What are my breast implant options?
Breast implants are commonly used for breast augmentation, breast lift with implants and breast implant replacement surgery. Here we discuss the different breast implant options available at Centre for Surgery.
Options for your breast implants and surgery
Once you have decided on Centre for Surgery, the next step is to consider the best breast implants for your surgery, including:
- Breast implant fill material – saline and silicone implants
- Size and projection of the implant – measured in cc’s / low profile or high profile.
- Implant surface texture – smooth or textured
- Implant shape – round or teardrop
- Incision location – inframammary, periareolar or transaxillary (armpit)
- Breast implant placement – above the muscle, below the muscle (dual place)
Centre for Surgery in London is home to some of the top breast implant surgeons in the UK, and they will work closely with you to help you achieve natural-looking results for a significant boost in self-confidence.
RELATED: What are the most natural-looking breast implants?
Breast implants have evolved substantially over the last 40 years. Early breast implants were composed of a very runny, almost liquid type of silicone. Saline breast implants lack the natural-looking feel of modern silicone implants and are rarely used in the UK. Both patients and surgeons prefer the latest fourth-generation silicone gel breast implants. Surgical techniques have evolved significantly as the composition of the internal silicone gel with highly advanced outer implant shells has made breast augmentation surgery a very safe procedure. Patients can now look forward to achieving natural-looking results with a very favourable risk profile. We commonly get asked about how to choose the best breast implants. Read further to learn about the implant options available.
Type of breast implant fill material
All the latest generation breast implants have a robbery outer silicone shell regardless of the internal fill material.
There are two main types of breast implant fill material:
- Saline (saltwater)
- Silicone gel
Saline-filled breast implants
Saline-filled implants are often described as feeling similar to a water bed and this can cause a ripple effect. Implant rippling is a recognised problem affecting saline implants. Women who have a minimal amount of breast tissue may find they have a higher risk of developing implant rippling, which may be easily visible through the skin of the breast. This problem can be minimised by using round implants with a smooth surface. By overfilling the implants, the implant feels firmer to touch but at the expense of making the implants take on a more spherical shape. Most women do not consider this a natural appearance, although what constitutes an ideal appearance will differ between women. If saline implants were to deflate, they most commonly do so within 2 to 3 hours of surgery. Saline implant deflation results in the internal saline solution being safely absorbed by the body with no adverse consequences. Saline implants have a higher risk of capsular contracture and ‘bottoming out’ than silicone implants.
Silicone gel-filled breast implants
Silicone gel implants have a much lower risk of implant rippling than saline implants. The silicone gel has a better consistency which is thought to minimise rippling. Silicone implants have a much more natural feel that resembles natural breast tissue and holds their shape better than saline implants. Unlike saline implants, silicone implants maintain shape better when placed in the breast. Silicone implants have a low risk of deflation, although there is a risk of implant rupture in very rare cases or where traumatic injury has occurred to the chest. Modern implants contain medical-grade silicone that is designed not to migrate if a rupture occurs. Silicone implant leakage or rupture could increase the risk of developing capsular contracture, which involves a hardening of the breast. Fortunately, implant rupture is a rare occurrence, and the vast majority of women have had intact breast implants for many years. If a silicone implant ruptures, you will need to have your breast implants removed and replaced immediately. Our surgeons can advise you about the different types of implants available and what will best suit your goals for treatment.
Saline implants vs Silicone implants – which is best?
Saline implants were a commonly used type of implant approximately 20 years ago when surgeons had doubts about the quality of silicone implants that were then available. Today, surgeons no longer have any concerns about silicone implants due to the significant advances in silicone gel technology and evolution in manufacturing processes. If you specifically request to have saline implants, our surgeons can still provide this. However, it is important to be aware of the significant differences in terms of look and feel and potential complications, including implant rippling.
Silicone implants are the best type of implant with many advantages, including:
- Their natural look
- More natural feel both at rest and during dynamic movement.
- High-quality cohesive silicone gel helps to prevent leakage
- They are not at risk of sudden deflation, unlike silicone implants
- Patients are better able to make accurate sizing choices
- It is easier for the surgeon to predict and control projection as they can better maintain their shape once placed in the breast.
