What size?
How to select the Correct
size of an implant?
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The idea that any woman can go for any size of breast implant is absolutely untrue. Many factors are considered for choosing right implant like your expectation of enlargement, your stature and size of body, your existing breast tissue, skin cover of your breast, laxity and sagginess of breasts, shape of your rib cage, any asymmetry of breasts etc. These factors are looked upon during you consultation.
External Sizers
Many times woman want breast enlargement, but she is not certain how much enlargement she will like and how much enlargement she will have after certain size of implant. For this purpose different external sizers are available. During consultation different sizers are put in bra and woman looks into the mirror. This will help to select the appropriate size of breast implant.
Implants are available in different sizes. Its volume is measured in ml. it’s available from 150 ml to 750 ml size. But routinely used implants are around 200 ml to 450 ml in volume. |
What fill?
Saline or silicon?
Which breast implants?
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Implant is silicon bag filled with saline or silicon.
Saline-filled breast implants
Saline-filled breast implants consist of a silicone shell that's filled with saline during implant surgery, after the shell has been inserted and is in place. Saline, on the other hand, isn't compressible and gives a more firm impression. Saline-filled implants have been criticized for feeling hard or unnatural.
Silicone gel breast implants
Silicone gel implants also consist of a silicone outer shell, but they're pre-filled with a silicone gel rather than saline. Silicone gel has a viscosity — a thick, sticky fluid consistency — that closely mimics human fat, which is a large component of female breast tissue. Silicone gel-filled breast implants look and feel more like natural breast tissue.
Advantages of very cohesive silicon implants.
• It has eliminated the two biggest problems, rupture and leakage. .
• They feel softer and more natural than saline implants .
• They are less likely to wrinkle. .
• They maintain the shape and upright position, .
• They last longer than saline implant.
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What shape?
Round or Anatomical?
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Round Implants.
Round breast implants are shaped like a globe; after they’ve been placed, they can rotate within the breast pocket created, without distorting the shape of the breast.
Anatomical/ Teardrop.
Anatomical implants are meant to mimic the slope of a natural breast.
a "shaped" implant by design has a top and a bottom (it is tear drop shaped). Unlike round implants, a teardrop implant will maintain the same shape lying down. Shaped implants tend to remain stationary, so they stay in the same place.
If the anatomic implant does rotate, the upper portion of it could end up inappropriately positioned outward or inward. With round implants, all sides are the same by definition. Therefore, if a round implant rotates, it does not matter.
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What surface? |
Breast Implant Surface -Textured Surface or Smooth Surface.
You've picked out a round or anatomical implant. You can choose a smooth surface breast implant or a textured surface breast implant.
Textured Implants.
Why do some implants have textured surfaces? All types of solutions have been attempted for decades to prevent scar tissue from becoming unacceptably hard around the breast implant. The body causes scar tissue to form around any foreign object in the body. The formation of scar tissue is known as capsular contracture. Textured surface implants are an attempt to solve this problem. By adding a textured surface, manufacturers hope to prevent scar tissue fibers from lying down uniformly.
Smooth Surface Implants.
Most breast implants have a smooth surface. Since there is little consensus on whether textured implants will actually reduce the rate of contracture or not. many doctors prefer to use smooth, round implants.
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What profile? |
Breast Implant Profile - Low, Moderate, High, or Moderate Plus.
If you chose a certain size implant, you would receive a determined amount of forward projection from that size implant. Now, you can choose an implant size and, if you like, have that size implant stick out more, or less than the base diameter would usually dictate.
For a woman with a very narrow frame, a moderate or low profile implant might result in a desired size, but may be too wide and carry the implant too far to the cleavage and underarm. By using a high profile implant, this patient can get the larger implant he/she desires. By the same token, a wide framed patient may find that in order to adequately cover the natural diameter of their breast size, the desired implant would have far too much projection. A low or moderate profile might work better.
  
Low Profile Implants.
These breast implants have less projection per measurement of base diameter than a moderate profile breast implant.
Moderate (Medium) Profile Implants.
This breast implant profile is the "normal" profile.
High Profile Implants.
These breast implants have more projection per measurement of base diameter than a moderate profile breast implant. An added benefit of the high profile is that in order to create the profile, the side wall of the implant has more height, which may reduce visible rippling.
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Implant placement :
above the muscle or below
the muscle? |
In both cases the implant is behind the breast tissue. The difference is that the implant is placed in front of the pectoralis major chest muscle (sub glandular), and it is placed behind it (sub pectoral). The projection is more with sub glandular placement. Incase of sub-pectoral placement the projection is camouflaged by some extent by pectoralis muscles.
 
1) If you have very little breast tissue…
It is advisable to put implant behind the muscle so more of the implant is covered by muscle. So the implant is not noticeable.
2) If you are unmarried or you want to be pregnant again….
Sub pectoral placement is preferred.
3) If you have some breast tissue…
You will have more of a choice between above and below the muscle.
4) If you have some breast tissue and bit "saggy" or "droopy" breast…
Sub Glandular (above the muscle) placement is preferable. In fact little sagginess is corrected by implant.
5) If your breast is too droopy….
Breast lift and implant placement can be combined together, in single sitting. The implant is put through the same breast lift incision.
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Incision preference :
surgery by which route? |
There are three common entry points, each with own advantages and downsides. |
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Inframammary Fold
Since the implants do not pass through the breast ducts, the risk of bacterial infection is greatly reduced. This incision gives a great deal of control over the placement of the implant. The incision is made just above the crease, or inframammary fold, underneath the breast. This is the most preferable route of insertion. Scars heal very nicely and it’s hardly visible after some time.
Peri-areolar
If mastopexy (breast lift), is to be done along with breast enlargement this incision is the choice. The Periareolar incision is made around the bottom half of the dark circle of skin surrounding the nipple. A properly healed scar from a well-placed peri-areolar incision is barely visible. A potential risk factor is the bacteria found in breast ducts, which can spread germs into the area holding the implants. More over there can be altered nipple sensation.
Trans-axillary
The immediate benefit of a trans-axillary incision is the lack of scars to the breast. The incision is located in the armpit, where it is only seen when you raise your arm. The scar is somewhat obvious particularly when you are wearing sleeveless clothes.
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