Which Breast Implant Should I Choose?

Which implant is best for me?

Which implants give the most natural look?

What are gummy bear implants?

These are some of the questions we often get in regard to implants used in Breast Augmentation. This article is going to highlight the different implant types and characteristics currently available here at Cool Springs Plastic Surgery. We will also touch on why some patients look more natural than others and why the implant is so important in this.

Breast implants continue to evolve and advance with time. Surgeons now have the ability to customize implant choices for their patients choosing between implants varying in size, shape, surface texture, fill type, height, width and projection to name a few. A patient trying to navigate all of these options alone will typically have some questions. Here are a few basics:

Implants are generally classified as either saline or silicone. Silicone implants are also known as “Gel” or “Gummy bear” implants. All implants have a silicone shell for their outer surface. Saline implants are filled with saline at the time of augmentation, while silicone implants come prefilled and ready to place during surgery.

All silicone implants are filled with silicone solution; however, different brands and implant types can have different gel qualities. You can have a soft and squishy implant ranging all the way to a slightly firm implant. The original “gummy bear” implant was a shaped gel implant. In order for an implant to hold its shape, the gel has to be more ridged to allow the implant to not distort. The firmer gel is, the more it holds its shape. The softer an implant is, the more it can be affected by external factors. This has advantages and disadvantages depending on the goals of the patient and the patient’s anatomy. It’s best to ask your surgeon what they prefer and why. My answers vary depending on my patient’s anatomy and desires for final outcome.

Both saline and silicone implants come in a shaped version and a round version. The shaped version looks like an implant shaped like a breast – a full lower half with a tapered top. The round implant simply looks round. Refer to photos A and B. Both implant types are useful in changing the breast shape and appearance.



Implant surface texture can be either smooth or textured. Smooth is currently preferred by most plastic surgeons universally in the US. Textured implants can offer additional options in the right patient and have been most commonly used in Europe and outside the US.

When it comes to size, you have many options. For most brands, the smallest implants start at around 100cc and go up to around 800cc. You can get larger, but they are special order and typically reserved for special circumstances. The average size choice for most patients is 300-400cc.

So, to go back to the question of why some results look more “natural” than others. Well, it’s several things. The most natural results occur when you have a patient starting with moderate sized breast prior to surgery, and you use a smaller implant. The more breast tissue coverage you have, the more you hide any visibility of the implant. If you start with a small amount of breast tissue and you choose a larger implant, your breast tissues will be overpowered by the implant, and your final result will be potentially be less “natural.” There are other factors involved, such as surgeon technique, your breast anatomy, and finally, what you consider to be natural.

This article just scratches the surface on implant types and characteristics. To discover which implant is best for you, you will certainly need a detailed consultation with an experienced plastic surgeon. Your outcome will depend on your surgeon’s technical ability, as well as their ability to guide you through this process so that you are making the best decisions for both short and long term success.