Breast Implant Options: An Interview with Dr. Cameron Craven

With so many options, choosing the right breast implant can be an overwhelming part of the breast augmentation surgery process for many patients. Besides deciding on implant size, which alone can be a difficult decision, there are other implant variables like material (silicone or saline), shape, texture and profile. reached out to Dr. Cameron Craven of Austin-based Westlake Dermatology & Cosmetic Surgery for some explanations regarding these general options. Dr. Craven is a board-certified plastic surgeon who serves as an investigator for the Mentor Post-Approval Study for Silicone Gel Breast Implants.

For the sake of our readers, can you tell us how long you’ve been doing breast augmentation procedures and how many (on average) procedures you perform monthly?

I have been performing breast augmentation procedures for approximately 10 years and currently perform 20-30 augmentations per month.

Silicone vs. saline is a common debate. What do you think of each implant type? Which do you prefer?

I prefer silicone implants, which are regarded worldwide as the “gold standard” in implant based breast augmentation and reconstruction. That being said, I recommend saline implants to a handful of patients who are seeking a more firm, projecting upper pole of the breast, and have significant breast tissue and subcutaneous fat to hide the implant. Most patients seeking augmentation, however, have either small breasts, or thin and atrophic tissues which offer poorer coverage of the implant. For this majority of patients, the silicone implant offers the most natural looking, soft feeling implant with a lower rupture rate, and less tendency toward rippling.

What’s your take on the different “profiles” (e.g. moderate, high, and low profile implants)? Are there specific breast implant profiles that work better for specific body types?

I use all available profiles of implants based on the patient’s goals and preoperative measurements. The patient’s goals are paired with a particular style or profile of implant, and her measurements of existing breast tissue and soft tissue dimensions further determine if the goals are realistic and maintainable. Commonly, however, patients with wide chest walls and wide breasts are best served with low or moderate profile implants to avoid unnaturally large implant volumes. Narrower breasted women can really choose whichever profile fits their desired outcome and most frequently they opt for moderate or high profile implants.

Many of our readers have questions about texture. Where do you stand on textured breast implants vs. smooth? Are there specific situations that suite the use of textured vs. smooth?

Both textured and smooth implants are very popular among patients and surgeons. In the United States, smooth implants are more commonly used. Smooth implants can be inserted through a smaller incision than textured implants. Also, smooth implants are able to move around more closely resembling the motion of a natural breast, while oftentimes textured implants have more of a “stuck on” feeling as they are adherent to the surrounding capsule and tissues.

Two common implant shapes are teardrop and round, what impact to the final result does implant shape have?

I find that both round and teardrop shaped implants give similar appearing final results. The shaped implants tend to be more firm feeling than the round implants, however this may also lend itself to less rippling. Shaped implants also require a significantly larger incision. I find shaped implants more necessary in reconstructive patients where creating a certain shape is needed as they have no remaining breast tissue. In a cosmetic augmentation, however, the patient already has a breast shape and simply seeks to enlarge and enhance it. In this case, the softer nature of round implants, lower cost, and the smaller incision make it preferable to most cosmetic augmentation patients.

Cameron Craven, MD, is a board certified plastic surgeon currently practicing at Austin-based Westlake Dermatology & Cosmetic Surgery.

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