The Ultimate Guide to Breast Implant Types, Pros, and Cons (UPDATED 2019)

Deciding to have breast augmentation is a truly personal decision. Women have various reasons for desiring breast enhancement; one woman wants to have a more attractive silhouette while another may be looking for ways to regain her pre-pregnancy body through a Mommy Makeover.

Whatever your reasons are, you will be delighted to hear that breast improvement is one of the surgical cosmetic procedures with the highest satisfaction rate -- up to a whopping 98 percent!

Working with a plastic surgeon who helps you achieve a sense of femininity and regain confidence is incredibly important in your breast augmentation journey. Apart from deciding on whether or not you should give it a go, you also need to consider several micro-decisions -- from implant types and sizes to implant and incision placement.

With careful consideration and thoughtful planning, a breast augmentation could be one of best life decisions you'll make. Choosing the best implant type is one of the core considerations during the planning phase. In this article, we take a detailed look at the various implant types available for breast enhancement today.

We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.

What's the Best Breast Implant Type?

By and large, there is no 'perfect type' of breast implant. What looked stunning on one of your best friends doesn't necessarily mean that the same implant will be the best choice for you. This is why we recommend face-to-face consultations; an honest discussion with an experienced, knowledgeable plastic surgeon about your desired enhancement is a must. And you'll want to consider your surgeon's opinion and recommendations based on your existing body type and physical assessment.

In a nutshell, today's breast implants are made of a silicone outer shell that is filled internally. Implant fill materials used today include regular silicone gel (aka traditional silicone implants), highly cohesive silicone gel (aka gummy bear silicone implants), and saline implants.

Each implant type can be a good choice, but they have subtle differences in their look, feel, and overall performance.

Regular Silicone Gel Implants

Regular silicone breast implants are filled with silicone gel. Silicone implants are FDA-approved for breast augmentation in women over the age of 22, and can also be used for breast reconstruction surgery.

The silicone gel feels a little bit more like natural breast tissue compared to its saline counterpart.

The Pros:

• Regular silicone breast implants are the softest and most natural feeling implant available today.
• Implant 'rippling' is less likely to happen in regular silicone implants compared to saline implants.
• Are the most commonly used implants chosen today because of their natural look and feel.

The Cons:

• Requires using a slightly longer incision in the skin compared to saline breast implants because the implant is pre-filled. This may make it more difficult or even impossible to place silicone implants through the areola, underarm, or belly button.
• If a silicone breast implant leaks, the gel may remain within the implant shell or may escape into the breast implant pocket. A leaking silicone breast implant will not collapse. This makes it more challenging to detect ruptures.
• These implants are available only in a round (not teardrop) shape.

If you choose silicone implants, you may need to visit us regularly after surgery and/or undergo periodic MRI screening examinations to ensure that the implants are functioning properly.

Rest assured, silicone breast implants are considered safe; they have not been linked to causing breast cancer or autoimmune diseases.

Highly Cohesive Silicone Gel Breast Implants

Highly cohesive silicone gel breast implants, also known as gummy bear or form stable implants, are filled with a highly cohesive gel that makes them a little bit thicker and firmer than implants filled with traditional silicone. Gummy bear implants are growing in popularity due to their excellent performance and highly satisfying outcomes.

The Pros:

• May have superior long term performance with lower rates of rupture, rippling, and capsular contracture compared to regular silicone breast implants and saline breast implants.
• May maintain better long term shape with enhanced projection and lower rates of malposition and bottoming out.
• Gummy bear implants are available in both round and teardrop (anatomic) shapes.
• The teardrop shaped gummy bear implant can achieve a more "natural" looking result with less bulging and roundness of the upper portion of the breast and increased projection and fullness of the lower portion of the breast compared to round implants, yet with the trade-off of a slightly firmer feel.

