Breast Implant Choices. 7 Options for Implant Surgery


Implant Fill, Size, Texture, Shape, Projection, Placement and Incision

One of the biggest decisions you’ll make about Breast Augmentation or Breast Implant Surgery is the type of breast implant you want to use.

  • In Australia, the most popular breast implants used by specialist plastic surgeons are the respected brands, Mentor Implants and Motiva implants.
  • The most popular breast implant choice for patients and Surgeons is high-grade Silicone implants.
  • Most surgeons are using round, smooth or micro-textured implants
  • Most popular implant sizes are around 300ml to 400ml

Things to consider when choosing the best breast implants

  • your existing physique and skin tissues
  • if you’re very thin or athletic – whether you have adequate body fat for coverage of the implant
  • skin condition/elasticity and resiliency (will it hold an implant or do you need a breast lift along with your breast implants to get the rounded, uplifted breast shape you’re wanting?)
  • what you’re aiming for in terms of augmentation and cleavage results. Another thing to consider is what the breast implants are made of in terms of the outer casing (shell) and internal contents (fill).
  • All modern breast implants have a rubberised-type of silicone outer shell, no matter what fill material is used.
  • So even a saline implant DOES have silicone in its casing or shell.
  • The shell of a breast implant may be SMOOTH or it might have varying grades of texturing.
  • It may have micro-texturing or a different form of textured surface (sometimes called ‘velcro-like’)
  • Texturing is often used in teardrop implants to help the implant adhere to surrounding tissues so that it doesn’t rotate.
  • There are different risks in using different types of implants and some textures may be preferred by your Surgeon.
  • Ask about this during a consultation
  • The internal contents and silicone grades, or firmness and weight, may vary.
  • So, too, can the implant shape (choose from round or teardrop, previously called anatomical).

7 options for your Breast Implants and Surgery

After choosing your Plastic Surgeon, a big step – the next things you’ll consider for your breast implant surgery is:

  1. the type of implant filling – Saline or Silicone
  2. the size of the implant – measured in ml
  3. the texture of the implant – smooth or textured
  4. the shape of the implant – Round or Teardrop (Anatomical)
  5. the projection – low or high profile
  6. the breast implant placement – above the muscle, below the muscle or dual plane (Between the muscle)
  7. the breast implant surgery incision site – under breast IMF, Armpit or other incisions

The following describes these 7 options in more detail.


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1. What is a breast implant made of?

There are primarily two of breast-implant fill material

  • Saline (saltwater) encased in a silicone outer shell and filled at the time of surgery.
  • Medical-grade Silicone gel (e.g, high-quality silicone gel for Mentor or Motiva brands)

Another option is fat transfer or fat grafting, but this tends to only give small increases and many procedures may be required, so it could end up costly with less volume than you’re seeking for your breast enlargement.  Ask Dr Wyten about your options when you attend a no-obligation consultation – she’ll go over the PROS and CONS of different types of implants that will best suit your surgery objectives, current skin/breast tissues, and overall physique.

What’s more popular for Breast Enlargement – Saline or Silicone Breast Implants?

Saline-filled implants gained a bit of popularity about two decades ago. People thought it might be a more natural approach as it used saltwater, but today, most patients and surgeons prefer silicone breast implants for numerous reasons.

So these are the more popular option for Breast Augmentation at the current time, and these can provide give shapely, natural-looking breast results.

A large majority of Specialist Plastic Surgeons in Australia, and patients and Surgeons around the world, are found to predominantly prefer to use SILICONE implants because of their:

  • natural look
  • natural feel including during dynamic movements, impacted by:
    • the size of the implant in relation to a skin condition
    • the breast implant placement/pocket creation
    • implant insertion techniques
  • strength/cohesive gels that aim to prevent leakage
  • not apt to suddenly deflate like a saline implant
  • easier for patients to make proper sizing choices
  • projection is easier to control/predict

Breast Augmentation with Saline or Silicone Implants helps women gain cleavage and greater breast volume. For some women, breast implants help balance out their lower physiques with upper body curves, especially if they have wider hips but little natural breast tissue. Even thin patients and bodybuilders can have natural-looking breast augmentation.

