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.
Implants can be filled with either saline solution or silicone gel material. The FDA approved the use of moderately cohesive silicone gel filled breast implants in November 2006. In February 2013, the Natrelle® 410 (sometimes referred to as “gummy bear” implants) highly cohesive gel implant received FDA approval. Other highly cohesive silicone implant brands include Sientra® and Mentor®. There are benefits and drawbacks for each implant fill type.
- 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 are more expensive, make shell ruptures harder to detect and require larger incisions since they are pre-filled.
- Advantages: The main advantages of saline breast implants are that they can be placed through a smaller incision, the size can be adjusted intra-operatively, they are less expensive and ruptures are very obvious.
- Drawbacks: They feel firmer than silicone implants and are more likely to show wrinkling and rippling.
Dr. Hasen offers round and shaped implants filled with either silicone or saline. 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.
If you need correction after your initial breast augmentation, Dr. Hasen can help. Learn about your options for breast implant revision.
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 the VECTRA® 3-D 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 illustration).
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 will consider the type of implant you choose, the amount of existing breast tissue you have, your lifestyle, and other factors when recommeding the best implant placement for you.
Under the Muscle
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
Placing implants above the muscle allows for less pain at the time of the surgery and no motion with contraction of the chest muscle. Again, usually only silicone implants are suitable for placement above the muscle. Dr. Hasen is able to provide beautiful, natural-looking breast augmenatation 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. Additionally, the Natrelle 410 breast implant was shown to have a 68% less risk of capsular contracture at 10 years compared with smooth moderately cohesive round silicone gel filled implants.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