Choosing the Perfect Breast Implants
All women considering having a Breast Augmentation are primarily concerned with exactly how their breasts will look afterwards. If this applies to you, you are likely asking the following questions with regard to how your ideal breasts might look:
- How big should my breasts be?
- Where on my chest should my breasts sit?
- What shape should my breasts have?
- What should my cleavage look like?
- How pert should my breasts be?
- Where should my scar be hidden?
The definition of ideal breasts is, however, highly subjective – it is based on each individual’s opinion and every woman will have her own unique goals and expectations. While some women want their enhancement to be subtle in order to give a natural look, others wish for a more noticeable or fake look. Neither goal is more correct than the other; there is no right procedure for everyone. In answer to all the above questions, therefore, your procedure can be tailored to achieve a look that meets your realistic expectations and compliments your existing body shape and size.
Preparation is key towards having a beautiful, natural enhancement to your femininity.
Breast Implant Options: Size, Shape, Volume, Texture, Manufacturer
Breast implants are manufactured by different companies in many varieties of content (or filler),base width (diameter), volume, shape and surface texture to suit your individual needs. Choosing the right breast implant and manufacturer is therefore key to a successful breast enhancement surgery. As part of the pre-operative consultation process at the “ ESTET & GYN ” - Clinic of Plastic Surgery and Aesthetic Surgery from Timisoara, Romania, Dr. Mihail COJOCARU, as a Breast Augmentation expert, will use his extensive experience and cosmetic artistry to help you choose the perfect breast implant.
The following factors will each play a role in the decision making process:
- Body shape and size
- Existing (or natural) breast size and shape (breast anatomy)
- Desired look – natural or fake
- Amount of sagging or drooping (ptosis) of existing breasts
- Amount and integrity of natural breast tissue
- Lifestyle and physical activity
During your consultation, Dr. Mihail COJOCARU will measure your chest and breast size, as well as your height and weight. These measurements will be used to recommend the right breast implants to fit your existing proportions, a method known as Dimensional Breast Augmentation. You will also be given an opportunity to look at, feel and try on samples of the various breast implants available to you (known as breast implant sizers). This is the most effective way to determine which breast implants is best for you and what you will look like after your augmentation surgery.
What Profile Should I Choose?
The profile of a breast implant refers to the distance an implant will project forward from your chest wall. A low profile implant is very flat, while a higher profile implant will protrude forward (stick out) from your body and create a more prominent breast. How much do you want your breasts to stand out?
To help you decide which breast implants profile is most appropriate for your body, Dr. Mihail COJOCARU will consider both the existing size and shape of your body and breasts, and the look that you desire. Some women ask for ultra-high profile implants because they aspire for the very bubbly, push-up bra look (the Fake Look). Other women wish to have the very subtle enlargement of a lower profile implant (the Natural Look).
When choosing your breast implants profile, your existing breast width is a key factor. In order to achieve a natural, proportionate appearance, it is important to ensure that the implant is equal to or marginally smaller than your existing breast width. Women with very little existing breast tissue and a narrow chest (described as petite) are therefore often limited to implants that are much smaller than they had imagined their ideal size to be. In such situations, keeping the implant diameter small, but increasing the profile of the implant (i.e., the extent to which the implant protrudes forward), permits the use of a larger size implant without it being too wide for the patient’s frame.
What Size Should I Choose?
The most common and important question among pre-operative Breast Augmentation patients is: “what size should I choose?”. However, choosing a breast implants size is often also the most difficult decision for a patient. It is not unusual for women to spend a lot of time alternating their decision between various sizes, especially since implant sizes do not correspond to traditional bra cup sizes. Breast implant size is instead measured based on volume in cubic centimetres (often referred to as cc’s); the larger the implant, the greater both the volume of cc’s and the projection from the chest wall (for a given implant diameter).
By consulting the breast implants volume sizing charts that will be shown to you during your consultation and trying on various sizers (or samples) you will have in-person visualisation of how different implant sizes will affect your shape. When making your decision it is important to consider that larger implant sizes typically give a fake-looking augmentation, may be problematic for women having a more active lifestyle (e.g., participating in sports, jogging and yoga), and are associated with a greater risk of complications, such as bottoming out (an unfavourable downward movement of the implant). Dr Zeuke will also evaluate your existing breast tissue to determine if you have sufficient tissue to cover and hide your chosen implant size. If the size you have chosen is too big,the implant edges may become visible following your surgery.
1. Try, Test and Simulate
In addition to trying on various breast implant sizers, Dr. Mihail COJOCARU will also perform a 3D simulation to give you an idea of what you will look like after surgery. A variety of bras are available for you to use, and if you also bring a tighter fitting t-shirt or top, this will allow you to determine how your breasts might look under clothing. Should you currently have very little existing breast tissue, any size may seem big at first, but you will become quickly accustomed to the new, larger size.
