• Kinds of implants

    • Breast Augmentation
    • Kinds of implants
Contents of implants

Saline bag

  • By prohibition of the FDA, USA, it became impossible to use silicone gel implants from the early 1990s. As a result, the use of saline bag implants grew rapidly and now it is the most widely used type of implant in the world. One disadvantage of saline bags is that it lacks a real breast feel due to weaker viscosity than silicone gel. Because the filler is a saline solution, it is relatively safe if implants rupture, and another advantage is that it can be performed through a small incision.

Cohesive gel

  • It is a kind of silicone gel; it has cohesive and shape memory properties like buckwheat jelly, so it does not leak out when it is ruptured. It was developed by an American company called INAMED in 1993, and its greatest strength is that it has a natural feeling.
    Implants developed by Mentor and McGhan (INAMED) were approved by the U.S. FDA in Nov 2006, and are used legally with official permission from many countries such as the U.S.A., Europe, and Japan etc. Recently, in Korea, the products of these two companies were approved as official import items by the KFDA on the date of July 19, 2007. So this turning point has allowed patients to get better surgical results due to a wider range of selection.
    Though the shell of the implants around the gel gets worn out, the contents do not leak, so the size of breasts stays the same. It is recommended to get an MRI every two years to check the degree of abrasion of the shell of the implants.

Silicon gel

  • It was developed in the early 1960s, and with it breast augmentation surgery, but due to FDA sanctions in the late 1980s, its use was discontinued. After many years of research, it was reapproved for use in 1996 and now it is used in many places throughout the world such as all of Europe, like France, and Canada. However, it did not receive approval in the USA and Korea, among other countries, so it was impossible to use. Only after the approval of cohesive gel in 2007, was it possible to use again. In addition, contrary to common knowledge, nothing was revealed about the maleficence of silicone gel. In the USA, after sufficient reason was provided by a medical team, it became possible to perform surgery with the consent of the patient. Silicon gel implants are also used on breast cancer patients.

Double-lumen implants

  • Double-lumen implants have another saline bag inside the outer silicon or saline solution bag. The inner saline bag is connected to a valve (port) through a pipe. Implants are inserted in the breasts of patients, and a valve is inserted under the skin of the armpit making it possible to change the shape and size of breasts after surgery by controlling the amount of saline solution through the valve. Between the inner saline bag and outer shell is a thin silicon gel which is designed not to spread throughout the human body or a saline solution of fixed amount, so it retains the soft feeling.
    The defining characteristic of these implants is the ability to control the volume of breasts freely after surgery on account of the fact that the saline solution can be inserted externally with a syringe by using the valve connected to the inner saline bag. It is possible to have natural looking and feeling breasts through tissue augmentation for a certain period by controlling the amount of saline solution inserted. To remove the valve, a second surgery is required, and there is a risk of contaminating the space where the implants are inserted.

Classification according to shape

Round shape

  • Since the shape is round, it looks natural when you are lying down. However, when standing, the round shape could seem unnatural but it generally starts to look more natural after surgery due to the effect of gravity. Especially in cases where the upper part of the breasts starts to disappear due to aging, or most of cases to form no breast at all , it is very useful.

Tear drop shape

  • The tear drop is the most similar to the actual shape of breasts when standing, and has the advantage of giving the bottom of the breasts a full look. Due to this structure, it is easy to make a natural curve, and has the effect of buffering the bulginess of the upper part of the breast, and it is easy to augment sagging breasts with a lower nipple point. However, in some cases it does not spread evenly when lying down, so it could seem a little unnatural. Therefore, the surgery needs to be precise and physique analysis thorough before surgery. It has a harder feeling than round shaped implants. Tear drop shaped implants are useful in cases where the upper breast tissue has more volume while the lower breast tissue is insufficient, for under developed breasts, and for correction of sagging breasts.

