Choosing the right breast implants is extremely important as they will affect your appearance in the long term. With a variety of breast implants available that vary in size and shape, it is crucial to understand the basic characteristics of the different implants. This understanding can help you choose the right breast implant for you.
How do different types of breast implants differ?
When it comes to the different types of breast implants, a distinction is made between the shape, size and texture of the implant, i.e. the coating.
What shapes and sizes are available?
When deciding on the right breast implants, you have two shapes to choose from: round and teardrop-shaped. Round implants have a uniform spherical shape and projection on all sides. Teardrop-shaped implants, on the other hand, are gently tapered and have greater projection and fullness on the bottom. As you weigh your options, think about what kind of breast appearance you want. Do you prefer round, shapely breasts with noticeable fullness on the top, similar to a push-up bra? In this case, round implants, such as Motiva® Round may be the better choice. On the other hand, if you prefer breasts that are gently sloped and have more fullness in the lower area, teardrop-shaped implants may be a more suitable option.
Round implants
Round implants, such as the innovative Motiva® Round breast implant, are characterized by a smooth and opaque surface. They are filled with highly cohesive Emunomic™* Breast Tissue Dynamic Gel and offer a wide range of sizes and projections. In my practice, I also offer the MENTOR® MemoryGel® Xtra breast implants, the MENTOR® saline breast implants and the PERLE™ implants from GC Aestethics, which are also round implant types.
Teardrop-shaped implants
Teardrop-shaped implants are often known as "anatomically correct" implants because they tend to mimic the natural anatomy of the breast better than round implants. However, not all round implants automatically look artificial. Under the right conditions and when placed by an experienced surgeon in the right patient, round implants can look natural and blend in with the rest of the body, much like teardrop-shaped implants.
An example of teardrop-shaped implants are the Motiva Ergonomix® implants, which are specially designed to move naturally with your body. Another variant is the Motiva Ergonomix2® implants from the JOY™ range, which offer optimized ergonomics and are even softer than the Ergonomix® implants.
In addition to the Motiva implants, the MENTOR® CPGTM gel-filled breast implants are teardrop-shaped and designed to achieve a natural breast silhouette.
The choice of the right shape depends on several factors. After examining your breasts, I can recommend the right shape for you.
Filling quantities and sizes
Of course, there are also implants with different filling quantities and sizes. Depending on the desired result, body type and positioning, silicone implants from 50 ml to over 1000 ml can be used. This wide range allows both small adjustments to the breast and an increase of one or even two cup sizes per procedure. One cup size corresponds roughly to a silicone implant with a filling quantity of around 150-200 ml. Depending on your breast tissue, implants with a size of around 250-300 ml, sometimes even more, can be used during the operation.
If you want an increase of more than two cup sizes, larger breast implants can be inserted in a separate session. In this case, we recommend the so-called B-Lite® Lightweight breast implants from POLYTECH. Due to their special design, these implants are up to 30% lighter than conventional models, which significantly reduces the strain on the breast tissue and skin.
What texture options are there?
Implants with smooth surface
Implants with a smooth surface, such as the POLYsmoooth™ implants from POLYTECH, usually have a surface structure that is not visible to the naked eye. These implants have been on the market for a long time and are particularly suitable for round implants with a central projection. Their smooth surface minimizes friction with the surrounding tissue, which can lead to reduced tissue irritation. In my practice I also offer the MENTOR® saline breast implants which also have a smooth surface.
Smooth, round-shaped implants are particularly common in the United States and in countries outside Europe that have close ties to the United States. Recently, they have also received increased attention outside the United States. Some argue that smooth implants are less likely to be associated with BI-ALCL (breast implant-associated anaplastic large cell lymphoma) under certain circumstances. The globally accepted ISO classification classifies even seemingly minimally textured products as smooth.
In addition, when choosing an implant, you should consider that smooth implants increase the risk of severe Capsular hardening which usually requires surgery. This risk is much higher than the risk of BI-ALCL.
