Anyone considering breast augmentation is quickly faced with a surprisingly wide range of options. Implants differ in surface texture, silicone gel composition, shape, and size—and each of these characteristics affects the final result and the risk of complications. This overview explains the main types of implants, how they differ, and why recommendations have changed in recent years.
Key Points at a Glance
- Four Distinguishing Features define every breast implant: surface (smooth or textured), gel composition, shape (round or anatomical), and size.
- Smooth-walled implants are chosen more often today than in the past because they are associated with a lower complication rate.
- Textured (rough) implants in a teardrop shape were the standard for a long time, but are now considered less suitable for use, as the rough surface can promote immunological reactions in the body.
- Round, smooth implants filled with soft gel may appear teardrop-shaped when placed submuscularly and when the patient is standing.
- Which implant is right for each individual case depends on body type, tissue, and the desired result, and should be discussed during a personal consultation with a doctor.
https://www.youtube.com/watch?v=ttSTHgOTnEc
Dr. Maria Wetzel, M.D., a specialist in plastic and aesthetic surgery, explains the differences between the various types of breast implants.
How do breast implants differ from one another?
At first glance, the variety of breast implants can seem overwhelming. In fact, it can be broken down into four key characteristics that describe each implant.
These four characteristics determine how an implant looks, how it feels, and what risks are associated with it:
- Surface: The outer shell is either smooth or textured (roughened). This characteristic has become the most significant factor in medical discussions in recent years.
- Filling material: Most modern implants are filled with a silicone gel, the firmness of which varies depending on the manufacturer. There are also saline-filled implants.
- Shape: Implants are either round or anatomically shaped—the latter mimic the natural contour of the breast with their teardrop shape.
- Volume: The volume is measured in cubic centimeters and is tailored individually to your body type and desired results.
During the consultation, these characteristics are not considered in isolation, but rather in combination—because it is their interaction that ultimately determines the final outcome.
Smooth and textured surface
Arguably the most important distinguishing feature is the surface of the implant shell. Expert opinion on this matter has shifted significantly in recent years.
Textured implants – once the standard
For a long time, implants with a textured surface were used. They were usually of the so-called teardrop shape, meaning they were anatomically contoured. The roughening was intended to give the implant better grip in the tissue and prevent it from slipping.
This approach has since been scaled back somewhat. According to Dr. Maria Wetzel, a specialist in plastic and aesthetic surgery, it is now understood that such a rough surface can trigger immunological processes in the body that are not considered healthy. This observation is one of the main reasons for the shift in thinking regarding implant selection.
Smooth-surfaced implants—the more common choice today
Nowadays, people tend to go back to using smoother-surfaced implants. The key advantage lies in the lower complication rate associated with this surface. For this reason, round, smooth implants are often the best choice.
In a nutshell
- Textured (rough) implants were the standard for a long time, especially those in a teardrop shape.
- Today, smooth-walled implants are more commonly preferred because they are associated with a lower complication rate.
- The reason for this change in thinking: Immunological processes can be promoted on rough surfaces.
Round and Anatomical Shape
In addition to their surface, the implants also differ in shape—and in practice, these two characteristics are interrelated.
Anatomical implants have a teardrop shape: they are flatter at the top and fuller at the bottom, similar to the natural contour of a breast. Traditionally, these implants were textured.
Round implants are uniformly shaped at both the top and bottom. Today, they are often the first choice because they combine well with the preferred smooth surface.
A point that may come as a surprise to many: A round, smooth implant does not necessarily result in a “round” appearance. Implants filled with a soft gel—the exact composition of which depends on the manufacturer—can take on a teardrop shape when placed submuscularly (i.e., under the pectoral muscle) and when the patient is standing. Gravity then shapes the soft gel into a natural-looking contour.
What are breast implants filled with?
The composition of the filler material has a significant impact on how the breast feels and how the implant behaves within the body.
