Breast Implant FAQs

Thinking about getting breast implants and curious about your options? Here you will find answers to some of the most frequently asked questions about the various types of breast implants, their risks and their benefits.

 

  1. Can saline-filled breast implants harden?
  2. What are the differences between smooth and textured breast implants?
  3. What are the differences between round and contoured breast implants?
  4. How long do breast implants last?
  5. Can fungus grow in a saline-filled breast implant?
  6. What are my breast implant options?
  7. Are silicone-gel-filled breast implants safe?
  8. How many cubic centimeters make a cup size?
  9. What is overfilling?
  10. What are expandable breast implants?
  11. Can I get "gummy bear"implants in the United States?
  12. What is the "IDEAL" implant?
  13. Can breast implants rupture during a mammogram?
  14. What is fat grafting breast augmentation?

 

1. Can saline-filled breast implants harden?

Yes. Capsular contracture, which occurs when scar tissue forms around the implant, can occur with both saline-filled and silicone-gel-filled breast implants. Learn more about the risks and treatment in our comprehensive article on capsular contracture.

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2. What are the differences between smooth and textured mammary implants?

The surface of the outer shell of breast implants can be either smooth or textured. Textured implants have a sandpaper-like surface, while smooth implants have a balloon-like surface. There are pros and cons to each. Smooth implants move about freely in their pocket and usually have thinner shells than their textured counterparts. The thinner shell allows smooth implants to feel more natural. Implants with smooth surfaces are also less likely to ripple. Textured implants were designed to lower the risk of capsular contracture, but this has not been proven. One type of implant shape — known as the anatomical or tear-shaped implant — is only available with a textured surface, because this surface helps keep these contoured implants in position. What´s more, textured breast implants may take longer to drop into a more natural position than smooth implants, resulting in breasts that appear higher on the chest. Some of the differences in the implant surface characteristics depend on what they are filled with — saline or silicone gel. Discuss your concerns with your surgeon.

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3. What are the differences between round and contoured breast implants?

Breast implants come in a variety of shapes, but the two major types are round and contoured (also called shaped, anatomical or tear drop). Contoured implants were designed to create a more natural-looking breast shape. They are flatter on top than the bottom, so if the implant rotates, a revision surgery may be needed. Some teardrop implants are textured to avoid this rotation. By contrast, round implants — circular mounds that are flat on the back and round on the front — do not change their shape when you move. It is a matter of taste. If you like and want the rounded, sharper-edged, "Victoria´s Secret" model look, go with round implants. If you're looking for the most natural result, talk to your surgeon about the contoured implant. In the future, a teardrop silicone-gel-filled implant may be available in the U.S.; this will give more fullness in the upper part of the breast and will likely provide a more natural result.

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4. How long do breast implants last?

The Institute of Medicine estimates that breast implants last an average of 16 years. Breast implant manufacturers such as Allergan and Mentor offer conditional guarantees for their implants. Each breast implant is numbered by lot and has a serial number for identification. You will most likely receive the serial number stickers as part of your postoperative information packet. In general, such warrantees protect you in case an implant rupture occurs. They cover the replacement cost of the implant itself, which is only part of the cost of breast augmentation surgery. You may also purchase additional coverage with the implant company.

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5. Can fungus grow in a saline-filled breast implant?

This is an extremely rare occurrence. The saline in saline implants is sterile, and plastic surgeons now employ a closed technique to fill the implant. These efforts help stave off contamination with fungus. In the past, when the implant was filled using an open technique, there were cases of fungal infection. During the open technique, the saline comes in contact with air. The closed technique allows the saline to be injected directly from the bag into the implant without being exposed to air.

If the saline breast implant is sterile when it is inserted, it should not become contaminated within the body.

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6. What are my breast implant options?

The Food and Drug Administration (FDA) has approved both silicone-filled and saline-filled breast implants. Both are basically shaped silicone envelopes that are filled with silicone gel or salt water (saline). Silicone breast implants are filled either with cohesive gel or with "highly" cohesive gel; the latter are sometimes referred to as "gummy bear" implants due to their consistency.

