Choosing the Right Implant – Dr. Adrian Smith
No longer is choosing a breast implant a simple matter. Implant options have grown dramatically in the past 9-10 yrs. Now patients have to decide whether they want saline or silicone; textured or smooth; round or anatomical. It is enough to make your head spin! With that in mind, The Face & Body Center staff wants to help you navigate the options.
There are several physical factors that both the patient and physician need to take into consideration when making this choice. The skin and soft tissue around the breast needs to be evaluated for thickness and suppleness. The breast tissue itself is also important. The quantity and quality will help the patient decide which implant is appropriate. Measurements need to be taken of the chest wall and breast diameter. Most ladies have one side of their chest wall that is wider than the other and this will lead to a discrepancy in breast shape.
Next, the patient’s lifestyle and wishes need to be taken into consideration. How much do you like to work out? How much breast projection do you want? How large do you want your breast to be? What type of shape are you looking for?
Saline implants are the simplest to understand. They require the smallest incision to place and give the patient the largest spectrum of sizes. For the most part the implants have a smooth texture and a round shape. Most saline implants have a variable fill volume. A 300cc implant can be filled from 300 to roughly 350cc. The exact volumes are determined by the manufacturers. This makes it a good choice for ladies who have a slight discrepancy in breast volume. Saline implants tend to be the most mobile of implants. They flow in the pocket nicely. Things to consider are that they sometimes “ripple” which means you can feel the implant through the lower pole of the breast. Also, patients who spend a significant amount of time in the gym or who do cross-fit may notice that the implant moves too much. Some ladies find the implants migrate too far inferiorly or laterally.
Silicone implants come in two major categories: round and anatomic. Anatomic implants are tear drop shaped and are often referred to as “gummy bear” implants. They are called “gummy bear” because the silicone is fairly dense and is the consistency of, wait for it………a gummy bear. Round implants have a jelly consistency which gives them their soft supple feel. All silicone implants require a larger incision and cost more than their saline counterparts. They tend to feel a bit natural and are less susceptible to migration or distortion from repeated muscle flexion. A good candidate for a silicone implant would be a very thin patient who works out 5 days a week.
As if things weren’t confusing enough, all round implants, regardless if they are silicone or saline, come in different contours or profiles. An implant’s contour roughly describes the amount of projection. The most common contour used today is probably a moderate contour with the high profile contour following closely behind. Girls with a very narrow chest wall benefit from an implant that has a bit higher profile or contour.
It should be as clear as mud by now! This is a choice that is very difficult to make without the proper guidance and education but is always very rewarding.