A breast implant is a silicone shell filled with either a saline (salt water) solution or silicone gel. The implant most often used today is saline-filled. Under some conditions, silicone gel implants can be used, but these are mostly used for reconstructive surgery. Because saline is similar in composition to other body fluids, if a saline implant should rupture and leak, the saline solution, which is harmless, is absorbed by the body.
There are round implants and anatomic implants. The anatomic implants may also be described as "teardrop", "anatomical",or "tapered" implants. The tapered implant is sometimes suggested for thinner women because it may result in a more natural-looking upper chest.
The rounded implant gives a fuller upper chest and cleavage. Implants of either type placed behind the muscle may provide a similar appearance.
The outer surface of the implant may be either textured or smooth. Textured implants may help reduce capsule formation around the implant. The evidence is not conclusive. Some surgeons have found that textured implants have more of a tendency to ripple. Advocates of smooth implants claim that they are less likely to cause visible rippling (especially if placed below the pectoral muscle) and are more natural to the touch.
Because there is a lack of evidence supporting the safety of silicone gel-filled implants, the Food & Drug Administration (FDA) restricted their use to primarily reconstructive procedures in approved clinical studies. Some women requiring replacement of existing gel implants may also be eligible to participate in the study. Saline-filled implants are currently under review for both reconstructive and elective purposes.
Adjustable-fill implants allow the implant size to be adjusted after the initial surgery. A self-sealing tube and valve allow the surgeon to add or remove additional fluid to increase or decrease the size, respectively. The valve is often removed surgically and the implants remain at their adjusted size.
An alternative implant filled with a purified form of soybean oil is also being evaluated and it is not known if it will be available for general use.
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