Pros and Cons of Silicone Gel vs Saline Filled Implants

  • Silicone implants have a lower incidence of rippling compared to saline-filled implants due to the consistency of the silicone gel.
  • They are designed to have a more natural feel similar to that of breast tissue and are known to hold their shape better than saline-filled implants.
  • These implants tend not to deflate, but they can rupture in rare instances. Cohesive gel contents in modern implants, such as those by Motiva and Mentor, are designed NOT to migrate if there is a rupture (ruptures are, fortunately, not a frequent occurrence and many women have intact breast implants for many years and decades).
  • If gel-filled implants do leak or rupture, there is an increased risk of capsule contracture or hardening of the breast (see Risks to consider).
  • Ask Dr Wyten about different types of Implants and what she believes will suit YOUR desires and augmentation needs the best in terms of your choices and implant preferences.

A potential problem with Saline Filled Implants – can deflate or ripple

  • Saline-filled implants have a ‘water bed’ like feel, and have been known to cause a ripple effect.
  • If a patient has small amounts of breast tissue, to begin with, the rippling of the tissue can be seen through the skin.
  • These problems can be reduced by using smooth surface round implants that are overfilled (still within the manufacturer’s specifications), resulting in an implant that is firm to the touch. The implants may also look spherical or rounded, which is not necessarily a very natural appearance. If saline implants deflate they do so rapidly, often within a few hours, and the saline solution is easily absorbed by the body.
  • Also, as with all prosthesis, there are other risks or potential issues such as capsular contracture, skin rippling or bottoming out.
  • Discuss these with your surgeon during a consultation.


2. Breast Implant Size. Big or Small?

  • Our implant manufacturers, including Mentor and Motiva, can supply thousands of different implant volumes in various dimensions.
  • Saline-filled implants can be filled after they have been inserted into the breast pocket, while silicone gel-filled implants are manufactured as a whole.
  • Silicone implants are the preferred option for many women and Plastic Surgeons because of their natural look and ‘feel’; as well as other benefits listed above.

You’ll have a wide variety of Breast Implant Size choices and projection options available to you.

Dr Wyten should be able to assist you to select the ideal implant shape and size just for you to attain the volume increases or breast proportions you’re seeking. Remember, however, that results can vary and that size choices should be made thoughtfully and in relation to your skin health, lifestyle, exercise preferences and overall physique.



3. Breast Implant Surface: Smooth or Textured?

Implants can have a smooth surface or a textured surface.

  • Smooth-surfaced implants feel softer than textured surfaced implants and are relatively easy to insert
  • Textured implants reduce the risk of implant movement due to the rough surface allowing surrounding breast tissue to adhere to the implant

4. Breast Implant Shapes – Round Breast Implants or Teardrop Shaped Implants (Anatomical)

Are round implants or Teardrop shaped breast implants better?

The answer is – it depends on numerous factors and that after surgery, you and others may not be able to tell the difference.

  • The shape of implants needs to be considered as well.
  • Implants can vary from manufacturer to manufacturer.
  • They may be available in a round shape or tear-drop shape.

Can you tell what type or shape of the implant was used AFTER surgery – e.g. teardrop or round – by looking at the breasts of surgery patients?

In women who have a moderate amount of breast tissue, it can be difficult to tell whether an augmentation has been performed with either round or anatomically shaped implants.  Even surgeons can’t spot the difference as good results look natural, and breasts also tend to adapt to a natural teardrop shape over time.

  • Often, you cannot tell once the implant has settled into its position.
  • Round implants, a popular option, can leave patients with just as natural-looking results as teardrop implants in many cases, so long as the right Surgical placement approach is used.
  • Skin also has an impact on what your breast tissues CAN or CANNOT handle in terms of size or type.
  • Droopy breast skin may require a breast lift or a combined surgery of a Breast Lift/Breast Augmentation using breast implants (Breast Augmentation Mastopexy).

Anatomical implants must have a textured surface to reduce the amount of implant movement within the breast pocket.  Ask your Surgeon about textural differences and preferences.

Round vs Teardrop Implant Shapes

Round implants are usually available in a smooth or textured surface (Mentor or Motiva).

Teardrop implants HAVE more textured surfaces; ask your Surgeon about the PROS and CONS.

Remember, if a teardrop implant rotates, it might look unnatural or deformed in shape, requiring surgical correction.

  • If a round implant rotates in the breast pocket, it will not tend to affect the breast shape.
  • Whereas, if a teardrop or anatomical breast implant rotates within the breast pocket, it must be repositioned to restore its natural appearance.

5. Breast Implant Projection – low, moderate and high profile

Implant Projection is how much the implant protrudes (or its height when it sits on a table). Your surgeon will work out which profile will get the outcome you desire.


6. Breast Implant Placement Options: The Placement Pocket

Another factor to consider when getting Implants is where your Surgeon will place them in relation to existing breast tissues. There are three common approaches for Breast Implant placement.

