Procedures

Posts Tagged ‘Breast implants’

Breast Implant Sizes

Breast Implant Specifications, Sizes, & Dimensions

There are many different types of breast implants available in the United States. Only two companies, Mentor Corp. and Allergan, have received FDA approval for their implants.

Implants come in a variety of shapes, sizes, textures. There are silicone, saline, smooth breast implants, textured breast implants, round breast implants, anatomical breast implants. There are various “profiles”, such as moderate profile, high profile, and low profile breast implants (this is how ‘tall’ it would be if you looked at it sitting on a table. You will want to familiarize yourself with the options available so that you can get an idea of what type of implant you want.

Some surgeons have a preference for a certain type of breast implant, such as smooth round breast implants, for example. Other surgeons don’t have a particular preference. You should know the advantages and disadvantages to all of the breast implants currently available and I’ll be glad to talk to you about them during your consultation. This knowledge will allow you to ask more educated questions at your consult, as well as help you to decide which particular breast implant is right for you.

Tags: Breast augmentation, breast augmentation plastic surgeon, Breast implants
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Saline or Silicone Breast Implants

Saline vs. Silicone –

Here’s some information that I’ve put together for my patients considering a breast implant type. It’s very updated and I’ve added a little background information to be as thorough as possible. Nowadays, the amount of information on the internet can be overwhelming so I’m providing you with a summarized, unbiased view that I’ve put together of the facts.

The truth is that silicone feels more natural than saline, nobody questions that. You’ll hear people say they chose silicone over saline for this reason, but you need to know that there are many other factors to consider in addition to this one. That’s just one reason to do silicone and in all fairness you need to know that there are other considerations.

While you’re reading this, remember that both options (silicone and saline) are excellent. THERE IS NO RIGHT OR WRONG ANSWER. They each have pros and cons so NOBODY can tell you that one is better than another. All they can tell you is their opinion which you may or may not select.

This way you can decide which is best for your lifestyle and which is most compatible with what you would want for the long term. Remember that I could pick it for you, but since you’re going to live with it I think it’s only fair for you to know the facts and choose what best fits what you want. Then we can talk about which you chose and why.

After years of waiting, silicone implants are finally back. Since 1992 there has been a ban imposed by the FDA on the sale of silicone gel implants. Women wanting silicone implants, since then, have had to “qualify” for the implants by meeting specific criteria to be included in a study. The ban was imposed due to claims of a connection between silicone gel breast implants and autoimmune diseases, connective tissue diseases and even cancer.

Scientific evidence since that time conducted by the Institute of Medicine and experts from all over the world has shown no such connection to exist. In July of 05’ a letter was sent by the FDA to a silicone implant manufacturer stating that silicone implants could be used if certain criteria were met. And as of November 2006, silicone implants are available to all breast reconstruction and revision patients, as well as women 22 years of age and older seeking cosmetic breast enhancement. A number of conditions came attached to the approval, including studies and follow-up.   So what’s different about these implants? In the 70’s and 80’s silicone implants were made of a more liquid consistency. Since the early 90’s implants are made of what is called a cohesive gel. That is the silicone in these implants is more cohesive or stable in form. If one of these implants is cut the implant for the most part will maintain it’s shape and not leak out. The shells of the implants in the 70 and 80’s were thinner and more likely to leak. It’s almost like they would sweat a little.
The implants today have shells that are made of several layers. This makes the implants feel more firm but help cut down on gel bleed. Gel bleed is the term that describes small amounts of the silicone moving through the shell. Although these implants are firmer than the implants of the past they are still softer in feel in comparison to saline. The so called “gummy bear” implants are also a cohesive gel implant. These are even more cohesive than the standard gel implants and therefore maintain their shape more. Due to the added firmness, the incision must be a bit larger and the shape of the implant is an anatomical shape. These implants are currently being used in Europe, and may have more use in reconstructive type cases.   Some think these are too hard. Originally, implants were designed like this but were discontinued because they were thought to be a little too hard. It turns out that they are experimenting with these again.

