Silicone Breast Augmentation Part II – Meet the Implant

Today’s silicone gel filled breast implant has come a long way from the device that was used by Dr. Cronin in Houston, Texas in 1962. Problems associated with this and other earlier breast implants have lead to the advances that have taken today’s silicone gel filled breast implant to the level of safety comparable to the saline implant, while also raising the standard on quality and durability.

Back in those early pioneering days, Dr. Cronin utilized a sponge containing silicone oils that were thick liquids which escaped into the surrounding tissue when implanted under the breast, causing inflammation. Eventually, most women developed a thick, contractile (shrinking) scar tissue, which deformed the implant making it feel firm (hardening of the implant). This process is known as capsular contracture, and can occur with both saline and silicone gel implants. It was this problem alone that drove doctors, scientists, and engineers to create today’s implant. Improvements were made to not only the silicone, but also to the creation and improvement of the containing part of the device, the shell.

Today’s silicone gel filled breast implant contains a semi-solid gel that has no loose oils that could potentially penetrate the outer shell. This new substance is called ‘cohesive’ by the Allergan company and ‘memory gel’ by the Mentor company. Both are thick gels that are not liquid, and do not run. They are not thick enough to hold a shape, so they are very soft and need to be contained in an outer shell. The soft nature of this cohesive gel allows manufacturers to utilize a round and smooth shell, to obtain the most natural, smoothest, and softest result.

Both companies also make a gel that is thick enough to be ‘form stable’ and can keep its shape without an outer shell. This thick gel has been utilized in implants known as gummy bears. These devices are being placed in women today only in clinical research trials. There are some compromises associated with this type of breast implant, though. Because they do not change shape, they need to be ‘breast shaped’, and therefore have a risk of rotation in the pocket, which would cause a change in the shape of the breast. To counteract this process, all breast implants that are shaped need to have their outer shell texturized, so that the body will ‘grip’ the implant into position. Textured implants have thicker shells, and potential irregularities are more easily felt when touching the breast. To be noted, implant manufacturers have touted breast shaped implants (’contoured’, ‘anatomic’, or ‘tear-dropped’) as an improvement over the round implant. In reality, a vast majority of plastic surgeons prefer round and smooth implants. Another potential problem with gummy bear implants is there fragility, which requires them to be placed through large inframammary incisions (under the breast in the crease). Although gummy bear implants have these potential compromises, they have virtually no risk of leaking, offering comfort to many individuals.

Like saline filled implants, today’s silicone gel filled implants come in a variety of profiles. The profile represents how flat or how tall the implant sits when lying flat on a table top. This in turn reflects how projecting the implant will be away from your chest wall and how full the tops of your breast will be after augmentation. In general, a moderate profile implant gives the best, most natural result. However, in situations where a larger volume implant is needed to obtain the augmentation desired in a more confined chest or narrow breast, then a high profile implant may be best suited.

To obtain the best results possible from your surgery; you need to choose a board certified plastic surgeon that has extensive experience and a great reputation in breast augmentation.