  • placing the implant in front of the pectoral muscle
  • behind the pectoral muscle
  • or partially behind the muscle (dual plane).

Each of these methods offers a different type of result, and Dr Wyten will be able to suggest the best-practice Breast Implant approach for your goals, depending on your skin, body composition, existing breast tissues, lifestyle and desired outcomes.

Remember, getting good results depends on a variety of aspects of your surgery. It’s important to plan the surgery carefully but also to follow pre-surgery and post-surgery instructions, not to smoke, but to eat well, rest, not exercise or do too much too early, and to understand the healing and recovery processes and time frames.  These can ALL vary and all surgery has risks.

Submuscular (Implant Placement)

  • Placing the implant underneath the pectoral muscle allows the soft tissue to cover the implant and disguise it, therefore achieving a more natural result.
  • More often a surgeon will recommend placing the implant behind the pectoral muscle.
  • Recovery in the first couple of days is a little more uncomfortable when the implant is placed/located behind your pectoral muscle, but the results over the long term mean you’ll usually get a more natural-looking outcome.
  • This can vary from patient to patient, however, and may depend on what you’re starting with.

Sub-glandular (Implant Placement in front of the muscle)

  • If there is already a good volume of breast tissue present (as determined by pinching up a fold of breast tissue) to hide the defined implant edges, your surgeon may recommend placing the implant in front of the pectoral muscle.
  • This procedure often affords a more comfortable recovery period, and faster procedure time as the muscles are not disturbed during surgery.

Dual Plane Breast Augmentation placement options

  • Partially behind the muscle, is another breast implant placement option you may be discussing with your Surgeon.
  • Ask Dr Wyten what she recommends during a confidential consultation in Hawthorn or in Berwick.

7. Breast Augmentation Incisions and Scars

There are 3 types of breast Implant Incisions, but in modern times, typically only 2 will be used – armpit or IMF – and the inframammary (IMF) incision approach is by far the most common.

  • All incisions will leave a scar.
  • But in patients who experience normal scarring and recovery, they fade over time and are usually inconspicuous when wearing clothing or when the hands/arms are at rest by the sides (versus raised overhead).
  • Dr Rebecca Wyten will be able to explain the level of scarring visibility for each approach, and a recommend which approach is best for your procedure.
  • Read the breast augmentation scar pages for information if scars after breast surgery are a concern.

1. Periareolar Incision (around the nipple) – is simply not used as much today because of higher risks to breast functions.

  • When it comes to the areola method, the incision is made around the outline of the areola.
  •  The goal is to make the incision in between the dark area of the areola and its surrounding skin, which helps to minimise scar visibility.
  • A disadvantage of the periareolar incision is higher risks of complications such as lost nipple sensation, or being unable to breastfeed (compared to other incision methods).

2. Transaxillary Incision – “Asian Breast Augmentation”

  • This type of incision is made in the armpit fold.
  • It creates a channel from the armpit to the breast so the implant can be placed behind the nipple.
  • The benefit of a Transaxillary Incision is its placement, making the scar virtually invisible as it rests within skin-folds in the armpit area (there WILL be a scar, however, and it may be seen especially in certain positions – it’s just less obvious in the armpit for SOME patients, especially when their arms are by their sides).
  • Women with darker skin that is prone to keloid scarring, or who are wanting to have children and breastfeed after breast augmentation, may be good candidates for this incision type, but it can only be used ONCE for primary surgery (or sometimes it can be used for removal of an implant, by some Surgeons, but not for removal and replacement).
  • There are some added risks to this approach – ask your Surgeon about the PROS and CONS of armpit-area incisions for breast implant placement.
  • Secondary Breast Augmentation or size changes will require an inframammary fold incision.

3. Inframammary Incision – in the breast crease under the breast (inframammary fold or IMF)

  • The most common incision site location for breast augmentation is the crease beneath the breast (inframammary).
  • This provides the most direct access to the implant pocket site and the most reliable approach for achieving a symmetrical result.
  • The scar is usually quite short here, from approximately 2.5-3.5 cm (a short scar) to 4cms or more in length, sometimes longer.
  • Motiva and Mentor brand implants may impact the potential length of your scar, as will existing tissues, prior surgery and insertion preferences/implant sizes.

If there are concerns about a scar in the inframammary fold or if the fold isn’t developed and the scar is likely to be visible, a periareolar approach can be used.

Ask Dr Wyten for more information during a no-obligation consultation, including where the implant is best placed for your breasts, skin, your body composition and your cleavage enhancement/breast augmentation goals.