filled with sterile saline. Bay Area Esthetics Plastic Surgery is proud to offer the IDEAL IMPLANT® Structured Breast Implant in our offices in San Francisco and Sonoma County, California. This implant uses new technology to combine the best features of saline and silicone implants.

As a structured implant it provides a feel that is natural and similar to silicone-filled implants while also providing a higher rupture strength than silicone filled implants (less chance of rupture). There is also no silent rupture or silicone gel leak. The implant can also be rolled and inserted through smaller incisions than silicone filled implants. Because of its design, this implant can provide a youthful shape and natural feel, combined with the safety of saline. The IDEAL IMPLANT® has been tested and used clinically since 2009 and studies have shown good outcomes with low rates of capsular contracture.

Summary of benefits of the Ideal Implant®:

• Smaller incision needed than silicone gel implants
• Higher rupture strength (lower rupture rate) than silicone gel implants
• No “silent” ruptures / no MRI scans needed to detect ruptures
• Filled with saline that is harmlessly absorbed by the body
• Curved design for less rippling than traditional saline-filled implants
• Low capsular contracture rate

IDEAL IMPLANT® Design

The Ideal Implant has an internal supporting structure that controls the movement of saline through the implant for a more natural look and feel. It was also designed to lay on a curved chest surface, so there can be less rippling than a traditional saline implant. Download the IDEAL IMPLANT® manufacturer brochure. If you are interested in this implant for your breast surgery, it is important to seek plastic surgeons who are experienced using them. Please contact us online at Bay Area Esthetics Plastic Surgery or call 415-523-5235 to discuss having your breast surgery with the Ideal Implant.

Form-stable implants are often referred to as “gummy bear” breast implants because the consistency of the silicone gel inside the implant is more cohesive than traditional silicone gel implants. This allows the gel to be thicker and maintain its shape even if the implant shell is broken. There is also a lower rate of silicone leak from these implants for the same reason.

These implants are desirable for women who want added breast fullness and projection with a feel closely matching a young woman’s breast tissue. There can be a risk of gel-fracture in these types of implants, when the filling material is forcibly separated from itself, which can permanently deform the implant. The incisions for this implant type may also need to be slightly longer.

It is important if choosing gummy bear implants to seek a plastic surgeon who knows how to place this type of implant properly and can minimize the visibility of your scars. We are happy to discuss ways we can optimize your breast outcomes with gummy bear implants. Please contact us online at Bay Area Esthetics Plastic Surgery or call 415-523-5235 to schedule a consultation.

Shaped form-stable implants have more projection at the bottom and are tapered towards the top, similar to the shape of a natural breast. Shaped implants are mostly used in patients undergoing breast reconstruction to maintain a natural teardrop shape in the absence of native breast tissue. Placing shaped implants requires careful planning and technique to prevent them from shifting. If a shaped implant rotates, it will fill / shape the breast differently and may require additional surgery to correct it.

Round breast implants on the other hand, have a tendency to make breasts appear fuller than shaped implants and are more sought after for breast augmentation. Higher profile options are available to achieve even more projection if that is your goal. Unlike shaped implants, round implants are the same shape if they spin, so there is less concern they may rotate out of place. At Bay Area Esthetics Plastic Surgery we are happy to go over these options with you.

Smooth breast implants tend to feel softer because they can move within the breast implant pocket. This allows them to naturally move with your breasts. Textured breast implants develop more randomly oriented scar tissue around them that sticks to the surface of the implant, similar to Velcro. This makes them less likely to move around inside of the breast pocket. A textured surface can be beneficial in shaped implant styles to help prevent the implant from spinning. Texturing can also reduce the risk of forming a tight scar capsule (capsule contracture).

If considering textured breast implants, it is important to know that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been associated with textured implants. For additional information on BIA-ALCL, feel free to visit the official American Society of Plastic Surgeons BIA-ALCL Summary page. Understanding all the potential risk factors with a procedure helps you make the best decision for you and your health.

Rippling, capsule contracture, and implant malposition are some of the top complaints in patients with breast implants. These problems can develop over time and may exist to varying degrees. Minor deformities are easy to fix while more severe cases may require a breast revision procedure to correct.

Rippling only occurs when implants are used, it does not occur with our natural breast augmentation involving your own tissues. Rippling may develop in just the outer portion of the breast, or across the entire breast surface overlying the implant. This type of folding can be when you’re standing still, or made worse with certain postures. It happens when the implant’s shell and filling material are compressed in a way that causes the surface to ripple. Rippling tends to be more noticeable in thinner patients with less breast tissue.

If you lose a significant amount of weight after surgery you may notice rippling. Gaining weight is a way to help reverse that. Patients who opt to not have the implant placed beneath the pectoralis muscle may experience more noticeable rippling. All breast implant styles have the potential to develop some rippling, however saline-filled implants and under-filled implants can be associated with more rippling. There are certain implant designs that can minimize the chance of rippling in both saline and silicone varieties. There are also adjunctive procedures like placing acellular dermal matrix or fat grafting that we can perform to reduce the chance of seeing any rippling. At B.A.E., we are happy to explain all the ways we can minimize rippling for your breast surgery.

Capsular contracture occurs when a tightened scar forms around an implant. This can lead to a deformity that you can feel and see, and may even cause pain. A capsule forms around any implant placed in the body. This capsule is normally very thin and difficult to feel or see from the outside. The thickness and characteristics of the surrounding capsule can change over time depending on the material and surface of the implant used, as well as the type of tissue the implant was placed inside. Using textured breast implants may reduce the chance of capsular contracture. There are also a variety of techniques we can perform during surgery and medications that we can provide to minimize the risk of capsular contracture for you.

Implant malposition is due to the implant or breast tissue changing their relative position over time. Examples include an implant “bottoming out” or sliding beneath the inframammary fold and creating a “double-bubble” deformity. Another example includes a shaped implant rotating within the pocket deforming the breast shape. Another example is from the implant causing the breast to stretch along with the implant, beneath the inframammary fold. Finally, there is breast ptosis, or sagging of the breast, which can develop as the breast naturally ages and hangs beneath the implant while the implant stays in relatively the same place against the chest wall. The first two problems are best avoided with careful planning and can be corrected with a breast revision procedure. The latter tend to occur more slowly over time due to natural causes and can be corrected with a breast lift. In many cases we may be able to save and reuse your existing implants while in some cases it may be advisable or unavoidable to replace them with new ones.

At Bay Area Esthetics Plastic Surgery we are happy to walk you through all the options for your breast surgery and discuss ways that we can keep you happy with the appearance of your breasts for a very long time. If you currently have breast implants and are bothered by rippling, capsule contracture, or malposition or just want your implants taken out, feel free to ask us about a breast revision procedure.

It’s time to take the next step and see the difference breast enhancement by Bay Area Esthetics Plastic Surgery can make for you. Please contact us online or call 415-523-5235 to schedule a consultation.