What are Breast Implants?

Breast implants are artificial implants used to enhance the shape and size of the chest. Breast implants come in three main varieties known as saline, silicone and cohesive gel. Breast implants are used during breast augmentation, revision, and reconstruction. Breast implants are considered safe; due to a long and successful track record, providing patients with several years of enhancement.

Before & After

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Types of Implants

Silicone Implants

Silicone implants have a more natural feel due to the viscous quality of the silicone, which mimics breast tissue. Any leakage is difficult to detect, as silicone is not absorbed, and the breast volume remains unchanged. An MRI may be needed to detect any silent leakage. Because they come pre-filled with silicone, they require a somewhat larger incision, typically beneath the breasts or through the areola. There are no valves or openings to adjust the volume or size of the implant. Currently, one must be at least 22 years old to receive silicone implants.

Saline Breast Implants

Saline Implants (saltwater) are popular because they are considered safe. In the event of leakage, the saltwater content will absorb naturally into the body. The change in volume will be immediately noticeable. These implants require only a small incision, as the saltwater filling is added only after the implants are in position.

The implant volume can be adjusted at the time of surgery to balance any unevenness in the breasts. Saline Implants have a tendency to form ripples from the folding of the implant shell. Due to the fluid movement of saltwater, they may feel less natural than silicone implants. Saline implants are typically positioned beneath the muscle to soften and conceal the implant outline.

Dr. Shienbaum and his staff are amazing and so caring! I was so pleased with my results and how quickly I felt back to normal! Would recommend to anyone!”


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Implant Shape

Breast implants come in different shapes and contours. Low profile or moderate implants are typically underfilled to achieve a softer more pliable contour. Medium Profile or moderate plus implants are designed to have greater height and firmness where the increased projection is desired. High profile implants afford maximum projection and shape retention but may appear somewhat round and projecting.

How do I determine my breast implant size?

To provide a fuller appreciation of each implant’s potential effects, our office offers special implant sizers. When placed in soft, loosely-paneled sports bras that mimic the natural response of breast tissues, and covered by a thin camisole top, this breast sizer system allows a very popular visual clue to the anticipated results. The breast implant should be no wider than your existing breast. One can select a slightly larger implant for Submuscular placement to account for the flattening tendency of the overlying muscle. Over time, normal atrophy of the breast tissues, as well as compression by the implants, will result in an apparent loss of size and a somewhat smaller outcome.

What bra size will I be after breast augmentation?

Bras are measured in two dimensions– the cup size and the body circumference around the rib cage. Implants are volumetrically sized in CCs or cubic centimeters. It takes approximately 200 CCs to create one full cup bra size increase. Because of differing bra styles and manufacturer patterns, the dimensions of a particular cup size are not necessarily uniform. Some women may prefer a tight and revealing cup while others desire full cup coverage. Plastic surgeons are therefore reluctant to predict a particular cup size after augmentation.

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Implant Placement

Placing implants behind the muscle (Submuscular) will provide the additional coverage to conceal and soften the outline of the underlying implants. This is essential in small-breasted women with thin tissues. This muscular coverage helps conceal the potential ripples and folds inherent in saline (salt water) implants. However, muscle activation in athletic or muscular women can produce implant movement and contour changes. In the event that the patient has an adequate amount of breast tissue of their own, implants can be placed over the muscle. This allows the implants to stay true to shape. However, implants over the muscles will be prone to more natural movement.


Stretch marks are caused by very rapid stretching, breakdown, and separation of the underlying dermal layers. Often, it is associated with hormonal changes and a genetic predisposition. While it is quite possible to have stretch marks after breast augmentation, it is unusual. Usually, the breast stretch marks occur when other body striae are present before the actual breast implants.

The feel of your implants will depend on the type of implant selected, placement above or over the muscle, the thickness of your existing breast tissues, and the type of capsule formed by your body. Silicone implants will feel more like your normal breast fat, and the anatomical-shaped, thick silicone gel implants will feel firmer. Over-the-muscle placement will have more normal pliability, especially if you have a soft capsule and some natural breast tissue of your own. The smaller the implant chosen, the less noticeable it becomes, and textured implants can feel overly stiff and immobile. Many women are satisfied with a large variety of breast implant choices.

Loose and deflated breasts with minimal sag or ptosis are ideal candidates for breast implants. Simply restoring the breasts to their original volume will give the immediate result. Whether from weight loss, breastfeeding, pregnancy, or the aging process, breast implants can provide a return of the natural shape, projection, and fullness of the breasts.

The chest wall is not flat but is cylindrically shaped with curved ribs and outwardly pointed breasts. A prominent breastbone (pigeon breast) will accentuate this outward effect while an indented or sunken breastbone (pectus excavatum) will allow for deeper cleavage but with somewhat inwardly pointing breasts. Deviating from the natural contour lines of the breast by overly releasing the normal skin or muscle attachments at the midline can lead to less than desirable results. Implants must be centered under the nipple complex– positioning the implants closer to the center midline can result in outwardly pointing nipples. Overly thick breast and chest wall tissues will conceal the contour enhancements provided by implants. Thin skin and breast tissues will often require muscular coverage to pad and soften the breast outlines. Adding larger volume implants will not necessarily correct many cleavage issues.

Cleavage after breast implants depends on many factors, including the structure and shape of the chest wall, the relative position of the nipples, the thickness of the surrounding breast tissues, and the type and size of implants used. Some women request maximum projection combined with the tight cleavage produced with push-up bras or crossing one’s arms. If your breasts are widely separated, either from a broad or prominent breastbone (sternum) or outwardly positioned nipples, this type of cleavage will be difficult to achieve. Altering the normal breast boundaries by sliding the implant closer together under the thin skin of the sternum can result in both palpable or visible rippling at the cleavage line.