Breast augmentation offers you a unique opportunity to alter the shape of your breasts rather than just change your bra size. Generally, the larger you want your cup size, the larger the breast implant the surgeon will consider, but the decision will also depend on the size of your breasts initially and the size of implant that they are capable of 'carrying'.
For the most natural look, you will probably want your new breasts to be in proportion or balance with your body as a whole. The width of your breast will determine the space between the breasts (cleavage). It also determines the outer curve of your breasts, a contour that is essential to the balance between your breasts and hips. The other
Composition
The two major compositions of a breast implant are Silicone and Saline.
Saline
Saline-filled breast implants were first manufactured in France in 1964, introduced by Arion with the goal of being surgically placed via smaller incisions. Current saline devices are manufactured with thicker, room temperature vulcanized (RTV) shells then earlier generations of devices. These shells are made of a silicone elastomer and the implants are filled with saline after the implant is placed in the body. Since the implants are empty when they are surgically inserted, the scar is smaller than if a silicone implants (which are filled with silicone before the surgery is performed). A single manufacturer (Poly Implant Prosthesis) produced a model of pre-filled saline implants which has been reported to have higher failure rates during the procedure.
Saline-filled implants were most common implant used in the United States during the 1990s due to restrictions that existed on silicone implants, but were rarely used in other countries. Good to excellent results may be obtained, but as compared to silicone gel implants, saline implants are more likely to cause cosmetic problems such as rippling, wrinkling, and to be noticeable to the eye or the touch. Particularly for women with very little breast tissue, or for post-mastectomy breast reconstruction, silicone implants are considered as superior. In patients with more breast tissue in whom submuscular implant placement is used, saline implants can look very similar to silicone.
Silicone
Silicone breast implants were first developed in Texas by two plastic surgeons, Thomas Cronin and Frank Gerow along with the Dow Corning Corporation in 1961. The first woman was implanted in 1962. These first implants were called the Cronin-Gerow implants for obvious reasons and subsequently were considered the First Generation of silicone breast implants. Current implants used in the UK are from the current, or Fifith Generation, of silicone implant design.
First generation
The Cronin-Gerow implants were made of a tear drop shaped silicone rubber envelope (or sac), filled with a thick, viscous silicone gel with a Dacron patch (to reduce rotation of the implant) on the posterior shell.
Second generation
In response to surgeons' requests for softer and more lifelike implants, breast implants were redesigned in the 1970s with thinner, less cohesive gel (i.e. the silicone would 'run' if the implant became ruptured within the breast pocker) and thinner shells. These implants had a greater tendency to rupture or "gel bleed" silicone through an intact implant shell, and complications such as capsular contracture were quite common. It was predominantly implants of this generation that were involved in the American class action-lawsuits against Dow Corning and other manufacturers in the early 1990s.
Another development in the 1970s was the application of a polyurethane foam coating on the implant shell which proved effective in diminishing capsular contracture by causing an inflammatory reaction that discouraged formation of fibrous tissue around the capsule. These implants were later briefly discontinued due to concern of potential carcinogenic breakdown products from the polyurethane. A review of the risk for cancer from TDA by the US Food and Drug Administration (FDA) later concluded that the risk was so small so as not to justify recommending explantation of the devices from individual patients. Polyurethane implants are still used in Europe and South America, but no manufacturer has sought FDA approval for sale in the United States. Second-generation implants also saw the introduction of various "double lumen" designs. These implants were essentially a silicone implant inside a saline implant. The double lumen was an attempt to provide the cosmetic benefits of gel in the inside lumen, while the outside lumen contained saline and its volume could be adjusted after placement. The failure rate of these implants is higher than for single lumen implants due to their more complex design. The contemporary versions of these devices ("Becker Implants") are used primarily for breast reconstruction.
Third & Fourth generation
Third & fourth generation implants, from the mid 1980s, represented sequential advances in manufacturing principles with elastomer-coated shells to decrease gel bleed, and are filled with thicker, more cohesive gel. The increased cohesion of the gel filler reduced potential leakage of the gel compared to earlier devices and the more substancial shell improved durability as compared to 2nd generation implants. A variety of both round and tapered anatomic shapes are available from different implants in this group. The anatomic or shaped implants are uniformly impregnated with a textured surface to reduce rotation, while round devices are available in both smooth or textured surfaces.
Fifth generation
Evaluation of "gummy bear" or solid, high-cohesive silicone implants that have been widely used since the mid 1990s in the UK other countries. The semi-solid gel in these type of implants largely eliminates the possibility of silicone migration. Studies of these devices have shown significant potential improvements in safety and efficacy over the older implants with low rates of capsular contracture and rupture.
Shape
Breast implants are available in two different shapes. Some implants are round, while others are shaped more like a teardrop, closely resembling the natural shape of a breast; these are called anatomical implants.
Round
Round is currently the most common shape for implants. If there is enough breast tissue to cover them, flattering, natural-looking results are achievable. Generally, round breast implants provide a full, rounded appearance to the upper portion of the breast and a flattering increase in cleavage. If you’re concerned about the size and location of the incision, round implants may give your surgeon more options. Plus, the procedure for inserting round breast implants is very straightforward, and there’s no concern if, in rare occurrences, the implant rotates.
It’s important to note that, in the course of time, as a result of gravity and the ageing of the skin, the upper part of round breast implants may become 'emptier', which means they may droop more than anatomical breast implants.
Anatomical
Anatomical implants are a more recent development, designed to produce a more natural-looking effect that follows the body’s natural lines. If you look at an anatomical implant from the front, it appears oval in shape. When viewed from the side, it appears to have more volume at the bottom, its upper area (your practitioner may refer to this as the upper pole) gently slopes downward and outward, thus projecting out in a more natural way. This upper portion is less likely to settle over time, in the way a round implant might.
A downside of anatomical implants is that they can, in very few instances, rotate in the pocket created for the implant, causing a distorted shape to the breast which will necessitate corrective surgery. The other downside to anatomical implants is that they are more costly to purchase and hence if you choose to have a breast augmentation with one you will pay more than if you had round implants.
Below is an example of how breast implants are measured, using projection, volume, diameter and shape to define the
With all the variations in size, shape, projection etc. implant manufacturers can offer over 500 different combinations of breast implants meaning there will be one that is right for you.
Types of Breast Implants (Outer Shell)
Smooth or Textured
The surface of an implant can be either smooth or textured. Textured implants are far more common that smooth as the fine surface texture offers the implant greater tissue adhesion when inside the breast pocket than a smooth implant would.
Advancements in Safety and Technology of Silicone Gel-Filled Breast Implants
Healthcare companies invest heavily in research and development so that they can create new and advanced medical devices or pharmaceutical products that meet the changing needs of patients and physicians. It is this research and development that lead to advancements in the safety and effectiveness of medical devices, such as breast implants.
Like other medical devices on the market today, silicone gel-filled breast implants have evolved as a result of research and development and innovations in technology. For example, the silicone gel-filled breast implants available to women today have a thicker and more durable outer covering (shell), and a more cohesive silicone gel filler than earlier implants. These innovations were designed to improve both the overall strength and durability of silicone gel-filled breast implants, as well as a woman's satisfaction with her breast shape and size over time.
Manufacturers
Allergan
Eurosilicone (Euromedical Systems - UK Distributors)
PIP (Cloverleaf - UK Distributors)
Mentor
Nagor
Sebbin
Sientra (Formerly Polytech Silimed)
