What are the Different Types of Breast Implants?
When it comes to selecting a breast implant, American women have more choices now than ever before. Between the different shapes, materials and profiles of implants, it can sometimes become a little overwhelming in trying to figure out what might work best for your own particular goals.
In this section, we’ll review the options, and their advantages and drawbacks.
1. Traditional silicone gel filled implants
These are a very popular option with our patients. The main reason is the “feel” of the implant – it feels very natural, as silicone gel is a good mimic for the feel of natural breast tissue. It also has the advantage of a low “ripple rate” – when the implant folds can be felt through the skin – so this is an advantage for women who are very slender. Also, there are a wide variety of shapes and sizes available from the FDA approved manufacturers.
Disadvantages: it is a little more expensive compared to a saline implant. It is not adjustable in size, as it is pre-filled at the implant factory. Follow-up imaging, with breast ultrasound or MRI, is needed to periodically check on the status of the implants.
2. “Gummy Bear” silicone implants
This is a new generation of high-tech silicone gel implants that has rapidly been growing in terms of popularity. Although the term “gummy bear” is widely used, the correct name for this implant is a “form-stable cohesive gel implant” or “generation 5 implant”. The gel on the inside is still made of silicone, but it is formulated in a way that it is more thick and semi-solid. (Think of “Jell-O”, rather than honey.) As a result, should the implant develop a tear in the outer shell, the thick gel on the inside does not migrate or spread out, giving the gummy bear implant more of a leak-resistant nature. Ripple rate is also very low. New data suggests that this type of implant may have a reduced rate of capsular contracture.
The cost of the round gummy bear implants from Sientra is about the same as that of traditional round silicone gel implants. The gummy bear implants are slightly firmer in their feel, compared to the traditional silicone implants.
Gummy bear implants are manufactured in both round and teardrop anatomical shapes. The round shape is much more popular with our cosmetic patients, since most patients want a little more fullness in the upper portion of the breast.
The new Inspira Cohesive gel implants from Allergan are now available for the cosmetic patient. They are a more expensive option but may be useful for women with implant-related rippling or thin soft tissue coverage.
3. Saline implants
Saline implants have the advantage of being the least expensive implant, and being adjustable by the surgeon at the time of the procedure, which may be especially helpful for women with major breast asymmetry. They can work very well in women who have good coverage of the implant, with about one inch of tissue thickness over the implant. In women who are slender, however, ripples and wrinkles from the implant can sometimes be seen or felt through the thin tissue. This occurs in about 10% of patients overall, and is most common in saline implants that were placed in the sub-glandular position (“over the muscle”). Sub-pectoral positioning can reduce rippling in the cleavage area, but may not help with ripples in the outer-lower part of the breast.
In the USA, there are three FDA-approved companies that manufacture and sell breast implants: Allergan, Mentor and Sientra.
After years of working with all 3 companies’ implants, we feel that they all are high quality devices. There are subtle differences in the sizes and shapes that each company makes, and subtle differences in the manufacturing methods.
Of note, Sientra only allows Board-Certified Plastic Surgeons, like Dr. Fiala, to use their implants. Each company has their own trade names for their products. Mentor, for example, uses the term “MemoryGel” to refer to the silicone gel in its traditional gel implants. Allergan calls their implants by the “Natrelle” trademark, while their newer implants also get the “Inspira” designation. Don’t get bogged down with these marketing terms.
All three companies have warrantees on the implants against leakage. These programs are very similar between the companies – and we are happy to provide details on this at the time of a consultation.