Implants with fine micro-textured surface
Another option is implants with finely micro-textured or nano-textured surface. These are very suitable for round implants. Well-known implants of this type are the PERLE™ breast implants by GC Aesthetics® and all implants of the company Motiva (round, Egonomix, Ergonomix 2 or JOY). POLYTECH, the manufacturer of all surfaces discussed here, considers implants with fine micro-textured surfaces, such as the MESMO® implants from POLYTECH, as an excellent option for widespread use. They offer excellent conditions for a long-lasting natural and natural-feeling breast. These implants also have an outstanding safety profile, with a very low rate of Capsular fibrosis and no case of BI-ALCL.
The fine micro-textured surface is currently not only used for traditional implants of POLYTECH available, but also for the innovative B-Lite® Lightweight Implants, which are up to 30% lighter than conventional implants. Due to its versatility, the finely micro-textured surface is gaining the trust of more and more patients.
At MENTOR® CPGTM breast implants A SILTEX® micro-textured shell is integrated, which can help reduce the most common complications of primary breast augmentation. The MENTOR® MemoryGel® breast implants, on the other hand, have the option of choosing between a smooth and a rough surface.
How does body type influence the choice of breast implants?
In order to preserve the harmony of the body, it is important to take into account the patient's existing proportions.
How does breast size affect implant selection?
The width of the chest and body symmetry play a decisive role in determining the implant size. At the same time, the skin around the breast must also be taken into account: if the breast implants are too large, unsightly stretch marks can appear, similar to those that occur during pregnancy. In addition, the implant could be visible from the outside if it puts too much strain on the skin. To achieve the most aesthetic result, the breast implant should be approximately one centimeter smaller than the natural breast circumference. This way, the implant is surrounded by sufficient soft tissue of the breast after the operation and is no longer visible.
What impact does the natural breast shape have on the choice of implants?
When deciding on the right implant size, not only the patient's personal wishes play a role, but also the existing breast size. It is important to me to take both your individual preferences and the natural conditions into account in order to achieve an aesthetic and balanced result. By taking the natural breast shape into account, we can select and adjust the implants accordingly to achieve a harmonious appearance.
What aspects are important when deciding on an implant filling?
When it comes to implant filling, you can choose between silicone gel and saline solution implants.
What are the differences between silicone gel and saline implants?
The most commonly used breast implants consist of approximately 90% made of silicone gel and offer a wide range of options for individual adjustment. They are available in different sizes, shapes, heights, widths and projections, both round and teardrop-shaped (anatomical). The silicone gel inside is dimensionally stable, which means that it retains its shape and does not shift. Even if the implant shell is damaged, the implant only empties minimally, as it is a so-called cohesive silicone gel that remains dimensionally stable even if the shell is torn. As a rule, breast implants with a micro- or nano-textured surface are the most commonly used today.
In contrast, saline-filled implants are essentially silicone shells filled with sterile water. These implants are first inserted into the body empty and then filled with saline in the prepared implant pocket. Since the saline offers less resistance to the surrounding tissue, it is important that the implant pocket is kept as large as possible after breast augmentation. Regular implant massage can help with this. In most cases, these implants have a smooth surface.
What are the advantages and disadvantages of the different filling materials?
The advantages of silicone implants are the large selection of shapes and sizes, which allow for individual adjustment and lead to an aesthetically pleasing breast shape. Silicone implants can be easily adapted to the anatomical conditions and provide a natural result even in slim patients.
However, there are also disadvantages and risks of silicone implants. Over time, silicone gel can diffuse through the implant shell and deposit in the body, especially around the breast implant, on the side of the chest wall or in the nearest lymph nodes. The organism cannot break down silicone on its own. In addition, since the beginning of 2018, a link has been established between breast implants and a very rare form of cancer, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare form of non-Hodgkin lymphoma. Although around 1,000 cases have been documented worldwide in around 35 million implanted people, the study situation is still limited due to the small number of cases. It is suspected that there is a connection with the coarse texturing of the implant surface. Therefore, medium and fine texturing as well as smooth implants are used and patients are fully informed about these risks.
