Breast Implants

Shapes, Surfaces & Size

Breast Impants

All breast implants consist of an outer casing (the ‘shell’ or ‘wall’) and an inner filler material.  This inner filler can be saline (salt water), silicone gel or a combination of both.

Breast implants also differ in a number of other ways: their shape (Round or ‘Tear-Drop’), their surfaces (Smooth, Textured or Polyurethane Foam-Covered) and finally their size and projection (the amount by which they project forwards).

Implant Shapes

Implant Shapes - Round

Round Breast Implants

  • Deliver more upper breast fullness.
  • Are sometimes the preferred shape to restore upper breast volume lost through breast-feeding or weight loss.
  • Can be inserted through any incision location.
  • Being perfectly round, implant rotation cannot produce any deformity of breast shape.
Implant Shapes - tear drop

‘Tear-Drop’ Breast Implants

  • Provide more fullness in the lower half that tapers off towards the top.
  • On profile, they deliver an attractive and natural straight-line drape of skin from collar-bone down to nipple.
  • Can only be inserted through an incision under the breast.

Please note: Polyurethane Foam-Covered Tear-Drop Implants (“Furries”), unlike Textured ‘Tear-Drops’,  have been reported as having no instances of deformity from implant rotation due to the ‘velcro-like’ adhesion of the polyurethane surface to the implant pocket lining.

Implant Surfaces

Breast implants also vary in their surfaces. Until 2009, the only choice in Australia was between Textured (also called ‘Rough’) and Smooth implants.

However, Australian women now have an additional choice in the form of the Polyurethane Foam-Covered Silicone Implants. These still have silicone gel as their inner filler material but the implant shell is coated with a fine 1-2mm layer of polyurethane foam. Manufactured to the highest quality in Germany by Polytech for over 25 years and used in over 60 countries worldwide, the foam coating gives them a ‘furry’ feel – hence their colloquial name “Furries”.

implant surfaces

Polyurethane Foam-Covered Silicone Gel Implants represent the most significant addition to the range of breast implants available in Australia since their introduction in 2009.

However, Polyurethane Foam-Covered Silicone Gel Implants do require fine nuances in surgical insertion techniques to get the best possible results from them.  Unfortunately for patients, not all surgeons are familiar with these or are willing to learn them.  As a result, not all breast augmentation surgeons offering patients these proven-safer implants despite the many overseas studies confirming that they dramatically reduce the most common reasons for repeat surgery : Capsular Contracture and Implant Displacement (implant moving away from its original position).

  1. Polyurethane Foam-Covered Silicone Gel Implants have been shown to dramatically reduce the risk of Capsular Contracture – proven to be the commonest reason for repeat surgery (refer percentage risks in the table below).
  2. Due to the Polyurethane Foam coating adhering like ‘Velcro’ to the implant pocket walls, these implants virtually eliminate the chances of an implant rotating, descending or moving away from its original position like Smooth & Textured silicone implants sometimes do. The Allergan Core Study in 2008 reported that such implant ‘displacements’ made up the second most common complication with Smooth and Textured Implants requiring repeat surgery.

 

  Smooth Surface Textured (‘Rough’) Surface Polyurethane Foam Surface
Incidence of Capsular Contracture at 10 years after surgery 19.1%* 19.1%* Dramatically less: approximately 1%
Adherence of implant wall to surrounding tissues None Minimal, if any ‘Velcro-like’ adhesion
Risk of Implant Displacement or Rotation of a ‘Tear-Drop’ Implant Not uncommon Not uncommon Displacement downwards  is very rare.

Rotation should never occur.

*Source: Allergan Core Study 2010

Please note that the foregoing information is not meant to convey the impression that we believe that Polyurethane Foam-Covered Implants are the only implants a patient should consider. Despite their advantages in greatly reducing the chances of repeat surgery for either of the above two complications, these implants may not be the only choice for any given patient.  That is why we offer ALL types of implants for every patient to consider.  By the same token, every woman considering Breast Augmentation should at least be given the opportunity of considering these proven-safer implants and not be restricted to choosing solely between Smooth and Textured Implants.

Unfortunately for patients, not all Breast Augmentation Surgeons are currently offering Australian women the opportunity of considering Polyurethane Foam-Covered Silicone Implants. This may be because:

  • These implants do require fine differences in surgical technique with which the surgeon may not be familiar or is unwilling to master.
  • In the current era of cut-price cosmetic surgery, some clinics continue to use cheaper implants to keep the total cost lower and appear more attractive on total price to prospective patients .

However, how would you feel if your Smooth or Textured Implants developed Capsular Contracture, or they moved out of position and you then required repeat surgery at considerable additional cost and your Surgeon had not even offered you the choice of Polyurethane Foam-Covered Implants which may have prevented the complication?

