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Breast Augmentation: the Implant Matters

Breast Augmentation: the Implant Matters

Choosing the right implants when considering breast augmentation is a truly personal decision. Whatever your reason for starting this journey, be it something you’ve always wanted or to go back to a pre-pregnancy body, we strongly encourage you to choose the right implant for you with a qualified plastic surgeon. 

There are a variety of breast implants that can work for you. There aren’t any implants that are “better” than others nor is the breast implant a friend might have had that is necessarily the type that will be the best for you. When considering these decisions, it is important that you communicate closely with your plastic surgeon so they are able to guide you through the different benefits of each implant.

Cohesive Gel Silicone Breast Implants

Breast implants have come a long way since we first heard of them. Breast implants now look a lot more natural and come in a variety of shapes and volumes that can cater to your needs in even more detail.

Something that we at Allure Plastic Surgery routinely use is Mentor Memory Gel Xtra. This breast implant is a silicone implant that has a variety of sizes and profiles so as to better fit the different types of bodies. These implants are filled with a cohesive gel that holds together well but is still able to retain a natural feel.

The shell of the Mentor Memory Gel Xtra implant has been designed to minimise silicone gel bleed. Because of the cohesive gel inside the implant, it is rather more like a solid than a liquid, although it has characteristics similar to a fluid. This also means that in the event of a crack in the shell of the implant, the contents will not leak out due to this cohesive nature, but rather remain within the shell. Hence, there is actually a lifetime warranty provided by the implant company with regards to shell breakage or leakage. While the rate of rupture is at about 24.2%, studies have shown that they are safe and effective to be used. [1]

Also, because of the varied range of volumes in shapes and projection of the implants, these allow for a better catering to your ideal reaching as close to your desired outcome as possible. 

They are also more of a hybrid implant, rather than the tear-drop or anatomical silicone implants. They will adopt a more tear-drop shape when standing or seated upright, but flow out when lying down. This is due to the more fluid nature of the cohesive gel and the more flexible shell. This results in an augmented breast that is softer and that behaves more like a natural breast would.

Other Breast Implants that You Might Have Heard of

After seeing what we use at Allure, let’s take a look at what are some other types of breast implants available and how these more traditional implants compare with what we can offer you.

Before we dive in, we will say that these things should not be seen as “good” or “bad” but what works best for you instead. Through honest consultations with your plastic surgeon, choosing the implant for you becomes an easy, effortless process. Some things to consider when deciding on an implant are body type, physical assessment and of course, your desired outcome.

Breast implants are made of a silicone outer shell and then filled internally. Implant fills include regular silicone gel, highly cohesive silicone gels and saline implants. These different types of implants work well but they also have their own differences in appearance, feel and performance so let’s dive into them.

Saline vs Silicone

Saline Breast Implants

Saline breast implants are implants that are filled with sterile saltwater. Don’t let this description fool you into thinking that it’s unhygienic. On the contrary, as it is filled with sterile saltwater, it allows for the body to absorb the liquid should the implant shell leak and naturally expel the fluid out of the body. Leaked saline poses no health risks. [2] This type of implant is for you if you are looking for alternatives to silicone implants.

Saline breast implants in particular allow for the breast to have a full upper pole projection and if the desired look for the breast is to achieve somewhat of a “Baywatch” look, this is the implant you’re most likely looking for although this implant can also look natural.

Regular Silicone Gel Breast Implants

Regular silicone gel implants are the implants you would probably first encounter before a formal consultation with your plastic surgeon for breast augmentation. They may come in an anatomical, tear-drop shape or even in a round shape. Also, they may be smooth or textured, although tear-drop shaped implants are always textured. These implants retain shape better and thus do a very good job of shaping the breast, as the shell is stiffer. Hence, these implants are still very useful in a select group of patients in Allure Plastic Surgery, such as those with certain chest anatomy that require the use of tear-drop textured implants.

When the shell of a silicone gel implant breaks, the gel may remain within the implant shell or may flow into the breast pocket of your body. If a silicone gel implant is the right implant for your body and what you’re looking to achieve, you may need to visit your plastic surgeon regularly for an ultrasound or MRI screening to make sure the walls of your implants are still functioning properly and that nothing has leaked into your body tissues.

