Types of breast implants: filling, shape and placement

If you’re thinking about breast augmentation with implants, you can already find a lot of information online about your options. Yet we often hear that incorrect information is also provided, and it is quite possible that you can’t see the forest for the trees. Therefore, we’d like to inform you about the placement of breast prostheses (also called implants). What are the pros and cons of different implants and why isn’t the same solution always the best?

Different brands of breast implants

Well-known brands of breast implants are Motiva, Mentor, Allergan/Natrelle, Eurosilicone, Nagor, Polytech and B-lite. Brands can differ from each other in terms of quality, filling (silicone, saline or hydrogel), shape, size and surface (rough or smooth). In choosing Motiva and B-Lite, the plastic surgeons at MOOI Clinic did extensive research on the various providers. Naturally, all brands meet the legal requirements, but at MOOI Clinic, quality and safety are paramount when choosing Motiva implants. It is also important that the implants feel soft and natural and produce beautiful results.

Shapes: Anatomical, round or ergonomic breast implants

First, let’s start with the shape of the implant, as this is important for choosing the implant placement (in front or behind the pectoral muscle). There are round and so-called anatomical or tear-drop shaped implants.

Drop implants (anatomical)

Tear-drop breast implants, as the name suggests, have a droplet shape and therefore look more like the shape of a breast. These implants have advantages and disadvantages. The advantage is that, this implant is less noticeable when placed in front of the pectoral muscle. In this case, you do need sufficient “coverage.” That means you should not be too thin and already have some breast tissue so that the implant is not too visible. After breast augmentation, your breasts still look very natural. Another advantage is that you can sometimes achieve a small lift with a drop-shaped implant. One disadvantage of anatomical implants is that they can rotate, and then the shape of the breast can start to look odd. Another surgery may then be required. Another disadvantage is that with an anatomical implant there will be less padding at the top of the breast, which is sometimes clearly desired.

Round breast implants

Round implants also have some advantages and disadvantages. The advantage is that if they turn this is not a problem. Another benefit is more padding at the top of the chest (and cleavage). The disadvantage of round implants is that if you place them in front of the pectoral muscle they are more visible. This is why round implants are usually placed behind the pectoral muscle. By placing them behind the pectoral muscle, the muscle presses slightly on the top of the implant and it naturally becomes more drop-shaped already. Placement behind the pectoral muscle, by the way, has a number of advantages but more on that later.

Ergonomix implants

There have been some developments. Recently there has been the so-called ergonomix implants. These are implants that change shape depending on whether you’re lying down or standing. When standing, they become more drop-shaped and when lying down they become more round. So the advantage of anatomical is combined with the advantage of round. At MOOI, we use these types of implants too!

Volume and profile

In addition to the shape of the implant, there is also a choice in the size, base and profile that must be made to achieve the desired result. The volume or size of the implant is usually given in number of ‘cc’. For example, breast augmentation with 200 or 300 cc. In addition, of course, there are smaller and larger volumes and everything in between such as 185cc or 410 cc.

For round implants and ergonomix, there are still different profiles. The profile is the distance of the implant from the chest wall and determines the fullness of the breast. The profiles can be low, medium, high or extra high. An average profile implant of 300 cc with a diameter of, say, 11.5 cm has a height of 3.9 cm, while the same amount of filling of 300 cc in a high profile has a height or projection of 4.9 cm.

Breast prostheses: smooth or textured

The shell of an implant is usually made of silicone. This shell can be smooth or more rough. Recently, there has been much discussion in the media about smooth and roughened implants. Roughened implants are widely used because they may have fewer complications such as capsular formation (scar tissue around the implant that can become painful). There is a very rare form of lymphoma (ALCL) that occurs (1 in. 12,000 in women in their 70s) that is more common with implants. There are suggestions that this disease has to do with how rough the implants are and therefore smooth implants would be better. However, there is no scientific evidence for this. By the way, there are all kinds of variations in the degree of smoothness. MOOI uses prosthetics that are so finely roughened that they are considered smooth. The idea is that the advantages of smooth and rough are thus combined. By the way, there is another shell that consists of a type of foam (polyurethane). This grows completely attached to the body. Again, there are specific advantages and disadvantages. The plastic surgeon will discuss which implant is best for you.

Filling: silicone gel or saline

There are basically two types of fillings currently on the market namely silicone, where nowadays this is always a silicone gel and saline implants. Silicone feels more natural than saline-filled implants. A third type of hydrogel implants were taken off the market for a time due to lack of CE certification but have recently returned to the market. Hydrogel implants have received virtually no scientific study. In the Netherlands and also worldwide, most breast implants used are filled with silicone. Each of the fillings has its own advantages and disadvantages which, if you wish, we will be happy to explain to you during the consultation.

B-lite implants

The demand for B-lite implants is increasing because these breast implants have a major advantage over normal implants, namely their weight. B-lite implants are up to 30% lighter than other breast implants. In B-lite implants, microspheres are bonded with silicone gel. Microspheres are strong and hollow, which makes them super light. B-Lite breast implants are manufactured in Germany and are CE approved. At MOOI Clinic, you can also opt for these implants.

Example: an implant consisting of 100% silicone of 390cc weighs 390 grams. A 390cc B-lite prosthesis weighs only 275 grams.

Placement: in front or behind the pectoral muscle?

When deciding whether to place implants in front or behind the pectoral muscle, the choice of implant (round or anatomical) plays an important role as described above. There is evidence that placing the implant behind the pectoral muscle is less likely to result in capsular contracture, but is often slightly more sensitive than an implant in front of the muscle during the first few weeks. A disadvantage of breast muscle implants is that the implant is not stopped by the breast muscle, and the breasts may droop more quickly as a result. However, the procedure is slightly less sensitive immediately after surgery and can sometimes give a better breast lift.

Dual plane

There is often talk about dual plane on all kinds of forums and sites. This is a confusing term with several definitions. When we talk about behind the pectoral muscle we always mean dual plane in breast augmentation, because the muscle only covers part of the implant. Sometimes by dual plane what is meant is that when an implant is placed behind the pectoral muscle, the mammary gland of the pectoral muscle is also exposed anyway, but there are specific reasons for that which are beyond the information being provided here.

Implant insertion and scarring

A breast implant can be inserted through a number of ways. A small incision is always made to insert the implant. This incision is usually made under the breast, right in the breast crease, making it less noticeable. Alternatives are through the nipple or armpit, but this depends on the choice of implant type and position of the implant.

In summary, breast augmentation is an important decision and not something you do lightly. In this blog, I have highlighted only one aspect of the operation. Also, for example, the size (the number of cc’s) depends a lot on what a person wants. Therefore, some kind of estimation using test implants can be done during the consultation. I hope it’s clear that every breast augmentation is customized and the best advice can be given after a consultation and examination in your specific situation.

Should breast implants be replaced?

Breast implants are not routinely replaced. Complaints may involve leakage or capsule formation, in which case replacement or removal is usually necessary. No implant is guaranteed to last a lifetime, and if an implant is chosen, additional costs in the future must be considered if an implant needs to be changed.

Risks and complications

Getting breast implants is an informed decision. It’s good to know that there are risks associated with any surgical procedure and there’s a chance of complications, like with breast augmentation. Most of the complications are not serious and are easily treatable. MOOI Clinic is happy to inform you properly and fully about breast augmentation surgery and also about the possible risks. For a complete overview, read the NVPC’s Surgical Package Leaflet. We also always give this package insert after a breast consultation.

Also read more about the risks and possible complications here.