Breast implant types: silicone, saline and gummy bear

The choice of breast implant affects both the aesthetic result and long-term comfort. Alongside your own research, a physical examination by the surgeon is essential — the size, shape and position of the implant must be chosen to suit the patient's anatomy.

1. Silicone or saline implant

Silicone (cohesive gel)

Structure: A silicone shell filled with cohesive silicone gel.

Advantages:

• A more natural feel (soft, like real silicone)
• If it ruptures, the gel stays in place
• A better aesthetic result (minimal rippling)
• A lifespan of 15-25 years

Disadvantages:

• More expensive
• An MRI is required to detect a rupture (every 3 years)
• Requires a larger incision

Saline (salt water)

Structure: A silicone shell plus a sterile saline solution.

Advantages:

• Cheaper (30-40% less than silicone)
• A rupture is visible immediately (the breast flattens)
• Can be placed through a small incision
• The volume is adjusted during the operation

Disadvantages:

• A "water balloon" feel (especially in patients with thin skin)
• Rippling is visible
• The upper pole does not look natural

2. Shape: round or teardrop (anatomical)

Round

Appearance: Like a ball — equally full at the top and the bottom.

Advantages:

• A full upper pole (attractive cleavage)
• Lower cost
• Rotation of the implant does not affect the result

Who is it for?

• Those who want a push-up effect
• Those with little natural tissue
• Those who want a full look in the cleavage area

Teardrop (anatomical)

Appearance: Fuller at the bottom than at the top — it imitates the natural shape of the breast.

Advantages:

• A very natural look
• "A teardrop shape even when standing" — better without clothing
• Less of a lift effect

Disadvantages:

• Usually more expensive than silicone
• There is a risk of rotation (a textured implant is used)
• Less full cleavage

3. Position: under or over the muscle

Under the muscle (submuscular)

Placed beneath the pectoralis major muscle.

Advantages:

• The edge of the implant is not visible (rippling is covered)
• Mammography is easier
• Lower risk of capsular contracture
• Keeps a natural look for longer

Disadvantages:

• More pain during recovery
• "Animation deformity" — in athletic patients the implant moves when the muscle contracts
• Recovery takes 1-2 weeks longer

Over the muscle (subglandular)

Placed under the breast gland but over the muscle.

Advantages:

• Faster recovery
• No animation deformity
• The breast looks "bigger"

Disadvantages:

• Rippling is visible (especially with thin skin)
• Higher risk of capsular contracture
• Mammography is harder

4. Surface: smooth or textured

Smooth

Advantages:

• A more natural feel (it moves)
• No risk of BIA-ALCL (a rare lymphoma)
• Usually somewhat more expensive

Textured

Advantages:

• Holds its position (used with anatomical implants)
• Lower risk of capsular contracture

Disadvantages:

• Linked to BIA-ALCL (an FDA warning)
• No longer permitted in some countries

Well-known brands

The price varies depending on the brand, size and surgeon chosen. The exact amount can only be found out at a consultation.

Tests at the consultation

1. 1VECTRA 3D — a body model on which you can "try on" different sizes
2. 2Sizers — trying real implants inside a bra
3. 3Asymmetry measurement — in 80% of women 1 breast is larger than the other
4. 4Pinch test — skin thickness (affects the decision on subglandular placement)
5. 5Activity test — an athletic or active lifestyle (subpectoral placement is needed)

Lifespan

• 10-15 years — the warranty on most implants
• 20+ years — silicone implants without problems
• A second operation is needed if there is: a rupture, capsular contracture, or a change of size

Recommendations

1. 1Consult 2-3 different surgeons — surgeons who have genuinely been vetted
2. 2Choose the surgeon, not the brand — the surgeon's experience matters more
3. 3Do not choose too large — a result 1-2 sizes smaller looks more natural
4. 4A long-term plan — a revision is likely after 10-15 years