One piece of advice Dr. Mihail COJOCARU gives to all his patients is to find the size that you think suits your body, and then choose a slightly larger size. All breast implants tend to look smaller once they have been placed under your breast tissue. This effect is more pronounced if an implant is placed below the chest muscle (pectoralis muscle). The muscle compression will further shrink the size of the implant and should therefore be taken into consideration when making your decision.
2. Ask Your Friends
If you have any friends who have had a breast enhancement, knowing their breast implant sizes may help you judge what will be best for you based on your respective body proportions. Remember, the higher the number in cc’s, the larger the breast implant (an increase of 150 to 200 cc’s equates to an increase of approximately 1 to 1.5 cup sizes). Bear in mind, however, that every woman’s anatomy is different, and that the results attained by one woman with a given implant size may not necessarily represent the results you will obtain with the same implant size.
3. Look at Photos
When consulting with a Plastic Surgeon, it is wise to take photos of cosmetic results in other patients that approximate your personal goals. For this purpose, there are numerous websites that show Before and After photos of Breast Augmentation patients. During your consultation with Dr. Mihail COJOCARU, you will also be able to look at Before and After photos of previous patients at the “ ESTET & GYN ” - Clinic of Plastic Surgery and Aesthetic Surgery from Timisoara, Romania. By looking through these photos it should give you a better idea of the size and shape you are hoping to achieve.
Should I Go Over The Muscle Or Under The Muscle?
Breast Augmentation involves the creation of a breast pocket that allows for the placement of the breast implant. Implant placement with respect to the chest muscle (pectoralis major) impacts on the shape and position of an augmented breast.
The breast pocket can be made in one of two places: under the breast itself (sub-glandular or sub-mammary), or under the chest muscle (sub-muscular or sub-pectoral). There are advantages and disadvantages for both approaches; a below the muscle placement can also be performed using one of three different variations.
Either approach is appropriate for all patients; each patient, being different, has different requirements and different desires. During the consultation process, Dr. Mihail COJOCARU will first examine your existing breast anatomy and discuss your personal goals with you, before recommending which breast implant placement will be most ideal for you.
Below the Muscle (Sub-Muscular)
The advantages of an implant placement below the chest muscle:
- More natural look
- Less visible implant in the upper breast
- Lower risk of Capsular Contracture (undesirable implant hardening)
- Lower risk of implant bottoming out (unfavorable downward movement)
- Less visible implant rippling/wrinkling (natural folds in the shell of an implant; further information is given here)
- Mammograms are easier to read (which can be beneficial for a woman with a family history of breast cancer)
The disadvantages of an implant placement below the chest muscle:
- More discomfort during post-surgical recovery (this is minimal and should not be used as a determining factor in which approach is used)
- Longer time for breasts to settle down into their optimal position and shape
- implant and breast movement during physical activity (when flexing chest muscles)
Above the Muscle (Sub-Glandular)
The advantages of an implant placement above the chest muscle:
- Less discomfort during post-surgical recovery
- Quicker post-surgical recovery
- Final (optimal) size and shape seen earlier
- More bubbly, rounded (or push-up) look (known as the Fake Look)
The disadvantages of an implant placement above the chest muscle:
- Higher risk of Capsular Contracture
- Higher risk of implant bottoming out
- Implant more visible
- Implant easier to feel
- implant rippling/wrinkling more visible in the upper breast
- Mammograms are harder to read (further information is given here)
What Type of Breast Implant Should I Choose?
In addition to breast width, projection, and volume, the following options are also available and must be chosen accordingly for your Breast Augmentation in order to meet your personal goals and give you the best possible result.
- Implant surface: Smooth or Textured
- Implant shape: Round or Shaped
- Implant content or composition: Silicone (Cohesive gel or Gummy Bear) or Saline
- Implant manufacturer: Allergan,Mentor or Polytech.
During your consultation with Dr. Mihail COJOCARU, you will be able to look at and feel the various types of breast implants to allow you to make a decision based on the feel of the implants.Dr. Mihail COJOCARU will guide you through every step of this process and ensure that you are fully informed on all of the options that are available to you, and the disadvantages and advantages of each.
Smooth or Textured?
The surface of a breast implant (implant shell) can be smooth or textured (rough, Velcro-like). First generation implants were first manufactured using a smooth shell; a textured shell was later developed in an effort to decrease the likelihood of Capsular Contracture (implant hardening).
Textured implants have a thicker shell to compensate for their intentionally rough surface, which has the disadvantage of more visible implant rippling/wrinkling and a harder feel. In order to achieve a better aesthetic result and natural feel, Dr. Mihail COJOCARU therefore prefers to use Smooth implants whenever possible
Round or Shaped?
