BACKGROUND: Breast implants come in all shapes and sizes

Jan 5, 2012, 13:07 GMT

Berlin - Choosing a breast implant isn't just about size - women opting for breast augmentation surgery today have a far greater choice of materials, shapes, textures and procedures than they did 20 years ago.

While most implants are round, which means they can rotate within the breast without causing any change to the shape, 'teardrop' implants are also available.

Teardrop implants are meant to mimic the slope of a natural breast more naturally - but if they move around they can end up looking like 'a horizontal loaf of bread,' according to one Los Angeles surgeon.

Round implants will always have a smooth surface, while teardrop implants are textured, which helps them to stay put. The texturing means they are firmer, can be more easily felt, and are prone to cause wrinkling.

However, many surgeons believe they are less likely to cause capsular contraction - when the body reacts badly to the implant and the layer of tissue which develops around the implants tightens, causing pain, discomfort, hardening of the breasts and distortion.

Women also have a choice between saline or silicone fillings, which are more expensive.

Saline implants can be filled during the operation to give the surgeon more control over the size. If they tear, the liquid is absorbed by the body while the breast simply deflates.

Silicone fillings are generally thought to provide a more natural feel and shape. But, if the contents leak into the body, it is harder to notice, since the gel collects in the breast. That can cause pain and distortion.

Women must also decide whether they want the implant inserted above or below the muscle - factors deciding this include: the risk of capsular contraction; how much breast tissue is already there; and the amount of exercise a woman takes.

They also have a choice of where the incision to insert the implant is made - at the breast crease, the areola, the armpit or even the naval, according to the type of implant and how much scarring the woman is prepared to accept.

But implants are not for life. Many women - 20 to 40 per cent according to one US study - will have to go through further surgery within the first 10 years after the initial procedure because the inserts have torn; leaked; become distorted or uneven; or because of the effects of weight change.