Choosing the right size and projection of implant
Breast implant manufacturers, including Mentor and Sebbin, offer hundreds if not thousands of different types of implant sizes with various dimensions. Saline implants are filled with saline after they have been placed into the breast pocket. Silicone breast implants come manufactured as a finished product and are not modified during surgery before or during breast implant placement. Most patients and surgeons prefer silicone implants because of their natural look and feel. You will have a wide choice of breast implant sizes and projection options to choose from at your in-person consultation. You can work closely with your surgeon to choose the right size and shape of implant for you. Your goals for treatment will determine the best breast implant size. It is important to bear in mind that breast augmentation results will be determined by choosing an appropriate size of implant that is not too large for your anatomy. Excessively large implants can affect your skin’s elasticity leading to stretching out of the skin envelope, and may affect your ability to carry out certain types of physical exercise.
RELATED: Common Questions about Breast Implants
During the consultation, precise measurements will be taken of your breasts, including height, weight, volume, the position of the nipples and the amount of skin elasticity. The shape of your chest wall will be analysed, and your surgery may use a breast-torso ratio to identify the ideal size of breast implant that is best suited to your chest.
Breast implant projection
Breast implant projection determines the distance the implant protrudes outwards from its base or its height when placed on a table.
Your surgeon will provide customised recommendations on the most appropriate implant profile to help you achieve optimal results. Breast implants come in a wide variety of different profiles, which helps to determine overall breast projection. High-profile implants are popular in the UK and are more likely to produce a perkier appearance. Low-profile implants may be more suitable for women who would like to achieve a more subtle-looking breast enlargement.
RELATED: Choosing the right size of breast implants for breast augmentation
Implant surface texture
Breast implants come in both smooth and textured varieties. The surface texture is related to the outer implant shell which is the surface of the implant and this is what patience can generally expect to feel under the skin.
Smooth implants appear transparent due to the lack of surface texture and often have the most natural feel. Most patients prefer smooth implants as they do not receive any differences beneath the skin. Smooth implants often rotate within the breast pocket as the outer surface cannot grip surrounding tissue. Smooth surface implants have a softer feel compared with texted implants and are technically easier to insert during breast implant surgery.
Textured implants have a rough feel, often resembling sandpaper. This surface is designed to allow the surrounding tissue to grip the implant surface, which reduces the likelihood of implant rotation within the breast pocket.
Over the last 10 years, there has been significant controversy surrounding breast implants that has caused a great deal of confusion and panic. Textured implants have been associated with the development of a very form of lymphoma known as BIA-ALCL or breast implant-associated anaplastic large-cell lymphoma. This is an exceptionally rare condition, with only 500 patients worldwide reported to have had the condition out of an estimated 50,000,000+ women who have breast implants. The use of textured implants has dramatically reduced since the link has been established between textured implants and BIA-ALCL.
Certain types of implants, such as very low-textured implants, also known as micro-textured or nano-textured implants, have not been linked with the development of BIA-ALCL. Here at Centre for Surgery, our surgeons only use micro-textured implants from Mentor and Sebbin. These breast implant types have a low surface roughness, and over 30 years of data have confirmed these implants as the safest available on the market in the UK and worldwide.
Implant shape - round or teardrop?
The shape of breast implants is another factor that must be considered when deciding the right breast implant choice for you. Breast implants come in both round shapes and anatomical (teardrop) shapes. For women with a moderate amount of pre-existing breast tissue, it can be difficult to determine whether breast augmentation has been carried out with round or teardrop implants. Most surgeons are unable to tell the difference as a well performed breast augmentation produces results that appear natural. The breasts will adopt a natural teardrop shape over time.
Many patients choose teardrop implants to provide increased height to the augmented breast and for greater contrast between the lower and upper portions of the breast. The versatility of anatomical implants makes them a popular option for many patients depending on the look they are hoping to achieve. Teardrop implants aim to follow the natural profile of the breast. Round implants can produce just as natural looking results as teardrop implants in most cases as long as the correct breast implant placement is chosen. The breast skin and its elasticity can significantly impact choosing the correct size and shape of the implant. Some patients may require a breast lift or a breast lift with implants to correct loose breast skin.