Saline-filled implants also have their advantages. If the implant shell is damaged, the implant empties immediately and the leakage of saline is visible. There is no risk of the saline leaking out of the damaged implant shell unnoticed and depositing in the body. The saline is completely broken down by the body and is not stored in the surrounding tissue. When using smooth implant shells, the risks of developing BIA-ALCL are, according to current knowledge, much lower than with rough implant shells. With sufficient tissue coverage, saline-filled implants move very naturally and breast surgery can be performed through small skin incisions. They are well suited for axillary or perimamillary augmentation.
However, there are also disadvantages and risks of saline-filled implants. Since saline is not dimensionally stable, only round implants can be used. When using smooth implant shells, it is recommended to perform regular implant massages throughout life to keep the implant cavity large and supple and to avoid deforming the implant. Over time, the implant may become smaller due to the slight loss of material.
How does implant filling affect the appearance and feel of the breast?
The choice of implant filling influences both the appearance and the feel of the breast. With silicone implants, there is a breast augmentation a wide range of shapes and sizes that allow the breast to be customized. This allows an aesthetically pleasing breast shape to be achieved that adapts well to the natural features. The dimensionally stable silicone gel inside the implants has a stable volume and prevents the filling material from moving back and forth.
However, due to the properties of saline, only round implants can be used. However, with sufficient tissue coverage, these implants will move and feel naturally.
How is the projection of breast implants determined?
In addition to the width and height of the implant, projection also plays a crucial role. Projection defines the distance between the highest point of the implant and the base (back) and influences the breast contour, i.e. how far the breast protrudes from the chest. A low projection profile ensures that the breast protrudes less from the chest wall, while an implant with a high profile makes the breast more prominent. The optimal projection for you should be decided together with your doctor.
The projection of breast implants, i.e. how much they make the breast protrude, is crucial for the appearance. A low profile means less protrusion, a high profile leads to more emphasis. This is achieved with the help of 3D technology such as VECTRA XT and Crisalix visualized to find the best option. VECTRA XT enables detailed 3D images to be created that show volume differences and possible results before the procedure. Crisalix offers online simulations to view changes in advance and discuss them during the consultation. The choice of implant (i.e. whether round or teardrop-shaped) can also be visualized.
What projection options are available?
Four variations are offered:
- extra high
- high
- moderate
- low
How does projection affect the appearance of the breast?
The projection of a breast implant affects how much the breast protrudes. A higher profile results in more volume and emphasis, while a lower profile results in a more subtle appearance. Modern 3D technologies such as Canfield's VECTRA XT and Crisalix offer the possibility of digitally simulating the results of a planned breast augmentation. This innovative approach makes it possible to choose together the optimal implant shape and size for you that best suits your ideas and the desired appearance.
What placement options are there for breast implants?
There are various surgical methods available to insert a breast implant. The method chosen depends on the shape and size of the breast implant and your physical condition.
What is the difference between subglandular and submuscular placement?
There are two different placement methods for breast implants: the subglandular and the submuscular Placement.
With the subglandular method, I place the implant on the pectoral muscle, provided there is enough of the patient's own breast tissue and the implant is not too heavy. The patient's own tissue can cover the implant well above the muscle and hold it securely, resulting in an even breast shape.
With the submuscular method, however, I place the breast implants under the pectoral muscle when there is little breast tissue. If the implant were placed on the pectoral muscle, it would be visible to the naked eye and could be felt. By placing it under the muscle, the implant is sufficiently covered and held in the right place by the pectoral muscle.
A combination of both variants is the so-called Dual-Plane Method in which a level under the mammary gland as well as under the pectoral muscle is prepared.