Classification according to quality of surface

Smooth surface

  • Implants with a smooth surface are sleek and have a good feeling and have the advantage of minimizing any scar. In addition, it is possible to rectify problems easily when they arise. However, in theory, a capsula is formed, so there is a possibility of capsular contracture that makes the breasts hard. So massaging is required to prevent capsular contracture after surgery. In addition, sagging in the direction of gravity may occur as time passes after surgery, so maintenance is necessary.

Textured surface

  • Implants with a textured surface are coarse, so tissue is placed on the surface and grown, which prevents capsular contracture and fixes the placement of implants. This reduces any change in the appearance of the breasts due to movement of location of implants in the body after surgery, and there is no need to massage the breasts in theory. Furthermore, there is a low occurrence ratio of capsular contracture. On the downside, in cases where cohesive implants are used, there is a limitation in the size of implants by armpit incision, so it is better to consider surgery through the nipple or fold under the breast. Also, they may feel uncomfortable compared to implants with a smooth surface. However, this type of implant would be necessary in the case that there is a higher risk that the implants may move due to problems with chest frame.

Projected degree of implants

Determining size of implants

  • Though all implants are essentially the same, they can be divided into high, moderate and low profile types. High profile types have a small area and a high projected degree while low profile types have a big area and low projected degree, and moderate profile types are in the middle. The size of implants is selected by properly determining the shape of breasts and size of chest.
Classification according to size
  • Implants come in various sizes from very small (50~100cc) to very big (700~800cc). The size of implants would be selected by determining the size of existing breasts, preference of individual, area of chest, height and weight. For Asians, a size between 200~300cc is general recommended.
  • Determination of size – Let’s consider long-term satisfaction rather than temporary satisfaction.
  • The bigger the implant, the bigger the breast, and a bigger breast causes the skin to loosen more. Consequently, a bigger breast may result in sagging that causes the upper part of the breast to empty out with age. Breast augmentation surgery prevents sagging that occurs naturally in non-augmented breasts, but if the implants are too big, then it may cause more sagging with age.
  • Then what is the proper size? The answer lies in the following two factors.
    • Ratio between the whole body and size of breasts
    • Ratio between the whole body and size of breasts
  • Optima plastic surgery clinic usually recommends an increase of about 2-cup sizes. In most cases any desired size is achievable, but breast size should be balanced with height or the size of hips. Also, the skin of every woman can be increased only to a certain degree. If it is increased too much, skin can be damaged and sagging may occur for it is impossible to support the breast. Subcutaneous tissue would be over-expanded, causing it to become thin and to shrink, so there is need to be more careful. In addition, to use bigger implants may cause existing breast tissue to shrink and the risk of sensory nerve damage could increase.
  • “I want my breasts to look very glamorous”
  • There are many patients who want bigger implants when they became applied to current implants due to increase tissue. However, there are few patients who worry about the results when bigger implants are inserted.
    Even if big implants are inserted, it is impossible to maintain the robustness of the upper part of the breast forever. As time passes and aging progresses, the skin under the breasts start to loosen, so they start to sag and the robustness of the upper part of the breasts slowly disappears. The bigger the implants are, the faster breasts start to sag and with more severity. On top of which, the boundary of implants or the wrinkles that are made by the fold become more visible and breast tissue starts to thin which increases the risk of losing sensation. Finally, the risk of removing the implants also increases.
    Is it a risk worth taking? Or is it better to have a balanced body?
  • How about the feel of breasts after surgery?
  • Breasts after surgery have a similar feel to actual breasts, but they cannot feel exactly the same as real breasts. If you want your breasts to feel natural, it is best not to get breast augmentation surgery.
  • The factors to determine feel are as follows:
    • Degree of mammary gland or fat, muscle – thin individuals without flesh to cover implants may be left with a bad feel.
    • Kinds of implants – saline solution implants have less of a real feel than silicone and cohesive gel.
    • Size – generally, using bigger implants would reduce the real feel of breasts.
    • Shell of implants – textured surface has less of a real feel than smooth surface.