Updated September 2018
Your breast implant options may feel overwhelming. Round or anatomical? Saline or silicone? Smooth or textured? What are gummy bear implants, Ideal implants, and adjustable implants? Breast implants are not one size fits all. All the options will provide a fit for every woman, but make it hard for you to decide what is best for you.
Breast implant shapes
There are two options in breast implant shapes: round or anatomical implants.
Round implants are currently the most commonly used implants, for they have the largest available selection and the least expensive. Round implants are available in saline or silicone, smooth or textured, and various projection profiles.
When placed on a flat surface, a rounded implant will have a flat bottom and a domed-shape top. When placed in the body, the round shape will settle into a shape similar to an anatomical implant.
Round implants have the reputation for looking augmented or fake, which is possible depending on the anatomy of the patient, implant choice and implant placement (e.g. over or under the muscle).
Anatomical implants are only available in textured “gummy bear” silicone. Some surgeons and patients refer to this implant as “teardrop” implants because of it’s bottom heavy shape. The implant has more variations in shape; it is customizable by width, height, and projection.
Anatomical implants may require a larger incision because they are shaped and made of a more firm silicone. The anatomical implant does provide some surgical challenges, so it is important to find a surgeon experienced in their placement.
Breast implants: Textured vs. smooth
Breast implants may be textured or smooth.
A textured coating can be found on all anatomical implants, but it is also an available option on round breast implants with saline or silicone. Textured implants were designed to reduce the rate of capsular contracture. Studies conducted to verify this claim show a wide result, so this topic is still currently under debate.
Textured implants are slightly firmer due to a thicker implant shell. They also have a unique complication called traction rippling, where the overlying tissue adheres to the implant shell, pulling the tissue into a wrinkle or ripple.
Smooth implant shells have a thinner shell, which makes them feel softer. They move freely in the breast pocket. Smooth implants are currently the most popular implant used today.
Breast implant types
There are different breast implant types: saline, silicone, and a blend of the two.
Saline implants have a silicone elastomer rubber shell. Most often they come to your surgeon’s office to be surgically placed and then filled with sterile saline solution. Because of this, your surgeon may be able to use a smaller incision. Saline implants are currently approved for use in breast augmentation patients 18 years old or over.
Silicone implants were re-approved for use in breast augmentation patients 22 years old and over in 2006. Current silicone implants are broken down into two categories: cohesive gel and form stable gel (aka gummy bear).
Cohesive silicone gel implants come pre-filled and are the softest and most natural feeling option currently on the market. Each implant brand has their own options for the level of cohesion and softness for their silicone gel. They are available in a round implant with a smooth or textured shell and up to 800cc in size.
Gummy bear implants are a more form stable silicone gel implant. While still soft and natural feeling, they do feel firmer than the cohesive silicone gel. Currently, only Sientra offers a form stable gel implant in a round implant shape, but all brands that offer an anatomical implant use form-stable gel. The form stable silicone gel does require a larger incision. You may see this implant type called gummy bear implants, form stable implants, or highly cohesive gel implants.
Ideal implants are a new addition to the implant market. They are a saline-filled implant that attempts to bridge the gap in softness between traditional saline and silicone gel. This implant uses an inner shell filled with saline to give the implant a shaped structure similar to silicone. There is an outer saline shell that holds additional saline filler. Between the two shells is three baffle shells that are designed to eliminate any sloshing movement of the saline filler. Newly approved by the FDA, the Ideal implant still has limited surgeon reach.
Adjustable implants may also be called expandable implants. The purpose behind this implant type is to allow the implant fill to be adjusted after surgery, allowing the surgeon and patient more control over the final size of the implants. There are several types of adjustable implants, some of which are not meant to be permanently placed. Becker implants have a silicone outer lumen with an adjustable saline inner lumen. They have a significant price difference over traditional implants. Spectrum Adjustable implants are saline only. Most surgeons no longer offer adjustable implants as they are able to correct symmetry issues with the multiple options of silicone and saline implants currently available.