Saline implants are the salt water filled implants that have been used in place of silicone implants, since the silicone ban. Now in addition to the choices of size, shape, shell type, incision site, location (above or below the muscle), patients will have to choose between silicone and saline implants.  

They both are thought to last the same amount of years and they both have a very very low incidence of rupturing (popping or leaking). So this shouldn’t be a major consideration in determining a difference.

So what are the advantages and disadvantages of silicone implants? The main advantage of the silicone implants is that they have a more natural feel and less visible rippling (wrinkling in the outer shell – you can see this in the office if you grab an implant). All breast implants have transverse creases which form around the edge know as rippling, saline do this more than silicone. Although silicone implants have this also it is far less evident when compared with the saline implants. This will be particularly important for women who have thin skin, perhaps after childbirth and breast feeding, or for women with extremely small breasts. For women with at least a B cup or with thicker firmer breast tissue rippling will most likely not be an issue because it’ll be camouflaged by breast tissue in most areas. However, the silicone implants will have a softer feel.   One of the disadvantages of the silicone implants are that they come pre-filled. This means the incision sites have to be larger and the surgeon won’t be able to adjust the implants at all after inserting them. For example a 450 saline implant might have a fill range between 450- 540 cc’s. This means the implant can be filled anywhere in this range depending on the type of look and size the patient wants and also to gain symmetry between the breasts. With the silicones the next size up after 450 might be a 500 cc implant. So the surgeon will have less flexibility with the silicone implants.
Lastly, a consideration in the scar tissue formation must be mentioned. The silicone implants have always been thought to cause a more intense reaction and more dense scarring. Nowadays corporate implant studies have shown a similar scar reaction between the two options but I think they have a conflict of interest because they profit more from selling a silicone implant. Nothing against the companies, but those are the facts.
I still believe that the scar reaction is thicker around a silicone implant and many plastic surgeons around the world do as well. This can mean two things. Additional scar could make the exchange sometime down the line (15years?) a little more difficult but that’s not really a big deal – it just means that surgery might last another hour or so and drains could be involved postoperatively. The second thing is that capsular contracture is more likely in silicone implants than in saline. Capsular contracture is a thickening of the natural scar shell around the breast implant and it can be felt to be hard and on rare occasion it can even be symptomatic (painful). The incidence varies greatly according to the studies you read so I won’t even quote any. I think the bottom line comes down to the fact that capsular contracture could happen with both options and it is a bit more likely to happen over the long haul with silicone implants. This being said, the majority of patients don’t develop capsular contracture with either but it’s still a factor to consider. Let’s not focus too much time on something that doesn’t happen the majority of the time.

Statistics can be confusing, so I tried to avoid them. I don’t want it to sound too generic, but I’m trying to keep as truthful as possible by using descriptive terms such as ‘rare’ or ‘usually’ and avoid some of the silly absolutes out there that are inaccurate dogmatic values. With this info, make a list of each and let me know your thoughts, we’ll have a much more fair conversation where you’ve had some time to digest all of these data.

Tags: Breast implants, dallas breast augmentation, gel implants, saline implants, silicone implants
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Ricardo A. Meade, MD · Dallas Board Certified Plastic Surgeon
Dallas Plastic Surgery Institute · 9101 N. Central Expressway · Suite 600 · Dallas, TX 75231 · (214) 823-1691
Legacy Plastic Surgery Institute · 5425 W. Spring Creek Pkwy · Suite 120 · Plano, TX 75024 · (972) 801-2100

Dr. Meade is a Board Certified Plastic Surgeon that specializes in breast augmentation, tummy tuck (abdominoplasty), rhinoplasty (nose surgery), liposuction and facelift. He serves Dallas, Plano, Fort Worth, Tulsa, Houston and San Antonio.