The choice of placement method depends on various factors, such as the amount of breast tissue present and your individual needs. Together we will discuss the appropriate method and make the best possible decision for your specific result.
What are the advantages and disadvantages of the different placement options?
Subglandular placement offers the advantage of reduced surgery and recovery time. However, the edges of the implant may be more visible under the skin, which can be considered a potential disadvantage. In addition, imaging during a mammogram may be more difficult because the implants are placed subglandularly.
Submuscular placement, on the other hand, can help reduce the risk of the implants being felt through the skin and reduce the occurrence of tissue hardening around the implants. In addition, this placement makes it easier to image the breast during a mammogram. However, it should be noted that potential disadvantages of this placement option can include a longer surgery and recovery time.
What factors should be considered when deciding on a placement?
Your individual body profile and existing breast tissue are taken into account when deciding on the appropriate placement method. In addition, the size and shape of the implants chosen as well as your personal goals and preferences for the result play a role.
What other considerations are important when choosing breast implants?
How long do breast implants last?
There is a common misconception that breast implants need to be replaced every ten years. However, this assumption is not true, at least not for modern implants. As long as you do not have any problems with your breast implants and your regular check-ups do not reveal any complications, replacing the implants is not necessary.
What type of scars result from breast augmentation?
The surgical access routes for a breast augmentation or breast lift for the insertion of breast implants include the armpit area, the inframammary fold or the edge of the areola. Each of these approaches usually results in a fine scar. The best way to hide the scar is to place it in a natural fold, such as the inframammary fold or armpit fold. The approach at the edge of the areola is more likely to be chosen when correction of the nipple height or an additional tightening effect is desired.
What are the risks and complications associated with breast implants?
Breast augmentation is generally considered a lower-risk procedure, but there is always a certain residual risk.
Various complications can occur during the healing process, such as local bleeding, bruising, sensitive skin, mild to moderate pain and wound infections. Swelling, slight bleeding and pain in the operated area often occur after the procedure. These symptoms should usually resolve on their own within a few days. Only the pain can last a little longer.
Over time, other complications can also arise after breast augmentation with silicone implants. A common complication is capsular fibrosis, where a protective covering or "capsule" forms around the implant. In the first two stages, this capsule is soft and thin, similar to the surface of a balloon. From the third stage onwards, it thickens, becomes less mobile and the surrounding tissue hardens. This can lead to pain, tightness and deformation, which is why changing the implants is recommended at this stage.
A weakness in the implant material can occur in rare cases. However, the risk is low when using high-quality implants. If a defective implant is discovered, it should be replaced immediately.
The development of unsightly scars after surgery is also possible and depends partly on the individual's genetic predisposition. In such cases, scar correction can help.
In addition, natural breast tissue can change over time, for example due to childbirth, the natural aging process of skin and connective tissue, weight loss or hormonal factors. These changes can affect the result of breast augmentation.
Although extremely rare, in extreme cases an allergic reaction to breast implants can occur. This mainly occurs with low-quality implants made of cheap material. With high-quality brand-name implants, this risk is extremely low. The resulting condition is called breast implant illness. In such very rare cases, the implant should be removed in one piece along with the surrounding capsule (en bloc explantation).
Finally, there is a rare risk that the breast implants may slip or twist after surgery. This can cause visible deformation of the breast and require corrective surgery. The use of textured implants can reduce this risk.
What costs are associated with choosing an implant?
Prices for breast implants can vary depending on the manufacturer, with the cost of a single implant typically ranging between 500€ and 1000€ The total cost of breast augmentation, including the insertion of the implants, is usually between 4000€ and 8000€.
The cost is made up of several factors, including the implant itself, as well as the operating room and medical team costs. Saline implants are generally less expensive than traditional silicone implants. On the other hand, B-Lite® implants can be more expensive, with total costs of up to €10,000 possible.
