Breast Implants

Shapes, Surfaces & Size

Breast Impants

All currently available 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
  • 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, any rotation cannot produce a 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
  • Produce 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 a zero incidence of rotation and shape deformity.

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 Polyurethane Foam-Covered silicone implants. These still have silicone gel as their 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 gaining TGA approval in 2009.

However, Polyurethane Foam-Covered Silicone Gel Implants do require a special technique of insertion with which not all surgeons are familiar or are unwilling to learn.  As a result, and unfortunately for patients, not all breast augmentation surgeons are offering 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 (the 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 table below).
  2. Due to the Polyurethane Foam coating adhering like ‘Velcro’ to the implant pocket walls, these implants virtually eliminate the risk of the implant rotating, descending or moving away from its original position like Smooth & Textured silicone implants can do. The Allergan Core Study reported in 2008 that such implant ‘displacements’ made up the second most commoncomplication in Smooth and Textured implants requiring revision surgery.

 

  Smooth Surface Textured (‘Rough’) Surface Polyurethane Foam Surface
Risk of capsular contracture (CC) Incidence varies widely in different studies up to 19.1%* Incidence varies widely in different studies up to 19.1%* Significantly 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 should never occur as these have a zero reported incidence of rotation
*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 the above two complications, these implants may not be the only choice for any given patient.  Nonetheless, we believe that every woman considering breast augmentation should at least be offered these proven-safer implants for her due consideration.

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 a special technique with which the surgeon may not be familiar or unwilling to learn.
  • In the current era of cut-price cosmetic surgery, some clinics continue to use cheaper implants to keep the total cost low and appear more attractive on price.

How you would you feel if your smooth or textured implants developed Capsular Contracture, or moved out of position, requiring 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 any very minor disadvantages.

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

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 detailed chest and breast measurements, your surgeon at Breast Excellence 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 visualise in front of 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’.