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, FACS Plastic and Reconstructive Surgery

1021 Park Avenue, New York, NY 10028 (212) 452-1230

How to Choose the Right Breast Implant

Choosing the right breast implant is not easy. Make sure that you understand the risks and benefits of breast
implant surgery, and discuss with your doctor your expectations. We have created a list to help you make sure that
all of your questions are answered.
1. Anatomy of the Breast It is important that you understand the limitations that may exist due to
characteristics of your own breast tissue. No woman has two breasts that match exactly, and therefore
there will still be some asymmetry following augmentation surgery. The right implant is the one that will
balance your goals with what your tissues will safely allow.

2. Implants: Silicone vs. Saline Both silicone and saline implants are FDA-approved for cosmetic use. Each
type of implant has its own unique benefits and trade-offs:
- Silicone
a. contains a safe, cohesive silicone gel
b. feels more like natural breast tissue
c. requires a slightly larger incision
d. more expensive than saline implants
- Saline
a. contains a salt-water solution
b. feels firmer than silicone
c. higher risk of visible wrinkling and rippling
d. can use a smaller incision
e. lower price than silicone implants

3. Location: Subglandular vs. Submuscular breast implants can be placed either partially under the
pectoralis muscle (submuscular or dual-plane) or over the muscle and under the breast tissue
- Subglandular
a. not recommended for thin tissues
b. more visible and palpable implants
c. higher risk of capsular contracture
d. more difficult mammograms
- Submuscular
a. appropriate for thin tissues
b. less visible and palpable implants
c. lower risk of capsular contracture
d. easier mammograms

NINA S NAIDU MD., FACS Plastic and Reconstructive Surgery
1021 Park Avenue, New York, NY 10028 (212) 452-1230

4. Implant Size the best size for a given patient is determined primarily by the patients measurements and
tissue characteristics. While your goals and desires are very important, its also important you understand
that an implant which is too large for your tissues can create additional complications, including excessive
skin stretch. A specific cup size cannot be guaranteed, as bra cup sizes are not standardized across

5. Implant Shape both silicone and saline implants are made in round and teardrop shapes.
- Round implants - most often used in cosmetic breast surgeries.
- Teardrop implants - provide additional fill to the upper portion of the breast and are most often used
in reconstruction surgeries.

6. Implant Texture The implants surface can be smooth or textured.
- Smooth implants - move easily and feel soft.
- Textured implants - have a slightly bumpy feel on the surface. Textured implants do not move as
much within the breast pocket, but they are associated with a higher risk of visible wrinkling.

7. Incision Locations there are three commonly used incision locations: within the breast fold (infra-
mammary), around the nipple (peri-areolar) and under the arm (transaxillary).
- Infra-mammary affords the best visualization of your tissues and is well-concealed; lower risk of
difficulty breast feeding.
- Peri-areolar also well-concealed, but it may be associated with a higher risk of infection and of
difficulty breast feeding.
- Transaxillary- incision is within the armpit; may be visible in some types of clothing; there is a risk of
injuring important nerves and vessels in the arm; very difficult to place larger silicone implants
through this incision.

8. Risks as with any other surgery, breast augmentation carries risks and benefits. Some of the risks
associated with breast augmentation include:
- Rupture
- Capsular contracture
- Scarring
- Asymmetry
- Wrinkling
- Implant displacement
- Change in nipple and breast sensation
- Infection
- Possible breastfeeding difficulty

9. Additional Procedures in some cases implants alone may not be sufficient to address all of
your concerns, such as sagging or extra skin. A breast lift is sometimes recommended at the
time of breast augmentation.

NINA S NAIDU MD., FACS Plastic and Reconstructive Surgery
1021 Park Avenue, New York, NY 10028 (212) 452-1230

10. Board Certification make sure your doctor is board certified by the American Board of Plastic
Surgery board certified plastic surgeons complete a minimum of 5 years of surgical training
following medical school, including a plastic surgery residency. State laws permit any licensed
physician to call him- or herself a plastic or cosmetic surgeon, even if he or she has not been
trained as a plastic surgeon or has had no surgical training at all be sure to select your doctor

For more information about breast implants:
Additional sources of information about the use and safety of saline and silicone breast implants can be
found online at the following sites:
Nina S. Naidu, MD, FACS:
Breast Implant Follow-Up Studies (BIFS):
Breast Implant Answers:
American Society of Plastic Surgeons:
Food and Drug Administration:
Institute of Medicine Report on the Safety of Silicone Implants: