Question: Dear Dr. Cappuccino, can you explain about the different kinds of breast implants? Also is it true they are placed below the chest muscles?

Answer: Today there are multiple types of breast implants available from several manufacturers, so the options are many. First off, breast implants can be used for both cosmetic breast enhancement as well as breast reconstruction following a mastectomy or congenital defects. Implants come with different fill materials, different shapes, and different outer shell coatings.

Fill materials: Breast implants are broadly divided into either saline or silicone. Both materials are contained within a silicone outer shell. Silicone implants tend to feel softer and more natural. Both saline and silicone implants are equally safe and both are FDA approved devices.

Silicone implants can be round or anatomically shaped. Round implants have different profiles for any given volume. Lower profile implants provide a more modest appearance while high profile implants create a fuller more projected appearance. Anatomically shaped implants, often called “gummy bear” implants are the newest type of implant available in the United States. Anatomic implants maintain their shape inside the body. These implants also come in a variety of profiles and different widths for a given volume, allowing the ultimate flexibility in choosing the final breast appearance.

Finally, implants can have a smooth or a textured outer shell. This really depends on the type of implant and where the surgeon plans on placing the device.

Surgical positioning of the implant can be above the chest muscles (sub-glandular), below the muscle covering (sub-fascial), or below the chest muscles (sub-muscular). There are many variations of these techniques depending on the patient’s anatomy, lifestyle, and surgical goals. Some variation of sub-muscular placement is most common in this country.

With the myriad choices in breast implants and surgical options, I spend almost 2 hours with each new breast augmentation consultation, personally explaining the options and helping them understand the procedure. We even have a sizing kit that allows prospective patients the ability to see what different size implants would look like on their body.

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