Choosing the Right Implant

Silicone or Saline Breast Implants?

Saline ( salt water ) implants have the perceived advantage that if they leak or rupture, they'll simply spill out and your body will just absorb the fluid without any harm to you. That was because there was a perceived danger from Silicone implants. However, despite many years of detailed studies, nobody has been able to show that silicone is detrimental to your health. In fact, even the saline implants have silicone. The capsule or bag that holds the saline is made of silicone. Thus the one perceived benefit of saline implants is not really beneficial. The downside of saline implants is that they feel very fake, just like a balloon of water. They ARE a balloon of water. They maintain their shape less well than silicone implants, and they ripple more often than silicone implants. Rippling is the wrinkling in the capsule that can be very palpable and visible in thin people. For this reason many people place the implant under the muscle to mask the rippling by covering it with muscle tissue.

Breast Implant Size

Breast implant size is a personal choice. However, you need to take into consideration your body size. If you have a very petite frame, having large breast implants may mean that the breast touch in the middle and that they hang under the arms. As each implant gets bigger, it gets wider. Now imagine if your chest 30 cm wide and you chose implants that are 20 cm wide each. Two implants side by side are 40 cm. That leaves no space between them (no cleavage) and you still have an extra 10 cm of width that extends out to the sides. It would not be a pretty sight (unless you're an extra in a sci fi movie)

Breast Implant Placement

Should the implant go above or below the muscle? There are two benefits of going under the muscle. First, placing an implant under the muscle means that the muscle is lying on top of the implant, thus adding an extra layer of padding to cover up the edges and wrinkling of the implant. This is important in very thin patients who have very little fat to cover and hide the implant. The second benefit of going under the muscle is that it has been shown to dramatically reduce the risk of capsular contracture, also known as the 'hardening' of the implant. On the downside, going under the muscle is much more painful, takes longer to see the final results and the muscle tends to compress/deform the implant. Whenever you move your arms and the muscle contracts, the breast will jiggle.

Going above the breast is much less painful, the recovery is quicker, and you see the results quicker. Implants tend to hang more naturally (the muscle has a tendency to keep the implant high) which is important in most women who have some drooping of their breast. Also, women with pre-existing breasts tend to have better looking results because the implant and the breast stay together, as compared to implants under the muscle where there is the risk of a 'double bubble' when the implant stays high under the muscle and the breast starts to droop over time and 'falls off' the implant.