Types of Breast Implants
Women might choose to get breast implants for cosmetic reasons, or they may opt for implants to restore their appearance after mastectomy. If you’re thinking about implants, you’ll have another decision to make—the type of implant. What types of breast implants are safe to choose from? Your choices may vary, depending on whether you’re seeking cosmetic enhancement or breast reconstruction, but, in general, most women can choose between saline or silicone breast implants. Learn more about different breast implants and how getting implants might change your breast health.
Possibly the top question women ask about breast implants is “are they safe?” All breast implants must be approved for safety by the FDA (U.S. Food and Drug Administration), which means these prosthetics must go through clinical trials to prove their safety before they’re ever offered to the public.
Breast implants themselves—whether saline or silicone—are safe, but they are not considered “lifetime devices.” They can cause health issues the longer they are implanted. A few of the complications women experience due to breast implants are:
- Asymmetry: one breast being larger, smaller, or positioned differently than the other
- Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL): a very rare type of cancer
- Capsular contracture: tightening of the scar tissue surrounding the implant
- Deflation: leakage of the saline solution out of the implant
- Reduced sensation in the breast or nipple
- Rupture of the implant
Women who receive breast implants either for cosmetic purposes or for breast reconstruction should be aware that both saline and silicone implants can obscure actual breast tissue on mammograms, which can make it harder for a doctor to detect early breast cancer lesions. If you have breast implants, you should notify your mammography clinic about the implants. For women who have breast implants, the sonographer usually takes four additional mammography views to help the radiologist see all of the breast tissue clearly.
After talking with your doctor about the safety of breast implants, you should think about other considerations, including:
- Cost: Cosmetic breast enhancement generally is not covered by insurance, whereas breast cancer reconstruction is. The cost of treating complications that occur with cosmetic breast implants usually must be paid out of pocket, including the costs of additional surgeries that may be required.
- Potential complications: Ask your doctor about infection rates and your personal risk of other possible complications.
- Surgical process: How many surgeries will you need to achieve your desired appearance? Will you need breast tissue expanders to be placed first, or only the breast implant itself?
- Types of breast implants: Beyond saline and silicone types, breast implants also are available in a variety of sizes, shapes and textures. Ask your surgeon which style and type might help you best achieve your desired look.
Both types of breast implants consist of a silicone shell or pouch.
Saline breast implants are empty when placed into the surgical cavity. The surgeon fills them with a sterile solution during the procedure. This allows the surgeon to adjust the implant size a bit during the surgery to achieve the precise look you’re seeking. Silicone breast implants are prefilled with a gelatin-like substance and cannot be adjusted for size during surgery.
If a saline breast implant ruptures, you will notice it immediately because the affected breast will “deflate.” Ruptures of silicone breast implants do not produce this effect and often can only be detected through magnetic resonance imaging (MRI).
Silicone implants are thought to better mimic the look and movement of real breast tissue, compared to saline implants, which provide a uniformly firm feel. However, capsular contracture (tightening of scar tissue around the implant) can occur with either type of implant, turning the implant hard, misshapen, or even painful.
Silicone implants are available in anatomical shapes, sometimes referred to as “teardrop” shaped; whereas, saline implants only come in a standard round shape. Some women and surgeons feel the anatomically shaped implant confers a more natural appearance.
Both saline and silicone implants are available with a smooth or textured shell, and your surgeon can recommend the most appropriate type for you. Textured breast implants may reduce the risk of capsular contracture, but they also have been linked to the very rare cancer, BIA-ALCL.
Both saline and silicone breast implants can be used safely by adult women to enhance their appearance for cosmetic reasons or for reconstruction after mastectomy. To increase the likelihood of achieving the best outcome, look beyond the type of implant involved and carefully choose a board-certified plastic surgeon with substantial experience implanting both saline and silicone breast implants. Ask the surgeon if he or she has surgical outcomes data to share with you. This would include the number of surgeries performed and complication rates. Your doctor might also have deidentified patient photos to share, so you can get an idea of what your experience might be like.