What types of breast prostheses are there?

There are different types of breast implants, depending on the physical and functional characteristics of each one.

Types of breast implants

According to content or filling:

• Silicone implants: they are the most used (90%). It has been proven to be the safest material. Its texture is soft and similar to the normal breast.
• Saline implants, of physiological saline. They have the advantage that in case of rupture, the material is reabsorbed. Their disadvantages are that they can deflate, are harder, and give temperature changes and sounds (sloshing).

Depending on the cohesiveness of the silicone gel:

Currently all gels are cohesive to avoid migration in case of breakage. They can be of low, medium, high or stable cohesiveness. The lower the cohesiveness, the softer and less stable the gel. The more cohesive, the harder and less likely to deform and leak in case of rupture, but require wider approaches, leaving a larger scar.

Depending on the shape of the breast prosthesis there are different options, customized to the taste and anatomy of each patient:

• Round: They are the most used and traditional. For each volume there are different profiles: low, moderate, high and ultra-high. The greater the height, the smaller the diameter of the implant. They are easier to insert and without rotation problems. Sometimes they do not give a natural shape, especially in the subglandular plane.
• Anatomical: they are oval, teardrop or water drop shaped prostheses. Its shape can vary in its three dimensions, length, width and height (projection). It is said to give a more natural shape, so its use is increasing. However, they are more consistent, so they require wider approaches, more precise designs, with a more complex postoperative period, since they have the risk of turning, which would distort the result.

According to their cover or envelope. The silicone covering of the breasts can have a different surface.

• Smooth: they have more risk of encapsulation in the subglandular plane. They can be introduced with less scarring, have a softer feel and less incidence of infections and post-surgical seromas.
• Textured or rough: less risk of encapsulation. They have a more irregular feel and less risk of displacement.
• Microtextured: more modern and with less risk of encapsulation and better feel.
• Polyurethane: wraps around the silicone envelope. They were developed to reduce the risk of capsulation, but are not widely used due to their possible harmful effects on organisms.

Considerations about breast implants

The FDA approved the use of silicone gel breast implants for breast augmentation (augmentation) in women over the age of 22 and for breast reconstruction (after surgery for breast cancer or other medical conditions) in women of all ages. It also approved the implants for revision surgeries, which correct or improve the result of an original augmentation or reconstruction surgery.

After nearly five years, FDA reports continue to support the safety and effectiveness of these implants when used appropriately, but state that women should fully understand the risks before considering their use.

There are many important things to consider before undergoing breast augmentation surgery using an implant, including personal expectations and reasons for undergoing this procedure:

• Breast implants do not last a lifetime. They will require replacement.
• With the passage of time the risk of complications increases, so they will require reoperations.
• The most frequent local complications and adverse effects are: capsular contracture, reoperations, rupture or alteration of the implant. Other complications include implant folding, scarring, asymmetry, pain and infection.
• Many of the changes that occur after wearing breast implants can alter the esthetics and be irreversible.
• If the implants are removed without replacing them, changes and deformities in the natural breasts will occur.
• If implants are carried, the breasts should be monitored throughout life. Ultrasound scans should be performed every several years and in case of doubt of rupture, an MRI.
• If you have breast implants you may have an increased but very low risk of developing a rare breast cancer called Anaplastic Giant Cell Lymphoma (ALCL), around the implant. This may require specific treatment.

Your Plastic, Aesthetic and Reconstructive Surgery specialist will help you choose the one that is right for you.