Currently there are only two manufacturers whose breast implants are FDA approved for use in the United States – Mentor and Allergan (formerly McGhan and Inamed). Between the two of them they provide over 500 different styles and sizes of implants! I believe both are excellent companies and I am quite comfortable using implants from either of them. There are times where one of them may have an implant with a feature that I think will fit a particular patient best. However I feel any patient should be quite comfortable with an implant from either of these manufacturers.
The outer shell of all implants currently available in the United States is made of silicone elastomer. The feel of the shell is similar to that of a zip-lock bag, only a little thicker.
The implants may be filled with silicone gel or saline. Saline solution is simply salt water. It is the same solution often used when someone receives an IV for dehydration or surgery. The silicone gel is more cohesive with a more viscous consistency. The gel in earlier implants was more liquid (like honey), whereas now the tendency is to make the gel more cohesive (like gelatin). With today’s implants, you can cut them in half and the gel doesn’t just run out. It holds together more. Any candidate for breast augmentation may have saline implants. To get silicone gel implants a woman must meet certain study criteria and enroll in an FDA (Food and Drug Administration) study protocol.
The surface may be smooth or textured. The current texturing is the silicone elastomer surface, though other substances had been used in the past. The reason for texturing is that it was thought to reduce the incidence of capsular contracture (firmness). The texturing does help hold the implant in position so it is used for anatomic shaped implants. However almost all the deflations I have seen from the currently approved manufacturers in the United States have been textured implants. Therefore I only recommend a textured surface for use with anatomic implants.
The two basic shapes available for breast implants are round and anatomic. I recommend round implants for most applications but am quite comfortable placing anatomic implants. There are some instances in which I will highly recommend an anatomic implant. It may be easier to achieve a particular shape desired by the patient by using a particular shaped implant.
Implants now are available in low, medium and high profile. For a given volume, the low profile implant will have the widest diameter and the least projection. The high profile implant will have the narrowest diameter and the most projection. The medium profile implant is in between in terms of diameter and projection. An important concept to understand is that the center of the implant is centered in line with the nipple. Therefore as the implant profile increases, the diameter decreases and the space between the breasts becomes wider. High profile implants also give a more rounded upper breast.
Saline implants come out of the box empty and are filled with saline at the time of surgery. The proper fill of an implant is very important. The less saline in an implant, the softer it feels but the more it wrinkles. The more saline in the implant, the firmer it feels but the less it wrinkles. The implants also come labeled for a particular volume – the nominal fill volume (i.e.: 300cc). The package insert will specify a normal fill range (300 – 325cc). Underfilling the implant in the example means filling it with less than 300cc. Overfilling would mean filling it with more than 325cc. Studies have shown that underfilled implants are more likely to deflate. I almost always fill implants at least to the upper end of the fill range and sometimes will overfill them. These fill issues will vary with different styles of implants as the current trend is to develop implants that require more volume for a given shell surface area.
A significant portion of the consultation is spent measuring the breast and determining implant size. For more information regarding size selection refer to For more information regarding size selection refer to the section titled New Breast = Implant + Breast
BREAST IMPLANTS ARE NOT A LIFETIME DEVICE. In time they will deflate. Both Mentor and Allergan have automatic free-of-cost basic warranties that cover spontaneous deflation of the device only. Both companies have additional warranties available for a moderate fee. It is important to understand that both companies pay these as a reimbursement after they have analyzed the deflated implant in their own laboratories. In other words the patient must initially pay the surgeons fee, anesthesia, and operating room costs then waits about 6 weeks to get reimbursed by the company. I personally have never had a problem getting Allergan or Mentor to honor their warranties.
Please click on the following links to view the warranties for Mentor and Allergan.
- Mentor: http://www.mentorwwllc.com/global-us/WarrantyInformation.aspx
- Allergan: http://www.cppwarranty.com/pdf/termsconditions.pdf
- Introduction to Breast Augmentation
- Breast Augmentation Overview
- Who Is A Candidate For Breast Augmentation?
- Breast Anatomy
- Breast Cancer Considerations
- Implant Location
- Scar Location
- Implant Types
- New Breast = Implant + Your Breast
- Implants and Lifts
- The Surgical Experience
- Recovery and Healing
- Benefits of Breast Augmentation
- Risks of Breast Augmentation
- Financial Aspects of Surgery
- Alternatives to Breast Augmentation
Contact us if you are interested in breast implants and would like a confidential consultation. Or call our Little Rock, Arkansas plastic surgery office at 501-224-1300 or 800-750-7607.