What You Need to Know About Breast Implants

Reviewed by Michael Olding, MD, FACS

Breast implants give you more control over your size, shape, and profile. Implant plastic surgery can improve appearance after aging and childbearing and can restore a more youthful appearance.

(Note that sagging breasts require a breast lift, which can be performed with or without implants.)

In breast augmentation with implants (augmentation mammoplasty), the implants are inserted behind breast tissue or above the breast muscle. Implants range in volume from 120 mL (milliliters) to 850 mL. You can view examples in our breast augmentation before-and-after photos.

In addition to the volume range, implants vary in shape, profile, outer thickness, and outer surface layer.

Read more about implant anatomy.

Silicone Implants

Some women feel that silicone implants are smoother and softer than saline-filled implants. These implants feel like a semisolid gel. Because of their smooth surface, silicone implants are often preferable for women who have little breast tissue, particularly for women undergoing breast reconstruction.

The U.S. Food and Drug Administration (FDA) removed silicone implants from the general consumer market in 1992 as a precautionary measure over conflicting reports of possible complications. However, they were reapproved in 2005. (Read more about implants and the FDA.) Some new types of implants are under development, including silicone implants, that attempt to simulate the smooth feel of the breast.

Options under development include cohesive silicone gel implants — also called "gummy bear" implants — and saline implants that allow implant volume to be adjusted after surgery. Cohesive implants are currently under FDA review. They are claimed to hold their shape better than saline or older silicone gel implants and look and feel more natural. The gummy consistency decreases the likelihood of rippling and should provide greater safety because, being more solid, the silicone will tend not to escape from the shell if it were to rupture.

Breast Implant Placement

Breast implants are placed in the breast in one of three different ways:

• Subglandular implant placement
• Partial submuscular implant placement
• Complete submuscular implant placement

These placements vary from shallow (subglandular) to deep (complete submuscular). The optimum implant location depends on the size of the breast implants, your anatomy, and other factors related to your goals and expectations.

Breast Implant Incisions

Implants are inserted behind the breast tissue or above the breast muscle through incisions carefully placed by the surgeon. Because breast augmentation is performed for aesthetic reasons, the incisions are made in locations designed to be as inconspicuous as possible after surgery. Four main types of incisions are used for breast augmentation surgery.

• Areola (periareolar incision or nipple incision)
• Transaxillary (transax or armpit incision)
• Crease (inframammary fold incision)
• Belly-button (transumbilical, navel, or TUBA incision)

Talk to a board-certified plastic surgeon to find the best options for your individual needs and condition.

[page updated June 2008]