IMPLANTS

SILICONE
I will review everything you need to know about silicone implants in this section. First it is important to know that all implants are made with an outer covering, or shell, made of silicone. It's what is inside that shell that matters. In the case of silicone implants, the inside is filled with a thick "jello" like form of medical grade silicone. 
 
Silicone implants are categorized according to three features. This includes the texture of the outer shell (smooth vs textured), the style or shape of the implant, and the amount of silicone it can hold (its volume). Each one will be discussed here. 
SILICONE IMPLANTS

The first category is the texture. Implants can have a surface that is smooth or textured. Smooth silicone implants have a surface that feel smooth like a balloon. This is, by far, the most commonly used type of silicone implants. Textured silicone implants, on the other hand, have a surface with a rougher texture. Some people have described it as feeling like fine sandpaper and others have described it as having a velvety feel. These implants have microscopic bumps on the surface which give it a textured feel. 

 

TEXTURE

Textured implants were created in an attempt to reduce the chance of capsular contracture, which is hardening of the scar around the implant. Some studies have shown that it does decrease the risk of capsular contracture. Other studies show that it does not. At the moment, there is no definitive proof that textured implants reduce the risk of capsular contracture.

 

One disadvantage of textured implants is that it can cause visible rippling and dimpling on the surface of the breast skin. The textured surface may cause a stronger attachment to the under surface of the breast skin resulting in these visible irregularities. Given this risk, and given the fact that is has not been proven to decrease capsular contracture, fewer surgeons choose to use textured silicone implants than smooth silicone implants.

A smooth silicone implant (back) and a textured

silicone implant (front). 

STYLE (SHAPE)
Silicone implants can be further categorized by their style. This refers to the shape of the implant. Silicone implants come in a variety of shapes and each one was designed to achieve a slightly different type of result. These shapes include a low profile, moderate plus profile, high profile, extra high profile, and a "shaped" or anatomic profile. The low profile implants are usually called "moderate" profile. 

The picture above will explain the significance of the different shapes. These are the 4 basic shapes of implants (the anatomic shape implant will be discussed in a separate section). Every implant has a measurement for its diameter (how wide it is), projection (how much it "sticks out"), and the volume (its size or how much saline it holds in cc's.) These are listed in the columns under the picture of each implant. If you look at the first column for each implant above, you will notice that the diameter, or width, of the implants are all very similar. They are 12.2, 11.9, 12.0 and 11.9 cm. respectively. These widths only vary by about 0.3 cm (or 3 mm) which is negligible. So, it is fair to say that these 4 implants are all basically the same width. 

 

Although the implants are all the same width, you can clearly see that they are very different from one another. What makes them so different? It is their shape. If you look at the other two columns under each picture, you will see measurements listed for the implant's projection and its volume. If you look carefully at these columns, you will see that as the profile increases, the projection and the volume increases. In fact, the volume increases tremendously from 270 cc for the low profile implant to 500 cc for the high profile implant, even though the width stays the same! You can also see that the implant gets much rounder as the profile increases. In summary, the higher the profile of the implant, the more volume it can hold in the same width and the rounder it becomes. 

 

Why is this important? The reason it is important is because each of these implants was designed to create a slightly different kind of result. A low profile implant (also called a moderate profile implant) will create a wider breast with a small amount of extra projection. This implant style is rarely used. The moderate plus profile, on the other hand, is the most common implant used. This is because it tends to create a very natural breast augmentation result. The gentle curvature of the implant tends to create a "tear drop" shape to the breast when a woman is standing. This is considered a natural result. The high profile implant tends to create a very round shape to the breast. This is a good implant for someone who wants maximum size and roundness. This tends to be less natural looking than the moderate plus profile implant. The extra high profile is rarely used. It creates an exaggerated result and causes tremendous pressure on the breast skin and on the rib cage below the muscle. It is not routinely recommended. 

As mentioned above, each implant style or shape was created to give a certain kind of result. Moderate profile (low), moderate plus, high and extra high have been discussed. There is another option available. It is called the highly cohesive, shaped silicone gel implant. It's also known as the "Gummy Bear" implant. 

The shaped silicone implant has has a tear drop shape built into it. That is, it is thinner at the top and fuller at the bottom. This is also called an anatomic shape. This is the shape of a beautiful and natural female breast. 

These implants vary in the height (or how "tall" the implant is from the bottom of the breast to the top of the breast), the projection (how much it sticks out from your chest), and the volume (or size). The height can come in F (Full height), M (moderate height) and L (low height). The projection can be L (low projection), M (moderate projection), F (full projection) or X (for extra projecton). All of these options also come in different volumes or sizes. Therefore, the surgeon has at least 12 different options for any given size. 

Shaped (Anatomic) Silcone Implant

Shaped silicone implants come in a variety of heights, projections and sizes. This allows the surgeon greater control over the shape of the breast.

ADVANTAGES AND DISADVANTAGES
VOLUME

​Implants are also categorized by their volume. Volume refers to how much saline (salt water) the implant contains. Saline implants are empty when they are packaged into sterile containers for delivery. They are filled with saline only after being opened in the operating room during surgery. 

 

The amount of saline the implant can contain is measured in cc's, which is the same as milliliters (ml). Implants do not come in cup sizes. That is why there is no way to say how many cc's you need to be a certain cup size bra. The amount of cc's you need to be a certain cup size will vary depending on many factors such as your height, weight, how much breast tissue you have to begin with, the current width of each of your breasts and the style or shape of implant you choose. 

 

Each saline implant can be filled within a range of cc's. The range usually varies by about 30-50 cc. For example, a 350 cc moderate plus profile saline implant made by one manufacturer can be filled anywhere from 350 cc's to 380 cc's. Every implant can be filled to a minimal amount and a maximal amount. If, for example, the 350 cc implant is filled to 350 cc's, then it is said to be filled to it's "minimal" amount. If an implant is filled more than it's minimal amount, it is said to be "overfilled." If it is filled to 380 cc's, then it is said to be filled to its "maximal" amount. An implant should never be filled more than it's maximal amount. 

 

Although there is no conversion of cc's to cup sizes, there are some general guidelines. During your consultation, Dr. Diaz will review all implant size options and will describe in detail how many cc's you will need to achieve your desired result. In addition, he will use the Vectra 3D System to show you what each implant size will look like on you specifically.  

In this video, Dr. Diaz shows what happens to a silicone implant if it ruptures. This implant was purposely cut as an example. The silicone inside the implant does not leak or spill out of the implant shell. 

Silicone implants have several advantages. They tend to feel softer and more natural than saline implants. They also have less rippling than saline implants. More importantly, if the implant ruptures, the "jello" like silicone inside the implant does not "leak" out as it did in the older generation of silicone implants. Click on the video to see this. Thus, these new silicone implants are considered extremely safe. One potential disadvantages is the cost. Silicone implants ar more expensive than saline implants and thus the cost of surgery may be higher with these implants than with saline implants. 

ADVANTAGES AND DISADVANTAGES
SUMMARY

In summary, all implants can be organized into several categories. The surface of the implant can be smooth or textured. Implants come in a variety of styles or shapes. These include the moderate (low) profile, the moderate plus profile, the high profile and the extra high profile. Implants also come in a shaped profile. Each style or shape was designed to create a specific kind of result. Implants also come in a range of volumes, measured in cc. All implants have their specific advantages and disadvantages. 

 

The implant you choose will depend on many factors. During your consultation with Dr. Diaz, he will guide you step by step through the entire process in order to help you pick the implant which will give you the result you desire.