Understanding Breast Implants

While many still think of breast implants as comically large, fake-looking breasts, they couldn’t be further from the truth. Today, breast enhancement is highly customizable, allowing you to decide the size, shape and projection you want. If you’re considering breast augmentation, understand your breast implant options so you can make the decision that is right for you.

What You Need to Know

Consider choosing a qualified plastic surgeon as your first step, rather than your last. Involving them early in the process can help you understand the process, and get the results you want. Your plastic surgeon will review the aspects of implants with you, explain your options and provide you with the best recommendation to great the results that you want.

Filler Material

Implants can be filled with either silicone gel or saline (salt water). But the vast majority of implants are made with silicone since it has cohesive properties which help your implant look, feel and move more like natural breast tissue.

There was some controversy about the safety of silicone gel implants in the early 1990s. However, after many years of study in thousands of women, silicone gel breast implants have been confirmed safe by the U.S. Food and Drug Administration (FDA). For those who prefer saline implants, recent improvements (adding internal baffles) have made them feel more like silicone implants.

Shell Surface

The shell is the part of the implant that touches your tissue and holds the filler material. It’s made of a silicone polymer (rubber) and can have either a smooth or textured surface. A textured surface can help implants stay in place better and may reduce the risk of capsular contracture (excessive scar tissue). Which type of surface you need depends on your specific body characteristics, where in the body your implant is positioned, and the shape of your implant.


Implants don’t just come in different sizes. They also come in different shapes — “round” and “teardrop.” Teardrop implants (sometimes called “shaped” implants) can look round from the top view, or they can have a more oval shape. From the side, they have a lower portion that is thicker and projects more, while the upper part is thinner. Because there’s no up or down orientation, round implants can use either a smooth or textured shell. But because a shaped implant has to stay in the same direction (i.e., up is up), it must use a textured shell.


Whether round or shaped, implants can be made with different projections or profiles, meaning how far your breasts extend forward. Having these options means that your surgeon can help you match the right implant to the width of your breast with the right projection of your breast to give you the best results.


Implant size is one of the most important choices of all. Every woman has a different goal in terms of breast size. Some want a more modest look, while others want a very large increase in size. It’s important to remember, however, that the size of a breast implant should be compatible with your body. A large, wide breast implant in a chest that is small and narrow will not look natural, and over time can stretch the breast tissue or become displaced.


While implant positioning within the body isn’t a feature of implants per se, this is an important decision. There are two primary positioning options:

  • Subglandular augmentation — implants are placed on top of the breast (pectoral) muscle but under the breast gland
  • Submuscular or subpectoral — implants are placed under the breast gland and under the pectoral muscle

Each has its advantages and disadvantages. With a subglandular augmentation, recovery may be a bit easier the first couple of days, but the chance of capsular contracture (scarring around the implant) is significantly higher than with subpectoral augmentation.

Emory Aesthetic Center

When taking all of these different factors together, there are many combinations of implant size, shape, fill, texture, projection, and location for a given patient. A well-trained and experienced plastic surgeon can help you confirm your goals and understand your particular anatomy in order to make the best recommendation for you.

Emory Aesthetic Center surgeons are experts in breast enhancement. We’ll help you better understand your options and determine how to get the results you want. Schedule your complimentary consultation today.

Request an appointmentor call us at 404-778-6880.

About Felmont Eaves III, M.D., F.A.C.S.

Felmont F. Eaves III, M.D., F.A.C.S., leads the Emory Aesthetic Center as Medical Director. He is double board-certified by the American Board of Surgery and the American Board of Plastic Surgery.

Dr. Eaves’s leadership is apparent in his impressive accumulation of distinctions. He serves as Director of the American Board of Plastic Surgery, the board that certifies plastic surgeons nationally. Previously, he served as President of the American Society for Aesthetic Plastic Surgery; he is currently a Trustee.