Breast Implant Review from Dr. Adam Tattelbaum :

Allergan, Mentor or Sientra? Saline or silicone gel ? Textured or smooth? Shaped or round, cohesive or gummy bear? And that’s just the beginning. In this brief blog I will try to share some thinking and philosophy about the “too many” options we now have with breast implants.

If you read my last breast blog (silicone or saline) you know that I prefer silicone gel, provided the patient is comfortable with it. If you have a B-ish or C-ish breast you will hide a saline well, but silicone will usually look and feel more natural, particularly if you are starting with minimal breast tissue.

Three manufacturers are currently FDA approved to sell breast implants in the United States.  All make silicone gel implants, Allergan (formerly Inamed) and Mentor also make saline.  If you ask each company they will assure you that their product is best.  In my opinion, they all make excellent products and because they are all FDA approved they have gone through extensive testing. While I offer them all to my patients, I always recommend that the patients go with the brand their surgeon is most comfortable with.  We are just starting to offer Sientra—they are the new kid on the block, recently approved for use.

Textured or rough surface implants were created to minimize the risk of capsular contracture. The idea is that the rough surface breaks up the scar tissue. While evidence supports this for implants placed above the pectoral muscle, submuscular placement (which I prefer) does not benefit as much from texturing. I don’t like textured implants. I think they are more noticeable under the breast and the breast does not move as naturally.

Some implants are shaped, such as teardrop or oval. In order to maintain their position in the body these implants must be textured so that they stick inside the breast pocket. Occasionally they fail to stick and will rotate into an abnormal position. I think shaped implants are a good option for breast reconstruction when trying to match another breast, but I don’t favor them for cosmetic augmentation. I prefer a smooth round implant. If a round implant rotates around in the pocket it will not affect the appearance of the breast.

All currently available silicone implants have a cohesive (sticky) gel.  This means that the gel is most likely to stay put in the event of an implant leak or rupture. The gummy bear implant has the most cohesive gel, but as of this writing is not yet FDA approved or available. Even when available it is being brought out only as a shaped and heavily textured implant and will most likely find a home in reconstruction more than cosmetic breast augmentation.

If you are reading this then you are eager to hear the details. I encourage you to come in so that I can answer any further questions you may have.