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7. Are silicone-gel-filled breast implants safe?

Yes. Though the Food and Drug Administration (FDA) did remove silicone-filled breast implants from the market in 1992 after lawsuits alleged they increased a woman´s risk of autoimmune and connective tissue diseases, a subsequent FDA investigation could not find any link between silicone breast implants and these diseases. As a result, they re-approved silicone-gel-filled implants in 2006. The FDA issued an interim safety report in 2011 calling these implants relatively safe but stating that they were not meant to last a lifetime. Implant removal or replacement may be needed after 10 years.

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8. How many cubic centimeters make a cup size?

Breast implant volume or size is measured in cubic centimeters (cc).One study found that an average of 189 cc of saline was needed to go up one bra cup size. Increasing an A cup to a C cup required a total of 391 cc, or 196 cc per cup. Moving from a B cup to a D cup required a total of 448 cc, or 224 cc per cup. The largest change, an A cup increasing to a D cup, required 437cc, or 145 cc per cup. Remember, bra cup sizes are not standardized. A Victoria's Secret C is not the same as a Warner's C, for example.

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9. What is overfilling?

Overfilling involves adding more saline to the breast implant than the manufacturer says is the maximum amount. This is only an option with saline breast implants, as they are filled after implantation. Saline implants come in a wide range of sizes, and all of them have both a minimum and maximum fill amount. Overfilling may make the implant feel firmer, but will not affect its size. Overfilling may also increase the risk of deflation, and may void your warranty.

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10. What are expandable breast implants?

Expandable saline-filled breast implants can be adjusted in size by adding more saline through a special valve, or port. Originally, this type of implant was primarily used for women undergoing breast reconstruction after breast cancer surgery, but they may also have a role in cosmetic breast augmentation. Here's how they work: A surgeon uses a syringe to either inject saline into — or draw saline out of — the implants through a port that is placed beneath the skin where the implant was originally inserted. This can allow a woman room to experiment with breast size, without undergoing revision breast augmentation.

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11. Can I get "gummy bear"implants in the United States?

Yes, you can. Two types of highly cohesive gel or "gummy bear" implants are approved by the federal Food and Drug Administration (FDA). These include Sientra's Silimed implants and Allergan's Natrelle 410 breast implant. Both are approved for augmentation in women at least 22 years old and reconstruction in women of any age. A third "gummy" is still under investigation. These implants are made of silicone gel, but the gel has the consistency of a gummy bear, meaning if you cut it in half, it will not leak.

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12. What is the "IDEAL" implant?

The IDEAL implant is a saline-filled breast implant with double shells that offers a more natural look and feel that similar to silicone gel-filled implants. There is no risk of a silent rupture with IDEAL implants, which provides peace of mind. It can be difficult to tell if a silicone-gel filled implant has started to leak, but with saline implants such as IDEAL, it is obvious immediately. The IDEAL implant is FDA-approved for primary breast augmentation or replacement of existing breast implants.

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13. Can breast implants rupture during a mammogram?

Yes, an implant can rupture during mammography. This occurs when the pressure on the breast weakens the implant. The older a breast implant is, the more susceptible it is to trauma. This is not a reason to avoid mammograms. Tell the mammography technician that you have breast implants, and he or she will take special care not to cause a rupture. Please see our Mammogram and More section for more information on this important issue.

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14. What is fat grafting breast augmentation?

Fat grafting breast augmentation (also known as natural breast augmentation) involves taking fat from places in the body where it is plentiful, such as your buttocks or thighs, and implanting it in your breasts. It's a two-step process that involves liposuction to harvest the fat and injections to augment and shape the breasts.

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Breast augmentation with breast implants has become a very popular procedure for women who want to enlarge and reshape their bust lines. This website was developed as a comprehensive consumer resource for all information related to breast enlargement surgery, including details about the cost of breast implants and breast implants before and after pictures.

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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
    10 Chester Avenue
    Second Floor
    White Plains, NY 10601
    (914) 421-0113
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    Bahman Guyuron, MD

    29017 Cedar Road
    Lyndhurst, OH 44124
    440-461-7999
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