Breast augmentation remains the most popular plastic surgery procedure. Every year hundreds of thousands of women opt to have the appearance of their breasts changed, usually enlarged with implants. Often, women will ask,”What is the right breast implant for me?” Veteran plastic surgeon Dr. Pat McGuire explains the different products and procedures and how to determine what is the best breast implant for you. One thing is clear: never before has breast augmentation been able to be tailored so tightly to a patients’ unique situations.
Saline vs Silicone
It’s important to understand the choices when considering a breast augmentation, according to Dr. McGuire, a board certified plastic surgeon in St. Louis, Missouri. “There’s a lot of options now for implants and it can be very confusing because there is saline or silicone and it really does have a lot to do with the anatomy and what the final goal should be,” she says.
The first step is to decide if a saline or silicone implant is the right pick. McGuire says some of her patients are happy with saline implants, but she doesn’t think they feel as natural or last as long as silicone gel implants. “The gel implants are silicone shells on the outside and they are filled with the silicone gel.”
McGuire says the product has changed in the 25 years that she’s been in practice. She says in the early 90’s, when the product was pulled from the market, the gel was more like oil. “When the implants were brought back in 2006, they were upgraded with much stronger shells and the gel is more like jello now,” McGuire explains.
What About Gummy Bear?
McGuire says there is another option women can consider for an even higher consistency gel. “These are referred to as ‘gummy bear implants’ and it’s a highly cohesive gel implant,” she explains. She says they are available in both shaped – and now round – implants for patients who want a firmer look. “Those are for women who want more upper pole fill and a rounder implant, so they don’t mind a little bit firmer gel.”
There is a mid-ranger option for patients who want a full look, but a softer feel. “For patients who want a softer gel, but still want fullness, there’s now what’s called a ‘soft touch gel’,” says McGuire. She describes it as a cohesive gel implant without as much volume. “It’s a softer feel to the breast and it doesn’t have as much fill in the upper pole, so it’s a nice in-between.”
Picking A Size
Breast implants come in many different sizes and each patient will have to decide what is the right fit for her body and lifestyle, according to Dr. McGuire. “As far as size, that’s also a personal decision and each woman will have to make that choice based on a consultation with her plastic surgeon.”
McGuire says she uses various factors to arrive at the right size, including patient measurements and 3-dimensional (3D) imaging. “The 3-dimensional (3D) imaging is used to determine size and then we also discuss goals and what implant her tissues will work best with long term,” she shares. Dr. McGuire says it can be helpful to bring in pictures of breasts, but usually it is to rule out what WON’T work. “It will often tell me if someone has unrealistic expectations and that’s good to know.”
McGuire says she has plenty of ‘before and after’ books in her office that help patients decide on their goal for the breast augmentation. “I do have before and after books in my breast augmentation consultation room, and I tell the patients that is not a catalog. You don’t get to pick a look that you want from those books, but it does give me an idea what you want or don’t want and we can compare your anatomy to those patients.” McGuire says unlike a decade ago, most patient today opt for a smaller, more natural look. “We have seen a downward trend in the size of implants, which is a good thing because that look will last longer for a patient.
In general, women are choosing smaller breast implants and the trend of ‘bigger is better’ is fading away, according to McGuire. She sees it as a trend that will produce positive health benefits down the line. “As our bodies change you don’t want an implant that is too big as you get older.” It isn’t uncommon to second guess the size of your implant, but most women settle into their choice and grow to love their new look.
“I always tell my patients, six months after surgery you will wish you were bigger, but five years later, you will realize how smart you are because the breast will still look good long term.”