Implant Types
There are many types of breast implants. In general terms breast implants are either “gel filled” or “saline filled”. Both types of implants have the same shell made out of medical grade silicone.
Silicone implants are the most popular implants chosen by women considering breast augmentation. The first question women normally ask is , “What are silicone implants made of ” or “What is silicone surgery”? Silicone filled breast implants are silicone shells that have also been filled with liquid medical grade silicone gel. Their soft, natural feel closely resembles the feel of a natural breast, and for this and other reasons, various types of silicone implants have been the most popular choice over the years.
As their name denotes, saline implants consist of the same silicone outer shell filled with a medical grade sterile saline solution. Our bodies are composed of 80% “water” and a few women choose saline solution breast implants because they feel this is the correct option for them.
All gel filled implants contain cohesive gel. The cohesivity of the gel determines the feel, the projection and the shape of the implants and final breast characteristics. There are various types of cohesive gel implants. Most patients chose Cohesive I implants because they feel incredibly soft, have no rippling and have a natural feel. Some patients who are thin body builders choose Cohesive II implants because they feel extremely soft, have no rippling and have an enhanced upper pole fill. Some patients consider Cohesive III and Cohesive IV implants, often referred to as ‘gummy bear implants’ which are filled with a thicker, form-stable silicone gel. These implants are palpable and firm but some patients have personal reasons for selecting this option. There are many different projections and fill volumes for each style of breast implant. During the consultation, these will all be discussed and patients can pick the ideal shape, projection and feel for their breasts.
Some patients, who desire only smaller changes in their breast volume choose fat grafting for their breasts. Some refer to this option as “Natural breast implants”, or “organic breast implants” but these are not implants at all. This method relies on a fat transfer from another part of your body to enhance the fullness and shape of your breasts.
During your consultation, Dr. Barr will carefully assess your body shape, breast tissue characteristics, your concerns, your expectations and your personal goals for breast enhancement. The different kinds of breast implants will be discussed and he will guide you to make an informed decision based on your individual characteristics and aesthetic goals. Knowing what are the best and safest breast implants for your lifestyle is something that only a certified plastic surgeon can advise.
Surgical Approaches
Breast implants can be placed in a pocket created directly behind the breast tissue (sub-fascial / sub-mammary placement) or behind the pectoral muscle of the chest (sub-muscular placement).
Women who have a more breast tissue or who are seeking more cleavage and upper pole volume often choose the sub-fascial / sub-mammary placement. This placement can also correct slight sagging and a loss of upper pole breast fullness.
Women who have minimal breast tissue may choose the sub-muscular placement. The breast implant is placed in a pocket behind the pectoralis major muscle. This creates a less projected upper breast. Women who are very thin but desiring a “more natural” breast appearance, often consider the sub-muscular placement.
There is a short incision needed to insert the breast implants. There are three options for the insertion, which is less than 4.5 cm in length and virtually undetectable after a few months.
- Underneath the breast hidden in your breast crease (inframammary)
- Around the lower border of your areola (periareolar)
- You underarm area (transaxillary)
There are significant differences between these options as well as your own physical characteristics and goals that will determine which approach is best for you. These will be discussed at length during consultation with Dr. Barr.
Expected Outcomes
Following breast implant surgery, most patients can return to light activities immediately and are back at work within a few days. Dr. Barr will have you do specific arm movements for the first week following surgery and start implant movement “exercises” staring at one week following your procedure to ensure optimal results. During the first 6 weeks following breast augmentation surgery, you will need to support your breasts with a surgical bra that is provided for you.
Activities that increases your blood pressure must be avoided for 2 weeks after surgery (no use of the gym) and chest work outs or running is not advisable until 6 weeks following surgery. Any temporary soreness, swelling or change in nipple sensation will disappear gradually.
Choosing a Surgeon
- Confirm that your prospective surgeon is a member of the Canadian Society of Aesthetic Plastic Surgeons and a member of the American Society of Aesthetic Plastic Surgeons. . This ensures that your surgeon has extensive experience and proper training required to perform cosmetic / aesthetic surgery.
- Confirm with your provincial college of physicians and surgeons that your prospective surgeon is licensed and whether disciplinary action has been taken against him/her.
- Confirm credentials and training. While many cosmetic surgeons advertise they are “board-certified ” requirements vary greatly depending on which professional board is cited. In Canada, only the Royal College of Physicians and Surgeons certifies physicians and surgeons in medical specialties.
- Peruse your prospective surgeon’s website and review their Before/After gallery to see their work.
- Just as important as verifying credentials and reviewing their work, you must meet and feel comfortable with the surgeon you have selected. Be thorough when discussing your expectations with your prospective surgeon. Proper communication before surgery is key to achieving the best possible surgical outcome.
Final Decisions and Future Confidence
With an abundance of information available regarding breast implant types / styles / projections and breast surgery options the question of, ” What are the best breast implants for me? ” may feel hard to answer. Many of the determining factors are dependent on your personal goals, lifestyle, and physical attributes, and the only way to properly answer this question is to schedule a consultation with a board-certified plastic surgeon. This is the first, and most important step on your journey to achieving your cosmetic surgery goals.