Kent V. Hasen, MD: Aesthetic Plastic Surgery & Med Spa of Naples
3699 Airport Pulling Road North
Naples, FL 34105
Phone: (239) 262-5662
Monday-Friday: 9 a.m.–5 p.m.
Breast Implant Options
Board-certified plastic surgeon and breast augmentation specialist Kent V. Hasen, M.D. offers his patients a variety of options when it comes to choosing breast implants at his practice in Naples. Women from Fort Myers, Bonita Springs, and Marco Island, FL, and surrounding cities appreciate having the latest choices in saline and silicone implants, as well as flexibility in implant size and placement.
Breast Implant Fill Options
Implants can be filled with either sterile saline solution or silicone gel material. Dr. Hasen offers only FDA-approved implants including the smooth surface Natrelle® INSPIRA® SoftTouch and INSPIRA® Cohesive (sometimes referred to as “gummy bear” implants) silicone gel implants and the innovative Ideal Implant® for patients who want the latest in saline implant technology. There are benefits and drawbacks for each implant fill type.
The Ideal Implant is a recent advancement in saline implant technology. It was created by a plastic surgeon who wanted to make an implant with the benefits of a silicone implant without the associated drawbacks. The Ideal Implant is considered a structured saline implant because it has several shells within the outer shell. These nested inner shells act as baffles to limit the flow of saline through the implant. This is similar to the difference between the original waterbed and the newer waveless waterbeds which also use baffles to limit water flow. The Ideal Implant is FDA-approved and has lower rupture and capsular contracture rates than silicone gel implants. Ideal Implants have a natural feel and look, without the risk of silent rupture or the need for future MRI scans.
- Advantages: There is less palpability, wrinkling and ridging of the implant over saline filled implants. For this reason, silicone implants feel and look more natural. Additionally, they can be placed in a more superficial plane (i.e., under the breast, but above the muscle) without the same issues of visibility as saline breast implants.
- Drawbacks: They have higher rates of capsular contracture and implant rupture, they present a risk of silent rupture, and they require larger incisions since they are pre-filled. With silicone implants, it’s also harder to detect implant shell ruptures.
Ideal Implant (Structured Saline Implant)
- Advantages: The main advantages of the Ideal Implant (structured saline breast implants) are that they can be placed through a smaller incision, the size can be adjusted intra-operatively, they have lower complication rates of capsular contracture and ruptures are very obvious since they are filled with sterile saline solution.
- Drawbacks: Unlike the original saline implant, the Ideal Implant feels much more like a silicone implant than a saline implant. The Ideal Implant only has slightly more palpability than silicone and slightly higher chances of showing wrinkling and rippling. Many people feel that those drawbacks are a small price to pay for the added piece of mind of not having silicone gel implants in their body.
Breast Implant Shape
Dr. Hasen offers round and shaped silicone implants or the structured saline Ideal Implant. These implants are similar to the sizers that you can try on at the time of your breast augmentation consult to help you figure out the size that will provide the results you desire. Gummy bear implants are popular with women who want the most natural appearance without visible rounding of the upper part of the breast. The goal of breast augmentation is an end result that improves the appearance of your breasts with better shape and proportions that helps improve your self-image.
Can Breast Implants Be Combined with Other Procedures?
For additional body contouring, many women combine their breast augmentation with a tummy tuck for a Mommy Makeover. You can also slim down areas of stubborn fat with the help of liposuction. Additionally, patients who are unhappy with the size or projection of their nipples, especially after breast feeding, can have a nipple reduction at the time of the breast augmentation.
If you need correction after your initial breast augmentation, Dr. Hasen can help. Learn about your options for breast implant revision.
