Choosing the right size implant is generally the most important decision a patient will make. If a person chooses to go too large, it may be visible through the skin after the operation, or it may be more easily felt. Although the size is definitely important, the individual must consider other characteristics when deciding on an enlargement. An implant, which is surgically placed under the chest wall, contains an exterior sac or shell, which is made of a rubber-like substance. The plastic surgeon will evaluate the existing breast tissue to determine if the patient has enough tissue for the surgery. The doctor will also give suggestions on the proper size of the implant. After determining what will be appropriate for you, the doctor or his staff will discuss scheduling, pre and post operative care, and possibly financing if applicable. Silicon versus Saline: Silicone implants is filled with silicon gel that holds together uniformly while retaining the natural shape consistent with breast tissue. Silicone has a set volume. When inserting, the doctor will make a large incision size and will have various options for placement. Silicone-gels consist of a silicone outer shell and are pre-filled with a silicone gel rather than saline. Silicone-gels may look and feel more like natural tissue. Salines are filled with saltwater solution similar to the fluid that makes up most of the human body, creating a firmer feel. Salines have a flexible volume that can be adjusted by the surgeon. Surgeons create a smaller incision size with various options for incision placement. Salines consist of a silicone shell, filled with saline during surgery. Saline-filled have been criticized for feeling hard or unnatural, although improved surgical techniques have lessened these complaints. Textured versus Smooth: Scar tissue may form around the implant surface, creating a capsule. In many patients, the capsule can tighten and squeeze, causing a capsular contracture. Textured surfaces were designed to reduce the likelihood of capsular contracture, which can cause health risks to the patient. Round versus Anatomical: Round implants will always stay round, never changing shape. They are made smooth and textured. These are less expensive than an anatomical design and can look less realistic than anatomical designs. The results will depend on your anatomy, the amount of tissue you start with, plastic surgeon and the placement. Anatomical designs are primarily for reconstruction purposes. They are more natural looking breast, which look oval in shape. If viewed from the side, these appear to have more volume at the bottom and can take up a more conical shape, causing it to be bottom heavy. It is more likely that anatomical implants will flip or turn in the breast pocket; therefore, these come with a textured surface, which allows tissue adherence and helps to keep implant in place. If it is inserted correctly, patients will minimize the chance of it flipping. Remember to discuss all types and designs with your surgeon. If implants are placed in the body properly, there should be minimum recovery time or discomfort after surgery.
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