Something to note as well for these implants is that it is recommended for those aged 22 years old and older.

We have barely scratched the surface of the types of breast implants here and we highly recommend consulting a plastic surgeon before making your decision. With the many factors that need considering, it is unwise to choose an implant before professional consultation – as good as one implant sounds, it might not be the best implant for you.

With breast augmentation, it is not just the type of breast implant that we should consider but also the different types of placements best for you.

The Different Types of Breast Implant Placement

There are generally three different types of breast implant placements for breast augmentation and they are: over the pectoralis muscle, under the pectoralis muscle or in a dual plane manner, which is the ideal position for most women but also the most technically difficult to perform.

The pectoralis muscle is a muscle located on our chests and is broken up into the pectoralis major and the pectoralis minor. The pectoralis major is a fan-shaped muscle or large shell. When the implant is placed under the pectoralis muscle, it is placed under the pectoralis major and when the implant is placed over the pectoralis muscle, it is placed over the pectoralis minor.

Placement of Breast Implants

Over the Muscle Breast Implant Placement

Over the muscle breast implant placement also known as a sub-glandular placement, is the easiest method to insert a breast implant, where the implant is placed directly behind the breast itself. It is best suited for those who already have a moderate amount of natural breast tissue – this would typically mean a B cup and larger. 

One of the pros of over the muscle placement for breast augmentation is that it allows for easier recovery compared to under the muscle breast placements. However, this might not be the best placement for you if you are of a smaller frame. Breast implants will be easier to see and there may be ripping in the upper or inner parts of the breast especially if you have tighter skin. In the long term, the chances of complications are far higher, such as capsular contracture (hardening of the breast around the implant), implant sag, migration and rotation. Hence, it is not the preferred choice of implant placement.

Under the Muscle Breast Implant Placement

As covered in the previous type of placement, under the muscle breast implant placement is great for those with thinner frames because it makes the edges less visible and also creates a more natural-looking breast shape. However, because this breast augmentation procedure requires the manipulation and release of the pectoral major muscle to be placed over the breast implant, the recovery process post-surgery will take longer. There would considerably be more swelling that will take a longer time to subside as well as being more uncomfortable for up to a week during recovery.

Also, there is a greater amount of muscle pressure on the implant, which is contracted onto by the muscle constantly. Because of this, it might take a few months for you to see the end results that you wanted initially, as well as a higher risk of animation deformity, which is the excessive movement of the implant when contracting the pectoral muscles.

Dual Plane Placement

The implant is placed partially under the pectoral muscle in its top half, whereas the bottom half of the implant is placed onto behind the breast. This means that the pectoral muscle acts like a clamp, to prevent rotation or sagging of the implant with time, and also prevents the edges of the implant from being too palpable. It also reduces the muscle pressure on the implant, thus allowing for quicker recovery and a much more natural shape and appearance as compared to a traditional sub-pectoral muscle placement.

This dual-plane placement is the preferred method of placing breast implants in many top centres worldwide and should be the method of choice for the vast majority of patients.

Surgical Incision Choice

There are 3 typical areas - Incision in the breast fold, incision in the areolar and incision in the armpit. The preferred site is in the fold of the breast. By creating an incision in a fold underneath the breast, this placement allows for better and more direct control of the implant position. Because of this, this placement in particular has minimal effect on the milk-producing areas of the breast. If the implant shell has broken, for example, this incision procedure allows your plastic surgeon to go back to the same incision from before to treat any complications that may arise during the breast augmentation surgery. This placement works for all ages especially mothers and older patients.

  1. Caplin, D. A., Calobrace, M. B., Wixtrom, R. N., Estes, M. M., & Canady, J. W. (2021). MemoryGel Breast Implants: Final Safety and Efficacy Results after 10 Years of Follow-Up. Plastic and reconstructive surgery147(3), 556–566. https://doi.org/10.1097/PRS.0000000000007635
  2. Swanson E. (2020). Prospective Study of Saline versus Silicone Gel Implants for Subpectoral Breast Augmentation. Plastic and reconstructive surgery. Global open8(6), e2882. https://doi.org/10.1097/GOX.0000000000002882