With more than 300,000 breast implants performed annually, this surgery is the number one cosmetic surgical procedure in America. While women in their 30s are the most likely group to go under the knife, females from their teens to those in their senior years also opt to change the size and shape of their breasts.

Clearly these women know they want breast augmentation, but many don’t know which type is right for them. Will it be saline or silicone, and are there other options? Does it matter which is chosen? Yes, it does matter because breast augmentation is about the individual woman, and getting the best outcome depends on making the right breast augmentation choices.

Types of Breast Implants

Breast implant types fall into two main categories: saline and silicone. Saline , which contain saltwater, are firmer and offer a more uniform look and feel. A subcategory known as structured saline implants has a different inner structure to make them feel more natural. Saline types do have a silicone outer shell.

The silicone types is filled with a silicone gel, and it feels like natural breast tissue. These include the round, smooth, textured and gummy bear subcategories. Round silicone varieties look fuller than some other types, and there is less concern they will move out of place. The smooth type is the softest variety and has natural movement. Sometimes this type has visible rippling underneath the skin. Textured types move less because scar tissue develops that sticks to the implant. Gummy bear implants are known also as form-stable implants because they keep their shape, even if the device shell breaks. This type has thicker silicone than other types, and they are firmer.

Choosing an Implant

After deciding to have breast augmentation, there’s the choice between saline and silicone. For younger women, keep in mind that FDA approval for saline implants is for women 18 and older, but to get silicone, the patient must be at least 22. In a case where breast augmentation is for reconstruction purposes, both saline and silicone are available for females of any age.

Each type has its pros and cons. Those with saline are less expensive. In the event the device breaks, the saltwater is eliminated through urine in about a day, which means there is no health risk. On the down side, the saline ones don’t look as natural as silicone.

A more natural look and feel are some of the biggest advantages of silicone implants. They are also the softest option, and they hold their form, which limits the possibility of them tearing. If the device does rupture, it may not be noticeable because the thick silicone gel may not leak out. If there is leakage, the size and shape of the breast my change, and the gel may cause lumps in the breast, chest wall, arm or armpit. This leaked material may be difficult to remove from the body, but research shows that silicone implants don’t pose a health risk.

Other Options

After selecting an implant type, some other considerations include size, position and incision placement. Because each person has different wants and needs from an augmentation procedure, discussing these options with a board certified plastic surgeon can help the patient make the best choices. For instance, during a consultation, the physician gives the surgical candidate various sample sizes to try on with their clothing. Not only does this help the person determine what size feels and looks most comfortable to them, they get medical advice from the doctor about what size works best based on the candidate’s body type, physique and amount of breast tissue they have.

Patients have three choices for their device position. Submuscular implants are positioned under the pectoralis muscles, while subglandular types go on top of the pectoralis muscle. Option three is Dual Plane positioning, which is having the implant partially cover the muscle. Those with small amounts of breast tissue are typically recommended to have submuscular placement, but each case is different. During consultation, the physician explains pros and cons of each position and makes a recommendation.

Another decision to make is about the incision. There are four choices. Inframammary incisions are hidden in the crease of the breast, while transaxillary cuts are hidden in the armpit. Periareolar incisions are camouflaged around the patient’s nipple. Transumbilical, or TUBA, incisions go through the belly button. Of the four types, periareolar and inframammary allow more precise placement of the implant. While any incision will leave a scar, some physicians are able to make fine cuts so that the scar is barely perceptible.


Breast augmentation surgery usually takes an hour or two, and the patient has general anesthesia or IV sedation. Patients miss about a week of work time. While this procedure is considered safe, any surgery includes risks and complications. For breast augmentation, that can include asymmetry, which results in breasts that are uneven or have different sizes and shapes. Other possible complications include breast feeding difficulties, breast pain, calcification and other issues. The cosmetic surgeon will explain all possible outcomes to the patient before surgery.

Another consideration for some women is whether to have a breast lift at the same time as their breast augmentation. While the two procedures go together quite well, with one adjusting the size of the breast and the other adjusting the location of them, doing both procedures together is not for everyone. The question is best answered during the physician consultation so the doctor can determine if that is a viable option. All pros and cons of a breast lift, or Mastopexy, are explained so the patient knows what to expect and can make an informed decision.

To know more about your breast implant options, you may contact Aesthetic Surgery Center. Dr. Anurag Agarwal, Dr. Kiranjeet Gill, Dr. Richard Maloney are board-certified plastic surgeons with specialty trainings in aesthetic surgery of the face, breast and body. Dr. Gill specializes in various breast procedures including breast augmentation in Naples, FL. She focuses on exceeding patient expectations and providing natural results safely.

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