Breast Augmentation is the most common aesthetic surgical procedure performed in the United States, with over 300,000 surgeries annually. There are basically three styles of implants available.
The most common style, which is used by majority of plastic surgeons, is the smooth, round implant. As the name implies, the implant is round in shape and has a smooth surface. In my practice, I have exclusively used this type of implant without any complaints from patients. The post-operative results have been very good. Please visit my photo gallery for breast augmentation before and after photos.
The second type is the textured implant. As the name implies, the surface of the implant is rough to touch due to a textured surface attached to the smooth surface. The theory about this surface is to decrease the risk of capsular contracture. What is capsular contracture? Any foreign material placed inside our body will eventually form a capsule around it. The body forms this “shell” as a way of ignoring this foreign object. With time, many breast implants will develop a tightening of the capsule. If the degree of contracture is severe, the implant will become visibly distorted and may even feel hard to touch. Surgery may be required to correct the condition. Based on animal studies, the textured surface of the implant breaks up the formation of an organized, neatly arranged scar tissue thus minimizing the risk or degree of capsular contracture. Clinically, however, the risk of capsular contracture is essentially similar for both smooth and textured implants. The major disadvantage of textured implants is that breast tissue becomes stuck to the rough surface, increasing the risk of rippling. Rippling occurs when the patient moves and causes “ripples” in the skin around the breast. Another factor is the cost, textured implants are more expensive. For these reasons, majority of plastic surgeons do not use textured implants.
The third style of implant is the anatomical type. Anatomical implants are flatter on the top half and fuller in the bottom half. The rationale is to obtain a more natural look. However, in my experience, surgical technique is a better prediction of whether an implant will look and behave naturally or not. There are three main issues with this type of implant. The first is the cost; anatomical implants are much more expensive. The second is the risk of rotation of the implant. When a breast implant is placed, there is always some movement of the implant before the capsule forms. If the anatomical implant should rotate, surgery is required to reposition the implant. As a result, these implants only come with a textured surface to minimize the chance of rotation. However, as mentioned previously, this increases the risk of rippling. In my opinion, anatomical implants are better suited for breast reconstruction, where the implant is completely covered by muscle and the goal is to match the reconstructed breast to the other side.
The last style is the adjustable implant. The size of the implant can be adjusted up to six months after surgery by injecting saline through a port which is placed under the skin. I personally do not have any experience with this type of implant and am not aware of many surgeons using this type of implant. One concern, although small, is the risk of infection by injecting the port through the skin. In my experience, this type of implant is primarily used in breast reconstruction to adjust the final volume to match the non-operated side.
Dr. Michael Jazayeri is a board certified plastic surgeon and a member of American Society of Plastic Surgeons. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please call 714-834-0101.