Choosing a breast implant is not simply a matter of picking the “best” material. Implant type, size, shape, surface, placement and the patient’s own anatomy all influence the surgical plan. The right choice should be made after discussing goals, breast and chest measurements, existing breast tissue, previous surgery, pregnancy or breastfeeding plans, scarring, possible future revisions and the risks that apply to implants in general.
For an overview of the operation itself, see the breast augmentation guide. An in-person consultation is needed before deciding on a device or surgical approach.
Silicone gel implants
Silicone implants contain silicone gel inside an outer shell. Different products vary in gel cohesiveness, shape and profile. Many patients choose silicone because the feel and movement may suit their anatomy and preferences, but this does not make silicone implants universally superior.
Silicone implants can rupture. A rupture may not always be obvious from appearance alone, so follow-up and appropriate imaging may be advised depending on the implant, symptoms, clinical findings and current guidance. Patients should be told what surveillance is appropriate for the specific device they receive.
Saline implants
Saline implants have a silicone shell that is filled with sterile saline. Some can be inserted through a smaller opening before being filled, although incision size still depends on anatomy, technique and the operation being performed.
If a saline implant ruptures, loss of volume is usually more noticeable because the saline is absorbed by the body while the shell remains. Saline implants can also show visible rippling in some patients, particularly where soft-tissue coverage is limited.
More cohesive silicone implants
Some silicone implants contain a more cohesive gel designed to retain its shape to a greater degree. They are sometimes informally described as “gummy bear” implants. Cohesiveness can affect feel, shape and the way an implant behaves if the shell is damaged, but these implants are not leak-proof, maintenance-free or guaranteed never to need revision.
The required incision and the choice between round and shaped devices depend on the implant dimensions, surgical technique and individual anatomy. No implant type eliminates the possibility of capsular contracture, malposition, infection, rupture, visible rippling, asymmetry, sensation changes or future surgery.
Implants are not lifetime devices
Breast implants should not be presented as lasting for a fixed number of years or as devices that automatically need replacement on a particular anniversary. Some remain in place for many years without a problem, while others require earlier evaluation or surgery. Replacement or removal may be considered for rupture, capsular contracture, implant displacement, infection, changes in breast tissue, changes in patient preference or other clinical reasons.
Patients should also understand that breast appearance can continue to change with ageing, pregnancy, weight change and changes in the surrounding tissues even when the implant itself is intact.
Questions to discuss before choosing an implant
- Why is this implant type being recommended for my anatomy?
- What are the expected scars and implant-placement options?
- How might the choice affect future breast imaging, breastfeeding or revision surgery?
- What symptoms should prompt review after surgery?
- What follow-up or implant surveillance is recommended for this specific device?
- What are the alternatives, including fat transfer or choosing not to have surgery?
The most appropriate plan is individual rather than brand- or material-driven. Patients considering surgery can contact the clinic to arrange an assessment and discuss implant choices, limitations and follow-up before making a decision.