Which Type of Breast Implant is Right For You?

The New Year is upon us and millions of Americans are promising themselves that this year, this one for sure, is going to be the one where they decide to bite the bullet and make the move toward a healthier, thinner, and hopefully sexier future. But as the months go on, the numbers of enthusiastic resolution-makers will dwindle and dwindle until they’ve tapered off into the handful of folks who get to enjoy the summer turning heads while they relax Oceanside.

But a new health regimen may not be at the top of everyone’s list this year. Maybe you are one of the determined few who emerged victorious from the rigors of last year’s fitness promises, but are just not as satisfied with the results as you could be. This is why many women are changing the focus of this year’s resolution, and hope to make this the year that they get breast enhancement surgery to complement the body that they worked so hard for last year.

As of 2011, more than 300,000 Americans underwent some kind of breast augmentation, showing an increase in patients having this kind of procedure of 45% since 2000. This means that you are certainly not alone in your decision toward cosmetic improvement, and shouldn’t be shy when considering this type of procedure. With several decades of successful applications, breast augmentation is only becoming safer and more effective as technological innovation sprouts up around it.

So like any kind of major decision, medical or non-, you want to make sure that you are as informed as possible so you aren’t plagued with buyer’s remorse in the weeks following your procedure. And, again, like most decisions, breast augmentation provides its clients with a variety of options that range in terms of cost and substance to make the choice oh-so-much-more frustrating. What you need is a little bit of quick education (paired with the direction, care, and expertise of your physician, of course) on the subject of your cosmetic decision so that you can evaluate which type of implant is going to be the most feasible for you.

The Choice

Until recently, breast augmentative procedures generally relied on two types of implantation devices – Saline and Silicone - to help their patients safely replicate the look and feel of a natural breast. That means that the ambivalent patient could at least choose with a coin-toss if they really, really just couldn’t decide. But within just about the last year, a third type of implant has been introduced, which is proportionally increasing selection anxiety by about 50% for all women who were thinking about going under the knife.

The History

Before the advent of the new implant, the arena of breast improvement was dominated by the aforementioned implant types. The Silicone breast implant was the preferred implantation device, and was also used in the very first augmentation procedure in 1962. Shortly thereafter, the Saline implant variation was developed and deemed appropriate for medical use two years later in 1964. The Saline alternative was considered the second choice for breast enhancement surgery.

But in the early 1990s, the type of silicone implant that was being produced had to be hastily recalled and subsequently banned by the FDA after silicone implant leakage was linked to complications with the patient’s immune system; the saline alternative immediately took the role of the sole implantation device being used, until a satisfactory silicone design reemerged in the 2000s.

At about this time, clinical trials began on a new, third type of implant that would be an alternative to both the saline implant as well as the redesigned silicone options. Originally produced by Brazil’s Silimed, the new high-strength silicone implants began distribution under the “Sientra” title once the FDA concluded that they were safe.

The Candidates

The following material will objectively describe what you can expect from the silicone, saline (both offered by Natrelle and Mentor) and cohesive gel (Sientra) options for breast implantation. We’ll discuss how each implant is inherently unique, as well as some other factors such as risks and costs associated with each one. No bias here, just info.

What’s Inside

The attractiveness of the saline implant lies in part with its long record of safety. Deflation and implant rupture are always possibilities when undergoing a procedure like this, but the saline implant ensures that there will be no severe medical complications resulting from such an event. Although the outer shell of the device is silicone, this type of implant is filled, instead, with a sterilized saltwater solution, so in the event of a burst the familiar solution won’t throw a wrench in your body’s system.

The silicone and cohesive-gel variations, on the other hand, consist of silicone shells filled with additional silicone substances. Standard silicone implants were originally filled with a liquid gel, but after they were banned in the early ‘90s, the viscosity of the gel was increased to the point of it almost being jelly-like. This new, thicker silicone would be less likely to find its way into the patient’s blood stream, thus making it safer than its predecessor. On the other hand, the Sientra implants feature a “high-strength cohesive silicone gel” that is even more firm than that of the silicone implant. This shape-maintaining substance has earned the Sientra product the title of the “Gummy Bear Implant” since it can even retain its form after the implant has been cut in half. And although the nickname isn’t endorsed by Sientra, it still offers a pretty concise and accurate description of what the product aims to do; studies are still being conducted to determine whether the tastes are similar*. It should be noted that silicone implants allow for a wider range of implant shapes, so you should expect to make a second aesthetic decision after deciding against a saline implant.

*Studies not actually being conducted to determine similar tastes.

The Procedure

The silicone and Sientra products are both typically inserted the same way. They are considered “form stable” devices since they are inserted into the breast in their solid states. The outer membranes are filled with the respective form of silicone before the implant is deposited into the patient’s body. This means that a 3-4cm incision will be necessary to give the implant ample room for entry into the designated area. Although the size of the incision isn’t negotiable, the placement actually is, as you can choose to have it under the breast, or around the areola (outer nipple), depending where you and your doctor will think the small scar can be best concealed.

As opposed to the pre-filled silicone varieties, the empty silicone “sack” of the saline implant can be inserted before it is actually filled. Once the silicone barrier is in place, the solution inflates the implant gradually through a needle, rather than before the fully-expanded device is implanted.  If you are concerned about a scar being too visible or otherwise unattractive, the saline implant is a way that the marks of your augmentation can be more difficult to detect.

The Cost
As of 2011 the national average for the cost of breast augmentation is $3,694. However, this number only reflects the surgeon’s costs, and additional fees associated with the hospital, anesthesia, medications, tests and anything else will obviously make that number larger. Nevertheless, this figure will be the one that will reflect your actual implant selection.

The most affordable option is the saline variety, which is roughly $3,300 for a procedure with this choice. Above that will be the basic silicone implant at about $3,700, and the Sientra product is currently the most expensive, with estimations at about $500 more than the basic silicone option. You can see that there is a direct correlation between the filling substance of each implant and how expensive it is, but that doesn’t necessarily mean that price denotes success or effectiveness. A thorough evaluation of your body type and, really, what you expect to get from the procedure, should be considered before you think that the priciest option is objectively the best. It is also important to know that insurance will more than likely not cover breast augmentation since it is regarded as cosmetic.

Other Points of Consideration

In case you are interested in getting your implants early, you should know that there are age restrictions on which type of implant you will be allowed to have. Because mammary development continues into young adulthood, both types of silicone-filled implants will only be given to patients who are at least 22. However, the saline options are available to 18-year-old patients, likely because the filling solution can be deposited/removed more easily, should natural development affect you implants in the first few years after surgery.

The Verdict

Obviously there isn’t a definitive answer as to which implant will be the best for you. As mentioned before, your physician’s opinion is very valuable, and can help you select an implant that will be comfortable, and look the most natural. You have options, and should thoroughly consult your doctor about what you hope to get from this kind of cosmetic improvement. Being an informed patient will help you be more confident about a decision toward breast augmentation, and will ensure that you enjoy your future self-image.

Here's another resource that discusses implants and the general culture surrounding cosmetic surgery!