All anatomical implants come with a textured surface to minimise the degree of implant rotation inside the breast pocket. The appearance of the breast may appear deformed if an anatomical implant rotates. Round implants come in both smooth and microtextured surfaces. If round implants were to rotate in the breast pocket, this is not of great concern as the breast shape will not be affected. If an anatomical implant rotates within the breast pocket, it must be repositioned either non-surgically with external manipulation or surgically in some cases to correct its position.
Breast implant incisions
There are three main types of breast implant incisions. By far, the most common type of incision used for breast implant surgery is the inframammary incision located in the lower breast crease. It is important to remember that all surgical incisions will result in a scar. Patients who follow their post-operative instructions can expect the scars to fade gradually. After three months, most scars are barely visible when wearing most types of clothing or when the arms are at rest by the side of the body. Your surgeon will be able to explain how potential scars could look after each incision option and will recommend the best option for you. However, in virtually all cases, the inframammary approach is considered the gold standard technique.
Inframammary incision (under the breast)
The inframammary approach involves making an incision in the lower breast crease and is viewed as the best technique for breast implant insertion. Women who would like to breastfeed their child when they get pregnant most commonly choose this technique to retain the ability to breastfeed. This approach allows optimal control over implant selection and positioning. The infra memory incision is the most common approach for breast augmentation surgery in the UK. Choosing this approach allows surgeons to achieve optimal symmetry. The scar is relatively short and most commonly measures between 3.5 cm and 5 cm. The size and shape of the implant may affect the length of the required incision. Other factors that may determine the size of the incision include previous surgery, skin elasticity and whether a breast funnel is used to insert the implant. For women who are concerned about having a scar in the inferior breast crease, a periareolar approach can be chosen instead.
Periareolar incision (around the nipple)
This incision is located around the full circumference of the nipple. This approach is not preferred by both patients and surgeons. It can be technically difficult to achieve optimal implant placement with this incision. If patients have a combined breast lift with breast implants, the surgeon can achieve greater control as an inframammary incision will be performed simultaneously. The periareolar approach has a higher risk of affecting future breastfeeding ability. The incision is made around the areola at the border between the breast skin and the areola. This helps to minimise the visibility of the scar. The major drawback of this approach is the higher risk of altered nipple sensation and the risk of being unable to breastfeed.
Tranaxillary incision (through the armpit)
This approach is the least commonly used in the UK. The incision is made through natural skin folds in the armpit. This approach is only recommended for people at risk of excessive scarring, including keloid scars that commonly occur on the chest in dark-skinned people. This technique has a high risk of complications, and revision surgery rates are higher with the transaxillary approach. The incision must also avoid important nerves and blood vessels whilst achieving optimum implant placement. A channel is created from the armpit to the breast to insert the breast implant. Although the scar is virtually invisible as the incision is hidden within the armpit, it may still be visible, especially when people place their arms in certain positions. The approach may be recommended in certain cases for women who would like to breastfeed their children and those with darker skin with a high risk of keloid scarring. This approach cannot be used for revision surgery. All breast revision surgery is carried out via the inframammary approach. The risk of complications with this approach outweighs the potential benefits, and our surgeons rarely perform this breast augmentation technique through the armpit.
What scarring can I expect after breast implant surgery?
All surgical procedures involving an incision will form a scar, and breast implant surgery is no different. The surgeon will need to make an incision in the breast crease, around the areola or in the armpit to insert your breast implants. This will result in scarring, although an expert surgeon can ensure any scarring is inconspicuous. Centre for Surgery is a centre of excellence for scar management techniques using both minimally invasive techniques to improve the appearance of post-operative scars. Successful treatment can produce scars that are virtually invisible.
At your in-person consultation, your surgeon will perform a detailed physical examination to determine the most appropriate breast implant for your breasts, body shape and your goals for treatment.
Breast implant placement
Breast implants can be placed either in front of the pectoralis muscle, behind the breast tissue (over the muscle), or behind both the breast and the pectoralis muscle (under the muscle).
Subglandular implant placement (over the muscle)
The subglandular approach is suitable for women who have sufficient soft tissue coverage around the cleavage area. The breast implant is positioned between the pectoralis muscle and the breast tissue. Subglandular breast augmentation has a quicker recovery compared with the dual plane approach. Women can achieve enhanced breast cleavage. Mild to moderate degrees of breast ptosis can be corrected with this approach. Unlike the under the muscle approach, over-the-muscle insertion does not result in the double bubble deformity seen when women lift weights in the gym.
