Many implant manufacturers and device types are on the market, so I find that many of my patients come to their consultation overwhelmed by all their options. I will explain how I help guide my patients through this process to select breast implants that achieve their desired breast size and shape.
Breast Implant Manufacturers
Even though many implant manufacturers exist in Canada at the time of this post, two leading companies are selling devices. Their products are approved both by Health Canada and the US FDA. I am not mentioning specific brand names because my intention is not to promote one particular breast implant over the other. Although I insert implants from both companies, I use one brand for most cases due to their high level of service. I have found their commitment to warranty claims (for example, lifetime replacement of a ruptured implant) to be unwavering. In addition, they provided me with an extensive on-site inventory of different implants so I can give better care to my patients. Patients choosing from the common implant sizes we have on site do not have to make up their minds as far in advance. Also, for patients requiring a different implant size in each breast to improve their symmetry, I can achieve the closest size match possible during surgery by using sterile sizers to test the fit before inserting the actual implants.
I am always keen on using innovative new breast implant products if they are demonstrated to be superior, for example, with an improved feel or lower complication rates. However, newer breast implant companies and/or models will not have a long track record as established firms and products. Furthermore, if a patient chooses implants from a smaller company that becomes insolvent, they could be left without a warranty to replace a defective implant in the future.
The Outer Shell of Breast Implants
Every implant sold in Canada has a silicone outer shell and a durable, elastic membrane enclosing the contents. The outer shell can either be textured or smooth, and unique advantages and disadvantages are discussed during a consultation. In my practice, almost every patient receives smooth-surfaced implants so I will focus on the different types of smooth implants.
The Inner Contents of Implants: Silicone vs. Saline
The vast majority of breast implants sold in Canada are smooth round implants, meaning they have a smooth (non-textured) outer membrane of silicone elastomer and an inner core filled with silicone gel or salt water (saline). Silicone gel implants are more popular because they have a lower breakage rate and a consistency that most of my patients feel more closely mimics breast tissue. The gel inside of silicone implants is sticky like a “gummy bear”, which decreases (but not eliminates) the risk of the gel escaping into the surrounding breast tissue if the outer shell breaks. Some implant manufacturers offer implants with varying gel thickness, so patients can choose implants that will tend to stay rounder and hold their upper fullness more, versus those that will conform more to external pressures and gravity to form more of a “teardrop” shape.
Saline implants have the obvious advantage that in the case of outer shell breakage, there is zero risk of silicone gel migration because the only thing that can leak out is harmless salt water. Saline implants can be adjusted during surgery, and they may have a lower risk of capsular contracture. There are other pros and cons beyond the scope of this blog that should be discussed with your surgeon. Although most of my patients choose silicone gel implants, most of my patients who have chosen saline implants are happy with their results. In my experience, good results can be achieved with either type of implant.
Implant Shape or Profile
Many implant manufacturers offer implants with differing profiles, which is basically a ratio of their base width versus their projection. The base width of an implant contributes to “side boob” and “cleavage”, while its projection adds to “perkiness” off the chest. Low profile implants are wider and less projecting than high/full profile implants of the same size. Lower profile implants tend to provide more inner/outer breast volume, while full profile implants are usually more prominent off the chest. However, this is an oversimplification because implant manufacturers typically offer many profile choices (Low, Low Plus, Moderate, Full, and Extra Full profile). The difference in appearance achieved by one implant profile to the next can be quite subtle. In addition, implants of any given profile can look very different in each individual. The breast implants of the same profile would provide a very different result in a petite person with a very narrow chest, versus a large woman with wide breasts and broad shoulders.
Implant Size / Volume
When choosing breast implants, their size or volume is one of the most important criteria. Implants that are too small will not achieve the desired outcome in breast size and fullness. On the other hand, implants that are too large may result in a disproportionate, “augmented” result. Although some patients specifically desire this appearance, the risk of complications also increases if implants are too large for their body frame or tissue elasticity. There will be an increased risk of seeing or feeling the implants, unnatural-looking ripples or contours of the breast, premature sagging, chronic numbness, or other problems. It is important to have a proper, in-person consultation with an experienced plastic surgeon who can assess your breast width, tissue thickness, skin tone and other features. They can consider all of these factors, combined with your desired outcome, to make recommendations on the implant type, size and profile most likely to meet your goals.
Breast augmentation surgery is a major focus of Dr. Andrade’s practice. We have one of the top clinics in Ontario by number of procedures performed, as confirmed by our breast implant supplier. Given Dr. Andrade’s reputation as a breast implant expert, it is unsurprising that he is one of the top-rated plastic surgeons on websites such as RateMDs, Realself, and Google.
Disclaimer: This information is meant for Dr. Andrade’s patients and to supplement an in-person consultation. Medical science is constantly changing so it is not guaranteed to be complete or accurate.
