Look at the structure rather than the product name
When you look into breast implants, the names of various manufacturers come up first. But the names alone make it hard to tell what is different.
Breaking it down by structure makes it easier to understand. An implant consists of a shell that wraps the outside and the filling inside it, with the overall shape added on top.
These three elements each change something different. The shell surface relates to tissue response, the filling is involved in feel and shape retention, and the shape determines the finished silhouette.
This combination differs by product. So rather than saying one product is always better, it is more practical to look at which combination suits your current condition.
Differences in surface
Shell surfaces are divided into smooth and textured, with microtextured surfaces in between.
A smooth surface does not adhere to tissue, so the implant moves naturally. In exchange, the force holding it in place is weaker and the position can shift.
A textured surface catches on the tissue through its irregularities and settles in place. However, as the surface area increases, the tissue response can be greater.
A microtextured surface falls in between. It is reported to have a relatively lower risk of capsular contracture than a textured surface, and recent products are being developed in this direction.
The choice of surface is considered together with the placement plane. The suitable surface differs depending on where it is placed.
Filling and shape
What is widely used at present is silicone gel. How cohesive the gel is governs the feel and the shape retention.
Lower cohesiveness gives a soft, natural feel but a weaker ability to hold the shape. Higher cohesiveness holds the shape well but can feel firm. Resistance to rupture is known to be more favorable on the higher-cohesiveness side.
Shapes are broadly divided into round and teardrop. Round implants fill volume up to the top for a fuller silhouette, while teardrop implants are gentle at the top and convex at the bottom for a natural curve.
However, a teardrop implant loses its shape if it rotates. Conditions that hold it in place are also required.
Which combination is right depends on the thickness of your original tissue, the shape of the breast and the silhouette you want.
The placement plane also changes the result
Even with the same implant, how it looks differs depending on where it is placed.
Placing it under the chest muscle lets the muscle cover the implant so the upper border blends smoothly. This is favorable for people with thin tissue. In exchange, the muscle has to be lifted, so there is more pain early on, and the shape can move when you tense your arm.
Placing it under the breast tissue gives faster recovery and natural movement. However, if the covering tissue is thin, the border may be palpable or show through.
There is also a method that splits the two planes, with the upper part covered by muscle and the lower part sitting under the breast tissue.
Checking tissue thickness in advance is the starting point of the choice.
| Category | How it is divided | What it is involved in |
|---|---|---|
| Surface | Smooth surface / textured surface / microtextured surface | Tissue response and how well it settles in place |
| Filling | Lower versus higher cohesiveness of the silicone gel | Feel and shape retention, resistance to rupture |
| Shape | Round / teardrop | The finished silhouette |
| Placement plane | Under the chest muscle / under the breast tissue / split between the two planes | How visible the upper border is and the pattern of early recovery |
What TheLINE checks in a breast consultation
TheLINE Plastic Surgery Clinic first listens to the size and silhouette you want, then checks whether that is within the range possible with your current tissue.
Tissue thickness is the key. If it is thin, the implant border shows more easily, so the choice of placement plane and surface changes. In that case we also review covering the border with fat grafting.
If there is sagging, an implant alone will not tidy it up. Even after filling, the tissue stays in its lowered position, so a lift is planned together.
Where contracture or inflammation remains, TheLINE also handles the approach of managing the tissue condition with SVF isolated in the in-house laboratory before proceeding with reconstruction. Dr. Jaeho Cho and Dr. Yoosuk Chung assess the case together.
How is the size decided
This is not something that can be decided by numbers alone. Even with an implant of the same volume, the finished size looks different from person to person.
The width of the breast base is the reference. If the diameter of the implant exceeds this width, it pushes out toward the flank and looks awkward; if it is too narrow, the middle looks separated. So the base is measured first and the options are narrowed down within it.
Height, shoulder width and the shape of the rib cage are involved as well. The same size gives a different impression depending on your build.
The amount of your original tissue adds to it too. If you have your own tissue, the result is that much larger, so the outcome is not calculated from implant volume alone.
Bringing a photo of the look you want to the consultation makes it easier to align on a reference. That said, we note in advance that the same implant may not produce that appearance.
What happens over time
Implants are not placed on the premise of staying forever. Over time, the condition is checked and replacement or removal is reviewed.
What needs to be checked is whether there is rupture, whether contracture is progressing, and whether the position has changed. Since these are not always visible from the outside, imaging is used.
Changes in the body are involved too. If your weight changes or you go through pregnancy and breastfeeding, the surrounding tissue changes and may no longer match the original shape.
If the tissue thins with aging, the implant border can become more visible than before.
So keeping your surgical records is recommended. Which product was placed in which plane becomes the starting point for later decisions.
If you are planning childbirth and breastfeeding
This is a question that comes up often before breast surgery.
Implant placement is known not to necessarily prevent breastfeeding, because it is not surgery that removes the breast tissue itself. However, the effect can differ depending on the incision location and the placement plane, so if you have plans, let us know in advance.
More important are the changes that follow. Through pregnancy and breastfeeding, the breast tissue enlarges and then shrinks, and the skin stretches in that process. In many cases it does not return to its pre-surgery state.
So if childbirth plans are near, it is said to be better to delay the timing. If the body changes significantly after surgery, revision surgery may become necessary.
If the plans are further off, we assess it together at the consultation.
Limits you should know
The two sides will not become perfectly identical. In most cases the breasts were already asymmetrical, and since implants are standardized products, it is hard to match fine differences.
The feel is not the same as the original breast. The thicker the tissue, the more natural it is, but the fact that it is surgery placing a foreign material does not change.
Side effects such as capsular contracture, rupture, displacement and infection may occur. You should factor in that revision surgery may become necessary.
Breast cancer screening is possible, but letting them know what surgery you had helps with interpretation.
Unexpected inflammation or bleeding may occur, and the degree varies from person to person, so caution is required.
Frequently Asked Questions
Which product is best?
Rather than one product always being better, there is a combination that suits your current tissue thickness and the silhouette you want. It is more practical to look separately at surface, gel cohesiveness and shape.
Is the teardrop shape more natural?
It is gentle at the top and creates a natural curve, but it loses its shape if it rotates. Conditions that hold it in place are also required, so the choice depends on your condition.
When are implants replaced?
There is no uniform timeline; it is judged by condition. However, since they are not placed on the premise of staying forever, regular checks are recommended.
My breasts sag, is placing an implant enough?
In many cases the tissue stays in its lowered position even after filling. If sagging is present as well, a lift is planned together.
What does TheLINE look at first?
TheLINE Plastic Surgery Clinic checks whether the size you want is within the range possible with your current tissue. If the tissue is thin, the border shows more easily, so the choice of placement plane and surface changes and fat grafting is reviewed alongside.