A new variant of the over the muscle approach is the subfascial breast augmentation. This approach combines the benefits of the subglandular approach and elements of the dual approach without the need to split the pectoralis muscle.
RELATED: What is subfascial breast augmentation?
Dual plane implant placement (under the muscle)
The dual plane approach involves placing the breast implant between the pectoralis muscle and the underlying rib cage. In this approach, only the upper half of the breast implant is covered by the pectoralis muscle. The lower half of the implant is in direct contact with the breast tissue. This approach is ideal for women who have little or no breast tissue. The pectoralis muscle achieves coverage of the breast implant’s upper portion, which helps women conceal the implants’ edges.
Benefits of the dual plane approach:
- Natural looking upper portion of the breast
- Reduced risk of bottoming out
- The edges of the implant are less likely to be seen or felt.
- Reduced risk of implant rippling.
- A breast mammogram is easier to interpret as the implant is located behind the pectoralis muscle.
- Ideal for patients with a petite build and smaller breasts.
The totally submuscular approach is most commonly used for breast reconstruction, and is not commonly used for cosmetic breast augmentation.
RELATED: Breast implant placements – over or under the muscle?
What are the different options for breast augmentation?
Breast augmentation can be performed with either breast implants, fat transfer or both techniques in the same procedure.
Breast augmentation with implants remains the most popular method of enhancing the size and shape of breasts in the UK. Breast implants help to create a perkier appearance with an increase in size. Implant placement can be either on top of the muscle (subglandular) or beneath the chest muscle (dual plane). Getting the best breast implant results is determined by optimal patient selection, choosing the right implant and placing the implant in the most appropriate position.
Fat transfer to Breasts
Fat transfer to breasts, also known as fat grafting, involves removing excess fat from another body part, such as the abdomen or thighs, before being injected into the breasts. Some patients are not keen on the idea of having artificial implants in their bodies. This procedure involves using liposuction to remove unwanted fat and then injecting the fat into targeted areas of the breasts through tiny incisions. Breast fat transfer cannot achieve significant increases in breast size compared with breast implants and a slightly less predictable in the results it can produce due to some fat being naturally absorbed by the body.
Breast implant options at Centre for Surgery
Centre for Surgery is a specialist clinic for breast implant surgery in London. Our consultant breast specialists are considered some of the best surgeons in the UK. When you have an in-person consultation, you will receive customised recommendations on the most appropriate type of breast implant to suit your body’s anatomy and treatment goals.
What type of breast implant has the most natural looking feel?Silicone breast implants have the most natural feel. The latest medical-grade silicone filling helps them mimic natural breast tissue's feel. This makes silicone breast implants the best breast implant option for patients who want a natural look and feel.
What is the most commonly used type of breast implant?In the UK, virtually all of the breast implant surgeries performed involve using silicone breast implants. Saline breast implants are very rarely used due to the high risk of implant rippling and sudden deflation.
Are breast implants safe?Both Mentor and Sebbin implants have an advanced micro-textured surface to minimise the adjacent breast tissue developing inflammatory changes.
With Sebbin implants, the seal is the same material as the rest of the implant, which minimises the risk of implant rupture. With other types of breast implants, the area most likely to rupture is the seal, which is commonly made of a different material.
When do you need to replace breast implants?Based on current guidance, we recommend implant replacement every ten years regardless of the type of implant. Most reputable breast manufacturers have a lifetime warranty. This allows patients to undergo breast implant replacement to get the most advanced fourth-generation implants to achieve a youthful look. The appearance of your breasts can change due to the natural ageing process, changes in weight or pregnancy and breastfeeding.
How do I know if a breast implant is ruptured?Implant rupture is a risk associated with silicone breast implants, although it is very rare in the modern generation of breast implants.
Implant rupture can occur in two different ways. In the first type, implant rupture can be easy to spot when there is a visible lump on the chest or other clinical features, including pain or discomfort.
A silent rupture may not cause any symptoms and may only be picked up on a routine breast implant check.
This is why we recommend three yearly breast implant checks to check the integrity of your breast implants. A ruptured implant requires revision breast implant surgery which involves either breast implant removal alone or removal of the damaged implant combined with breast implant replacement.