Most implants used today contain a silicone gel. Its firmness is not the same across all products but varies depending on the manufacturer. A softer gel feels more natural and can adapt to your posture, as described above. A firmer gel maintains its intended shape more consistently.
In addition, there are saline-filled implants, which are filled with a sterile saline solution. They play a significantly smaller role in current practice than silicone gel implants, partly because silicone gel generally feels and looks more natural.
Choosing the right gel is therefore not just a minor detail, but a factor that directly influences both the feel and the visual result.
Why the recommendations have changed
The shift from textured teardrop-shaped implants to smooth, round implants is not a fashion trend, but rather the result of medical findings.
At the heart of the matter is the observation that rough implant surfaces can promote immunological reactions in the surrounding tissue. Internationally, this connection is discussed under the term “implant-associated changes”; some health authorities and professional societies have published corresponding safety advisories in recent years. It is precisely this development that explains why many dental practices today are once again favoring smooth-surfaced implants, which have a lower complication rate.
For female patients, this means one thing above all else: Choosing an implant is a safety-critical decision that should be made in consultation with an experienced physician—based on the latest scientific knowledge.
How to Choose the Right Implant
There is no one-size-fits-all answer to which implant is suitable in each individual case. The four characteristics—surface, filling, shape, and size—are always considered in relation to the individual circumstances.
A well-informed selection takes into account, among other things:
- The existing body type and proportions so that the result looks harmonious.
- The nature of one's own tissue, which helps determine which size and placement are appropriate.
- The Implant placement —above or below the pectoral muscle—which affects the aesthetic outcome and the behavior of the gel.
- The desired result—that is, how natural or pronounced the change should be.
This assessment is best done during a personal consultation. Only then can you determine which combination of features best suits your individual needs and preferences.
If you'd like to know how a breast augmentation with implants works in practice, you’ll find more detailed information on the corresponding treatment page. For anyone considering breast reconstruction without implants, you may also be interested in breast augmentation using your own fat be an alternative.
Choosing the right breast implant is a personal decision
Breast implants vary in surface texture, filling material, shape, and size, and—particularly with regard to surface texture—the recommendation has clearly shifted toward smooth-surfaced, round implants with a lower complication rate. The combination that is appropriate in each individual case depends on the patient’s specific circumstances.
If you'd like to explore your individual options, please schedule a personal consultation at PANTEA Health in Munich.
Frequently Asked Questions About the Different Types of Breast Implants
What types of breast implants are available?
Breast implants differ in four characteristics: the surface (smooth or textured), the filling material (usually silicone gel of varying firmness), the shape (round or anatomical/teardrop-shaped), and the size. These characteristics are tailored individually for each patient.
Are smooth or textured implants better?
Smooth-surfaced implants are chosen more frequently today because they are associated with a lower complication rate. Textured surfaces were the standard for a long time, but are now considered less suitable for use because they can promote immunological reactions in the tissue. A consultation with a doctor will determine which option is appropriate in each individual case.
What is the difference between round and anatomical implants?
Anatomical implants are teardrop-shaped and are fuller at the bottom than at the top, similar to the natural contour of the breast. Round implants are uniformly shaped. A soft, round implant may appear to take on a teardrop shape when placed submuscularly and when the patient is standing.
Does the shape of a round implant change when standing?
Yes, that is possible. When placed under the pectoral muscle, implants filled with a soft gel can take on a teardrop-shaped, natural-looking contour due to gravity while the patient is standing. The extent of this effect depends on the type of gel used.
What are modern breast implants filled with?
Most modern breast implants are filled with silicone gel. The firmness of the gel varies by manufacturer: Softer gels feel more natural, while firmer gels hold their shape more effectively.
Which implant is right for me?
There is no one-size-fits-all answer to this question. The right choice depends on your body type, tissue characteristics, the desired implant placement, and the desired outcome. These factors will be discussed and evaluated together during a personal consultation.
