Breast implant: A guide for breast enlargement

Breast implant: A guide for breast enlargement

Hasan Kobat

Written by Hasan Kobat on 18 Jan 2023

Breast augmentation or in other words breast enlargement is one of the most popular aesthetic procedures, worldwide. Advancements in medical research and technology resulted in significant improvements in the field of cosmetic surgery. Having a range of information before breast enlargement surgery is significant. 

This article aims to provide detailed information about the ones who are planning to undergo breast enlargement surgery. This guide helps you to gain evidence-based information about different types of breast implants, choose the right size and also information to consider before, during and after the surgery.

Who needs breast implants?

The use of breast implants for enlarging breasts is the most popular technique among women and is used for aesthetic and reconstructive purposes. Women who think their breasts are smaller in size or suffered from a disease that resulted in losing the breasts such as breast cancer are the two major populations who receive breast implants.

Today, 300,000 women (1) in the USA undergo breast enlargement every year. According to the American Society of Plastic Surgeons (2), women who lost their breasts and underwent a breast reconstructive operation are over 100,000 and 80% of them ended up with breast implants.

Evolution of breast implants

The history of breast enlargement goes back to 1895. In this patient's case, fatty tissue from the back of the patient was transferred to the breast of the women patient who lost her breast due to a disease.

The most well-known history of the “breast implant” was used in the 1930s (3). A “glass ball” was used as a breast implant.

The 1960s was the first-time use of “alloplastic materials” as a breast implant. “Teflon” was first started to be used in the 1960s. These implants resulted in discomfort and caused many complications. Because of the body's reactions and rigidity, they are no longer used.

The 1960s was the first time that “silicone gel implants” started to be used but these first-generation silicone gel implants had increased rates of complications. “Capsular contracture” is a body reaction to substances placed inside the body that reduced compliance and cause discomfort. The rate of capsular contracture was the major complication and was reported to be seen in nearly 70% (4) of the women with first-generation breast implants. Women who experience capsular contracture reported increased firmness and a change in the shape of the breast implant which also caused painful outcomes.

At present, fourth and fifth-generation silicon and saline implants are in use. The disadvantages of these are quite less when compared to their older generation products.

Who is producing breast implants today?

Today, breast implants are manufactured by three different companies in the USA. Sientra, Allergan and Mentor are the most frequently known manufacturers of breast implants.

Motiva, one of the breast implant producer companies, is a popular manufacturer of breast implants. The reason that makes them popular is their increased durability and also a significant feature: Motiva implants can transfer information about breast implants via radio waves that enable doctors to check the status of the implant. This feature makes Motiva one of the most popular companies worldwide.

What are the pros and cons of silicon and saline breast implants?

There is no doubt that both procedures are FDA-approved (5) but they have slight differences. The outermost layer of the saline implants is made up of silicon but it is filled with sterile saline whereas silicone gel implants are 100% silicon. The below list demonstrates the advantages and disadvantages of silicone and saline breast implants.

  • Advantages of saline breast implants: The advantage of a saline breast implant is that it is inserted from a small hole in the breast and is filled with sterile saline from the port.
  • Disadvantages of saline breast implants: Uncontrolled filling or overfilling can cause the hardening of the implant. Underfilling may cause a break or in other words "rupture" of the implant. Adaptation to environmental changes is challenging such as women with a saline implant may feel cold after swimming. The rates of breaks on the surface are higher than in silicone implants.
  • Advantages of silicon breast implants: Adaptation to environmental changes is better with a silicone implant. Physical visibility mimics the natural breast.
  • Disadvantages of silicon breast implants: Silicone implants are more expensive than saline implants. In the case of a rupture, it is hard to find out and a patient may be exposed to silicon for a long time.

What is the difference between “textured surface” and “smooth surface” breast implants?

Textured and smooth surface breast implants are different. Textured breast implants reduce the risk of the formation of a capsule and it is more stabilised to anatomical shape or in other words “teardrop” and decrease the risk of unwanted rotation.

Smooth surface implants were made by soaking the breast implant in liquid silicon several times. Body response to an external substance which is the definition of “capsular contracture” is less frequently developed in textured surface silicones and a need for subsequent surgery is less.

What is the difference between “round shape” and “anatomical shape” breast implants?

Round shape silicones are round in shape whereas anatomical shape breast implants are more similar to the natural anatomy of women. It is also called “teardrop”. Within the public, the term “looks natural” are more obtained with anatomical shape silicones. However, nearly 95% (6) of the people in the USA use “round shape” breast implants.

Which size of the breast implant is the most suitable one?

The answer to this question is simple. It “depends”. There are many factors that should be considered when choosing the correct type and size of breast implant.

The weight, height and body shape of the patient are the primary factors for determining the right silicon.

As a general rule of thumb:

The most appropriate breast implant selection process should include a comprehensive investigation of the factors below.

  • Breast shape
  • Elasticity of the skin
  • Dimension and volume
  • Thickness of the soft tissue
  • Weight
  • Height
  • Overall body type
  • Base diameter
  • Silicone volume

Things to consider before breast implant surgery

  1. Technology is getting more and more developed. A patient who is thinking to undergo breast implant surgery should ask for a real-time demonstration of the silicon within a bra. This will help patients to see what their breasts will look like after surgery. This is the most important factor in the decision-making process and minimises dissatisfaction.
  2. The selection of the breast implant should also be based on computerised software findings. There is software showing the appropriate breast implant in regard to clinical measurements of a particular patient. Another way of searching for the best-fit breast implant can be obtained via Mentor’s breast implant simulator.
  3. Every surgery has a risk of infection to some extent. Infection may also occur after the surgery. Your doctor most probably will prescribe you an antibiotic before the surgery to reduce the infection risk.

Things to consider during breast implant surgery

Generally, many patients are going back home on the same day of the surgery. Some centers require 24-hour follow-up but it mostly depends on patient outcomes and surgeon decisions. General anaesthesia is the most appropriate type for breast implant surgery.

Things to consider after breast implant surgery

  • Patients are encouraged to walk and do their daily routine tasks but with caution.
  • Wearing a “surgical bra” for six weeks (7) is the most important recommendation after the operation.
  • Although it depends on patient outcomes 1 to 2 weeks after the surgery is generally enough time to go back to work.
  • Taking a bath is allowed 24 to 48 hours after the surgery.
  • Patients should avoid using an underwire bra because it will reduce the healing process.
  • Patients can expect to be seen by their plastic surgeons a week after the surgery.

Conclusion

Currently, the satisfaction rates of patients with breast implants are between 85 to 95% (8). The decision of breast implant surgery needs comprehensive investigation. In this article, we provide the names of the manufacturers, types of breast implants, and factors affecting the size selection as well as things to consider before, during and after surgery. There are many unreliable and fake practices internationally. Patients should always check the membership of plastic surgeons beforehand.