Naturally, like all implants, Polyurethane Foam-Covered Silicone Gel Implants also have their pros and cons.  However, we firmly believe that their major advantages in reducing the risks of repeat surgery for Capsular Contracture and Implant Displacement far outweigh some very minor disadvantages.

Accordingly, if you find that the surgeon you are seeing does not offer these implants as a choice, or tries to dissuade you from considering them, or has limited experience in their use, you owe it to yourself to seek a second opinion from a Surgeon experienced in their use.

Implant Size

The final choice as to size of implant should be entirely yours. By all means, listen to your surgeon’s recommendations but don’t allow him/her to make the final choice for you.  Instead, choose the size that you feel gives you the ‘look’ you want and not what you think others may like.

Based on many chest and breast measurements, our Surgeon will hand you all the various implant shapes and sizes that suit your measurements and have you insert them one at a time into a ‘crop-top’ to see in a mirror the degree of correction each can give you. This is by far the most reliable way to choose the size and shape of implant that will best deliver the ‘look’ you’re after.

Most importantly, although we’ll insert whichever size YOU want – provided, of course, it’s surgically possible – we always recommend you choose a size that is in proportion with your overall figure and makes you look ‘great but not fake’.

Frequently Asked Questions

Brands aside, implants basically differ in terms of:

  • What they are filled with: Silicone or Saline;
  • Shape (Round or Tear-Drop);
  • Surface (Smooth, Textured or Polyurethane Foam-Covered); and
  • Size.

There are literally hundreds of combinations with the above choices. And because we don’t offer only one brand or one type of implant, we can customise your implant choices to exactly what you like and what best suits your breast measurements.

Silicone-filled implants are far more popular with patients than Saline implants because they:

  • have a more natural ‘feel’ because they feel more like breast tissue.
  • cannot spontaneously deflate.
  • have less chance of visible surface wrinkling/rippling.
  • enable patients to choose a very natural ‘tear drop’ shape whereas all saline implants are ‘round’.

This is largely a personal choice because every patient has in mind an image of how she wants her breasts to look. The basic differences in appearance are:

  • ‘Tear-Drop’ Implants deliver a more natural appearance because they are tapered towards the top and thus allow a straight-line drape of skin from collar-bone down to nipple.
  • Round Implants, on the other hand, are fuller at the top than ‘Tear-Drop’ Implants. Although this can be an advantage for women who have lost much upper breast fullness through breast-feeding, in other women they can sometimes produce a ‘stuck on’ look, especially if the woman has insufficient tissue coverage.

Our Surgeon will show you both types at your Initial Consultation and have you insert each into a ‘crop top’ to see which ‘look’ you like best.

If there was a simple answer to this, all implants would have the one type of surface! In reality, each type of implant surface has its pros and cons in terms of the following issues:

  • Risk of Capsular Contracture, the commonest reason for repeat surgery: Greatest with Smooth and Textured Implants, dramatically less with Polyurethane Foam-Covered Implants.
  • Risk of Implant Displacement (movement away from its original position), another common reason for repeat surgery): Greatest with Smooth Implants, less with Textured Implants, rare with Polyurethane Foam-Covered Implants.
  • Risk of BIA-ALCL (Breast Implant Associated – Anaplastic Large Cell Lymphoma). This is not breast cancer. It is a rare cancer of the immune system found in the fibrous capsule and fluid around an implant. Most cases are completely cured by removal of the implants. As 2019, its association with the different implant surfaces has been reported as follows:
    • Most cases have been in those with Textured Implants.
    • A small percentage has been reported with the Silimed brand of Polyurethane Foam-Covered Implants from Brazil.
    • Only 1 case worldwide has been reported with the Polytech brand of Polyurethane Foam-Covered Implants from Germany. The patient was completely cured by removal of her implants.
    • Whereas it was previously thought that Smooth Implants were immune from BIA-ALCL, America’s FDA has now reported a small percentage of cases in Smooth Implants.

Polyurethane Foam-Covered Silicone Implants – commonly called “Furries” – have been shown in many studies to DRAMATICALLY reduce the chances of the commonest reasons for repeat surgery: Capsular Contracture & Implant Displacement (implants moving away from their original position). Unfortunately for patients, not all surgeons offer these.
At Breast Excellence, we have a huge array of implant shapes and sizes, and based on your breast measurements, our Surgeon will hand you all your implant options to insert, one by one, into a crop-top in front of a mirror. In this way, you will actually see the correction each implant can give you. This is by far the best way to choose an implant size. Letting the surgeon recommend what he thinks will suit you or selecting from a catalogue is NOT the way to choose an implant size.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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