NINA S NAIDU MD., FACS – Plastic and Reconstructive Surgery 1021 Park Avenue, New York, NY 10028 – (212) 452-1230

www.naiduplasticsurgery.com

How to Choose the Right Breast Implant

Choosing the right breast implant is not easy. Make sure that you understand the risks and benefits of breast

implant surgery, and discuss with your doctor your expectations. We have created a list to help you make sure that

all of your questions are answered.

1. Anatomy of the Breast – It is important that you understand the limitations that may exist due to

characteristics of your own breast tissue. No woman has two breasts that match exactly, and therefore

there will still be some asymmetry following augmentation surgery. The right implant is the one that will

balance your goals with what your tissues will safely allow.

2. Implants: Silicone vs. Saline – Both silicone and saline implants are FDA-approved for cosmetic use. Each

type of implant has its own unique benefits and trade-offs:

- Silicone

a. contains a safe, cohesive silicone gel

b. feels more like natural breast tissue

c. requires a slightly larger incision

d. more expensive than saline implants

- Saline

a. contains a salt-water solution

b. feels firmer than silicone

c. higher risk of visible wrinkling and rippling

d. can use a smaller incision

e. lower price than silicone implants

3. Location: Subglandular vs. Submuscular – breast implants can be placed either partially under the

pectoralis muscle (submuscular or dual-plane) or over the muscle and under the breast tissue

(subglandular).

- Subglandular

a. not recommended for thin tissues

b. more visible and palpable implants

c. higher risk of capsular contracture

d. more difficult mammograms

- Submuscular

a. appropriate for thin tissues

b. less visible and palpable implants

c. lower risk of capsular contracture

d. easier mammograms

NINA S NAIDU MD., FACS – Plastic and Reconstructive Surgery 1021 Park Avenue, New York, NY 10028 – (212) 452-1230

www.naiduplasticsurgery.com

4. Implant Size – the best size for a given patient is determined primarily by the patient’s measurements and

tissue characteristics. While your goals and desires are very important, it’s also important you understand

that an implant which is too large for your tissues can create additional complications, including excessive

skin stretch. A specific cup size cannot be guaranteed, as bra cup sizes are not standardized across

manufacturers.

5. Implant Shape – both silicone and saline implants are made in round and teardrop shapes.

- Round implants - most often used in cosmetic breast surgeries.

- Teardrop implants - provide additional fill to the upper portion of the breast and are most often used

in reconstruction surgeries.

6. Implant Texture – The implant’s surface can be smooth or textured.

- Smooth implants - move easily and feel soft.

- Textured implants - have a slightly bumpy feel on the surface. Textured implants do not move as

much within the breast pocket, but they are associated with a higher risk of visible wrinkling.

7. Incision Locations – there are three commonly used incision locations: within the breast fold (infra-

mammary), around the nipple (peri-areolar) and under the arm (transaxillary).

- Infra-mammary – affords the best visualization of your tissues and is well-concealed; lower risk of

difficulty breast feeding.

- Peri-areolar – also well-concealed, but it may be associated with a higher risk of infection and of

difficulty breast feeding.

- Transaxillary- incision is within the armpit; may be visible in some types of clothing; there is a risk of

injuring important nerves and vessels in the arm; very difficult to place larger silicone implants

through this incision.

8. Risks – as with any other surgery, breast augmentation carries risks and benefits. Some of the risks

associated with breast augmentation include:

- Rupture

- Capsular contracture

- Scarring

- Asymmetry

- Wrinkling

- Implant displacement

- Change in nipple and breast sensation

- Infection

- Possible breastfeeding difficulty

9. Additional Procedures – in some cases implants alone may not be sufficient to address all of

your concerns, such as sagging or extra skin. A breast lift is sometimes recommended at the

time of breast augmentation.

NINA S NAIDU MD., FACS – Plastic and Reconstructive Surgery 1021 Park Avenue, New York, NY 10028 – (212) 452-1230

www.naiduplasticsurgery.com

10. Board Certification – make sure your doctor is board certified by the American Board of Plastic

Surgery – board certified plastic surgeons complete a minimum of 5 years of surgical training

following medical school, including a plastic surgery residency. State laws permit any licensed

physician to call him- or herself a “plastic” or “cosmetic” surgeon, even if he or she has not been

trained as a plastic surgeon or has had no surgical training at all – be sure to select your doctor

carefully.

For more information about breast implants:

Additional sources of information about the use and safety of saline and silicone breast implants can be

found online at the following sites:

Nina S. Naidu, MD, FACS: http://www.naiduplasticsurgery.com

Natrelle: http://www.natrelle.com

Breast Implant Follow-Up Studies (BIFS): http://www.bifs.us

Breast Implant Answers: http://www.breastimplantanswers.com

American Society of Plastic Surgeons: http://www.plasticsurgery.org

Food and Drug Administration: http://www.fda.gov/cdrh/breastimplants

Institute of Medicine Report on the Safety of Silicone Implants: http://www.nap.edu/catalog/9618.html