How to Choose the Right Implant Size
There is no perfect way to choose the size of the implants for your desires. A 300 cc breast implant will look very different on someone who is 5′ 0″ with no breast tissue than someone who is 5′ 10″ with a full B cup. Dr. Hasen uses many measurements of the breast including breast width and other factors to choose an appropriately sized implant. For each breast width, there are 3 different options of projection of the implant to give less or more implant size. Additionally, Dr. Hasen has used preoperative sizing with sample silicone breast implants you can place in a sports bra to get an idea of how the implant would look in clothes.
Dr. Hasen offers VECTRA® 3D patient imaging system, which enables you to see the outcome of breast augmentation surgery — on your body — before the operation. This computer simulation lets you experiment with breast implants of different types and sizes to find the one that best suits you. Dr. Hasen enables you to view the “new you” from any angle and easily compare before and after, side by side for a better understanding (see photo).
Breast Implant Placement Options
Implants can be placed either above the chest muscle (the pectoralis major) called a subglandular placement or under the chest muscle called a submuscular placement. Dr. Hasen also offers a combination pocket called subfascial, which places the implant below the fascia (the thick coating over the muscle) but still above the chest muscle. Dr. Hasen will consider the type of implant you choose, the amount of existing breast tissue you have, your lifestyle, and other factors when recommending the best implant placement for you.
|Submuscular||Subfascial and Subglandular|
|Better implant coverage||Reduced pain at the time of surgery|
|Reduced rippling/wrinkling||No motion with contraction of chest muscle|
|Initial pain after surgery||May impair mammography|
|Implant motion with contraction of chest muscle||Possibly more visible rippling|
|Better implant coverage|
|Initial pain after surgery|
|Implant motion with contraction of chest muscle|
|Reduced pain at the time of surgery|
|No motion with contraction of chest muscle|
|May impair mammography|
|Not suitable for saline implants|
Under the Muscle (Submuscular)
When an implant is placed under the pectoralis muscle, it mainly helps hide the implant edges in the top and medial aspect of the breast. Because the muscle is fan-shaped, it does not cover the implant’s outside edge. Furthermore, the bottom of the implant is not covered by the muscle either because the lower edge of the muscle has to be lifted off the underlying rib during the surgery to allow the implant to sit low enough. Thus, the problem areas of palpability and skin wrinkling or rippling in cases of implant placement under the muscle usually occur on the side and/or the bottom of the breast. The main drawbacks of placing the implant under the muscle are the initial pain after surgery and variable degree of motion of the implant and breast that occurs with contraction of the chest muscle that can be quite bothersome to patients.
Above the Muscle (Subglandular or Subfascial)
Placing implants above the muscle allows for less pain at the time of the surgery and no motion with contraction of the chest muscle. In the subglandular pocket, only silicone implants are suitable. However, in the subfascial pocket, the Ideal Implant (structured saline) can be placed with excellent results because of the added coverage at the top of the pocket. Dr. Hasen is able to provide beautiful, natural-looking breast augmentation results using this placement.
The FDA warns that placement of the implant above the muscle may impair mammography more than below the muscle. Many mammographers and plastic surgeons contend this point. Many radiologists feel that the biggest limiting factor to getting reliable mammography with implants is the presence of a capsular contracture regardless of the breast implant being above or below the chest muscle. Mammography in patients with significant capsular contracture of the implants is difficult because the firm implant and capsule are adherent to the breast tissue and do not allow for displacement of breast away from the implant for the mammogram. In smooth round silicone gel implants, data suggests that placement above the muscle has a higher capsular contracture rate compared with placement under the chest muscle.1
If you’re pursuing breast augmentation, you have other options, too. Dr. Hasen offers nipple reduction, a simple procedure that can easily be incorporated into breast augmentation surgery. View real before‐and‐after photos of some past nipple reduction patients to understand what’s possible.
1 Maxwell GP, Van Natta BW, Bengtson BP, Murphy DK, Ten-year results from the Natrelle 410 anatomical form-stable silicone breast implant core study., Aesthet Surg J. 2015 Feb;35(2):145-55. doi: 10.1093/asj/sju084. https://www.ncbi.nlm.nih.gov/pubmed/25717116