The Cons:

• Gummy bear implants feel slightly firmer to the touch compared to regular silicone breast implants.
• Placement requires a slightly longer incision in the skin, which can make it more difficult or even impossible to place these implants through the areola, underarm, or belly button.
• Shaped gummy bear implants have been linked in very rare circumstances to a slow growing form of cancer of the immune system called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). See more information about BIA-ALCL below.
• Shaped gummy bear implants have a slight risk of malrotation (about 1%), which round implants do not.
• Shaped gummy bear implants, in particular, are slightly more expensive than other breast implant options.

Saline Breast Implants

Saline breast implants are filled with sterile saltwater. This implant type is recommended for women who do not wish to have silicone implants as well as some women who desire the 'Baywatch' look with a high degree of upper pole fullness and projection. In the right patient, saline implants can also look very natural. Saline implants are generally less popular today than silicone implants.

The Pros:

• Saline implants are adjustable in regards to volume filled at the time of surgery which can help adjust breast size in woman who do not have equal breast sizes (although silicone breast implants do come in many sizes).
• Can produce the highest degree of upper pole fullness and projection, which may be indicated for some women desiring a "Baywatch" type look.
• A slightly smaller incision can be used during placement.
• Implant rupture is easier to detect (your breast will deflate).
• Saline implants generally cost slightly less than silicone implants.

The Cons:

• Saline implants feel slightly firmer and less like natural breast tissue compared to silicone implants.
• Implant rupture and rippling are slightly more likely to happen.
• Saline implants weigh slightly more than silicone implants, which slightly increases the risk of 'bottoming out' due to gravity.

Saline breast implants are filled with sterile saltwater. This implant type is recommended for women who do not wish to have silicone implants.

A Word on Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare cancer of the immune system. It is not breast cancer. It is generally a slow-moving cancer that can often be treated by removing breast implants and scar tissue. Fewer than 10 patients per year get BIA-ALCL.

The exact cause of BIA-ALCL is unknown, but the vast majority of cases are associated with implants that have a textured surface (shaped silicone, textured round silicone, and textured saline). BIA-ALCL may occur among women who receive implants for breast augmentation as well as breast reconstruction.

Fat Transfer Breast Augmentation

Breast enhancement with fat transfer removes unwanted fat from your thighs, abdomen, or hips. Following purification, these fat cells are then injected into your breasts.

This procedure is growing in popularity because it is an all natural option that offers the double benefit of sculpting other areas, but it is still much less commonly performed than implant breast augmentation because it is less consistent and less reliable.

Fat transfer breast augmentation has a few important limitations. First, fat transfer is typically limited to approximately one cup size increase in breast size. Second, the transferred fat may be absorbed again by the body. Third, it is more expensive because of the extra time involved in harvesting and processing donor fat as well as possible need for a special vacuum bra device. This option is best reserved for women who desire a modest increase in size without using an implant.

In special circumstances, fat transfer may be used in conjunction with breast implants to provide additional softness and cover for the implants.

The Right Implant For You

Few patients ask for saline any longer. There are only three reasons for saline implants: they are less expensive, they can be introduced through smaller incisions, and some patients – despite all the evidence proving silicone is safe – remain skeptical.

Regular silicone is the softest implant and is often a good choice for women who want the softest feel.

The ‘gummy bear’ implant comes in both round and teardrop shapes. They have a firmer gel, which may give a better shape and may last longer. The round gummy bear implant is often a good choice for women with looser tissues and who want a more durable implant that remains soft. The teardrop shaped gummy bear implant may be a good choice for women whose tissues are relatively tight and desire a very proportionate and natural looking enhancement with less fullness of the upper portion of the breast and more projection and fullness of the lower portion of the breast.

The takeaway here is not to rush in deciding your breast implant type. Everyone is different, desires different results, and has a different physical makeup. Thus, it is best to get in touch with a plastic surgeon who is not just certified but is also an expert in aesthetic breast enhancement.

Dr. Fan and the rest of the team looks forward to an honest, detailed consultation with you! You can also take advantage of a self-assessment that will help you determine if you are a good candidate for breast augmentation surgery.