Breast implants can be Round or Shaped (also known as Teardrop or Anatomic implants). Round implants are symmetric, while Shaped implants have more volume and projection on the lower half, therefore creating a teardrop shape. A teardrop shape gives a more natural look; however, in our experience, most women prefer the fullness of a Round implant.
Dr. Mihail COJOCARU uses Shaped implants only for Breast Reconstruction in cancer patients when the recreation of a natural breast shape is important. For women who have Breast Augmentation for purely cosmetic reasons and already have a natural looking breast, exaggerating the teardrop effect with a Shaped implant does not create a sexy, full breast look.
Silicone or Saline?
Saline and silicone implants both have advantages, and both types of implants can produce excellent Breast Augmentation results.
Saline breast implants are comprised of a silicone shell that is filled at the time of surgery with saline (salt water). Since the silicone shell can be inserted into the breast area and then filled with saline once inside, saline implants require a smaller incision than silicone gel implants and can be customised. Virtually any volume of saline can be added to moderate the required implant profile and size, and the right and left breast implants can be filled differently to adjust for any mild asymmetry in existing breast volume.
The main disadvantage of saline implants, however, is that they feel less like natural breast tissue and are more prone to rippling/wrinkling than silicone (silicone implants also ripple, but not as prominently as saline implants). Over-filled saline implants have less rippling, but feel more firm.
Silicone breast implants feel and look more natural than saline implants and are available in pre-existing sizes (it is not possible to adjust their size during surgery). They have a solid silicone shell and a cohesive silicone gel filling. The density or thickness of the silicone fill, although more similar to that of natural breast tissue than saline, can be varied to give softer (more prone to rippling) to harder (less prone to rippling) implants (such as Cohesive gel implants as compared to Gummy Bear implants).
The two main FDA-approved manufacturers of breast implants are Allergan,Mentor and Polytech ; implants from both manufacturers are available at our clinic.
Allergan and Mentor and Polytech ,have years of research experience and a high safety standard. A wide range of reliable and durable silicone and saline implants that vary by implant density, profile, shape and/or texture are available from each manufacturer.
Silimed Round and Shaped Breast Implants were approved by the FDA on 9th March 2012. The first non-USA company to receive approval for silicone gel filled breast implants and the world’s first company to obtain approval for shaped silicone implants. Also present in over 60 countries and 5 continents, Silimed holds ISO 9001-2008 and EN 13485 certificates, as well as Good Manufacturing Practices from ANVISA and GMP, approved by the FDA. Its products bear the CE Mark and are approved by the principle regulatory agencies worldwide. Silimed produces highest Quality breast implants.
A five-year, multi-center, prospective study for the FDA Pre-Market Approval (PMA) for the Silimed textured and smooth breast implants was published in October 2012 in the American PRS journal. This study demonstrates for the first time the reduction of common complications in breast surgery (capsular contracture) by using Silimed textured surface implants verses smooth surface implants – from 10% over 5 years, to 3%.
Since Silimed were established in 1978, they have had a long history of making an excellent range of silicone breast implants. Silimed presents the widest range of breast implants in the market, all designed with the assistance of world leading plastic surgeons. They are made of a low-bleed silicone elastomer envelope filled with a biodesign high performance, form stable medical grade silicone gel, able to reproduce the soft tissues of the area intended. Presented in three surfaces, with over 31 design styles, many which are unique to Silimed and over 600 sizes. Silimed breast implants are a Grade III CE Marked product and Silimed are keen to work in accordance with the EU Guidelines on vigilance system for CE-marked medical devices (VG03 – August 2006).
Silimed has perfected a form-stable silicone gel which is highly crosslinked. The major advantage of this gel is the resistance to shape change, low bleed and the avoidance to knuckle fold or cause misshapen even under extreme events. Silimed use Medical Grade Silicone from Applied Silicone Corp (USA) in all there silicone breast implant devices.
Silimed are unique, in that they are the only leading supplier of breast implants, with a long history and with a proven and published track record, that produce implants with 3 surfaces.
Silimed Product Replacement Programme (PRP)
All Silimed breast implants are made to the highest standards and subject to vigorous testing and quality inspection. All Silimed breast implants are supplied with a patient passport that should be given to the patient for safe keeping after surgery. The card should be fixed with one of the unique product identity stickers contained in the box, so that the details of the implant are available to the patient (order code and size and unique serial number – S/N).
In addition, the Silimed PRP is available to all patients with Silimed breast implants. The replacement covers any loss of integrity or damage to the shell of the breast implant for the lifetime of the patient. In addition, patients who receive Polyurethane surface implants for primary procedures are also able to receive a replacement implant for other causes, such as Capsular Contraction and unwarranted movement, rotation, downward or lateral displacement, for 10 years post initial surgery.