Choosing the best breast implant for you is critical to a successful breast augmentation. While many choices are available, a thoughtful and logical review of the options and your personal needs and breast characteristics will allow you to narrow down your decision easily.

Here we review the key issues in breast implant selection. But, as always, we don’t expect you to make this decision alone. When you see us for a consultation our staff will review this information with you and help you become informed and confident in your choice of implants. Here are the key issues about breast implants:

  • Should the implants be filled with saline, silicone gel, or cohesive silicone?
  • Should the implants be round or teardrop shaped?
  • Should the implants have smooth or textured shells?
  • And, what size should the implants be?

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The best way to get your questions answered is to come in for an appointment.

Smooth And Textured Breast Implants

Breast implant shells may have a smooth or textured surface. As a natural reaction to any device placed in the body, scar tissue will form around the breast implant surface, creating a soft tissue capsule. In some women, the capsule can tighten and squeeze the implant. This occurrence is called “capsular contracture”.

Textured Breast Implants

Textured breast implants were designed to reduce the chance of capsular contracture. Clinical information from studies of a large number of women with breast implants show no difference in the likelihood of developing capsular contracture with textured breast implants compared to smooth-surfaced implants when the implants are placed in the subpectoral position.

Teardrop Implants Must Be Textured

All teardrop implants require a textured surface to prevent rotation of the implant within the breast. The textured surface creates friction with the surrounding tissue. This friction helps hold the implant in a fixed position. Keeping a teardrop implant in the correct orientation is necessary to maintain a normal breast appearance. If a teardrop implants rotates (for example, up-side-down) then the breast will be misshaped. 

Smooth Breast Implants

We usually recommend smooth breast implants when round implants are used. Smooth implants are softer and feel more natural than textured breast implants. One is less likely to feel the edges of smooth implants and smooth implants generally cause less visible implant rippling compared to textured implants. And, smooth implants move with the breasts better than textured implants. In addition, with some models of breast implants, the textured versions have a higher chance of failure (leakage) compared to the smooth versions. Saline and silicone filled breast implants are both available in smooth and textured shells.


Breast Implant Safety

The results of the vast body of information on breast implants have led to the world-wide acceptance of silicone breast implants as an appropriate means to enhance and reconstruct the female breast. In addition, the validity of the safety data on breast implants has lead the U.S. Food and Drug Administration to approve the use of saline-filled and silicone gel-filled implants for breast augmentation.

Breast implants are among the most extensively studied medical devices available to patients. Concerns about breast implants and breast cancer and connective tissue diseases have been addressed in many publications and forums.

“Immediately when I met Dr. Connall, he felt like a friend. He just made me feel so comfortable that I knew right away this is who I wanted to pick.”


Breast Implants And Breast Cancer

The Institute of Medicine reported in 2000: “Evidence clearly shows that silicone breast implants do not cause breast cancer or the recurrence of breast cancer. In fact, some studies suggest that women with breast implants have fewer new or recurring cancers.”

Breast Implants And Autoimmune Diseases

Also in their 2000 report, the Institute of Medicine addressed concerns regarding breast implants and connective tissue diseases with the following statement: “there is no evidence that silicone breast implants contribute to an increase in autoimmune (connective tissue) diseases. A review of 17 separate studies of the occurrence of connective tissue disease in the population was remarkable for the consistent finding of no elevated risk and no indication of an association of implants with disease. Evidence suggests that such diseases are no more common in women with breast implants that in women without them.”

Breast Implant Safety Update

In 2011 the FDA published an update on the safety of silicone implants. They reviewed the most recent studies on implant safety. In addition, the recent data was compared to historical safety data. The evidence reaffirms prior studies; that silicone gel implants are safe devices for breast augmentation and reconstruction. 

Are Breast Implants Always Trouble-Free?

Though breast implants have not been shown to cause systemic disease, implants can cause some local problems within the breast. Some of those issues include: firm scar tissue formation around the implant (capsular contracture), deformation of the breasts, calcium deposits in the tissue around the implant, nodule formation around an implant (silicone granuloma), pain, and changes in nipple sensation.

Though these complications are not the norm and can usually be successfully managed, it is important for women to recognize these and other issues related to breast implants.

Women considering breast augmentation must recognize that breast implants add an increased level of complexity to the maintenance of the health and aesthetics of the breasts. And, that once implants have been placed, additional implant related surgery will likely be needed at some point in a woman’s lifetime.

Shape and Texture

There are two basic breast implant shapes: Round and Teardrop. Understanding the differences in these designs is central to your implant selection.

A key advantage to round implants is that a soft, smooth implant shell can be used. The smooth shell is generally less likely to be felt than a textured shell. And, the smooth shell tends to cause less implant ripples, thereby decreasing the chance of visible implant rippling through the skin.

The teardrop implant requires a textured shell but since they are made in a variety of shapes, a greater degree of control can be added in fitting the implant shape and dimensions to a woman’s anatomy and desired breast shape. This control is especially useful in patients that wish to emphasize filling a certain area of the breast, such as the upper pole.


Breast implants are filled with either saline or silicone gel. Millions of women have had successful breast augmentations with saline and silicone breast implants. So, which breast implant is best for you? There is no single universal answer to this question and the decision must be customized to each woman’s unique characteristics and desires. We break down the issue into four key points. One is the actual aesthetic appearance achieved. Two is the feel the breasts have after implantation. Three is the implications of implant failure. And, four is the impact of the implants on the maintenance of breast health.


Find out more about breast implant shape, texture and fill. Contact our in Portland office for more information on breast implants or to schedule a consultation. Call (503) 783-0544 or use our online form today.