Breast implant types, shapes and sizes: how to choose the right implants

Breast implant options at a glance

Choosing implants is not about picking one "best" model. It is about matching several separate parameters to your body, your breast tissue and the result you have in mind. Each parameter changes how the breast looks, how it feels and how it behaves over time.

The main choices are the shape of the implant, the filler, the shell surface, the profile and volume, the position of the pocket and the incision. The table gives a short overview; each point is explained in more detail below.

Round or anatomical (teardrop) implants

Round implants

Round implants are symmetrical: the volume is spread evenly from the centre to the edges. They give the upper part of the breast more fullness and a lifted, rounded look. Because the shape is the same from every side, a round implant does not look wrong if it turns slightly inside the pocket.

Round implants are often suggested when a person wants a clearly visible change, has enough of her own tissue to cover the edge of the implant, or wants more cleavage. When they are placed under the muscle and chosen in a moderate size, they can also look quite natural.

Anatomical (teardrop) implants

Anatomical implants are thicker at the bottom and slope gently towards the top, following the outline of a natural breast. They are usually considered for slim patients with very little breast tissue, for a narrow or long chest, and in some cases of mild sagging or reconstruction.

These implants have a textured surface so that they stay in the right orientation. If an anatomical implant rotates, the breast shape can become visibly distorted and a further operation may be needed. They also tend to be firmer. For these reasons, many surgeons use them selectively rather than as a default choice.

Silicone or saline, smooth or textured

The filler

Most breast augmentations today use silicone gel implants. Modern cohesive gel holds its form and feels closer to natural breast tissue, which is why silicone is usually preferred for a natural look. Saline implants are filled with sterile salt water; they can feel firmer and show ripples more easily under thin skin, and they are used less often. The minimum age for each type of filler is set by regulators and may differ between countries.

The shell surface

Smooth implants move freely inside the pocket, which many people find gives a soft, natural movement. Textured implants have a slightly rough surface that grips the surrounding tissue and keeps the implant in place. Anatomical implants need texture; round implants can be either.

Regulators, including the US Food and Drug Administration (FDA), note that the rare lymphoma called BIA-ALCL is linked mainly to textured implants. This is one reason why smooth round implants are now widely used. Your surgeon should explain the surface of the specific implant offered to you and why it was chosen.

Implant profile and volume: choosing the right size for your body

What profile means

Profile describes how far the implant projects forward compared with the width of its base. Two implants with the same volume can look very different: a low-profile implant is wide and flat, while a high-profile one is narrower and projects further.

• Low profile: a wide base and gentle projection, often suitable for a broad chest.
• Moderate profile: a balanced option that suits many patients.
• High and extra-high profile: more projection on a narrower base, often used for a narrow chest or when more fullness is wanted without extra width.

How the surgeon matches the size to your body

Size is chosen in millilitres (cc), not in bra cups, because cup sizes vary between brands and countries. The surgeon examines the breasts and takes measurements: the width of the breast base, the distance between the breasts, skin stretch, the thickness of the tissue that will cover the implant and the position of the breast fold. The implant base should normally not be wider than your own breast base.

Your wishes matter just as much. Photos of results you like, your lifestyle and sport, and how you want your clothes to fit all help the surgeon suggest a range of suitable volumes. An implant that is too large for the tissue can stretch the skin, show visible edges and speed up sagging over the years.

Trying on sizers

Many clinics let you try on sizers: test implants placed in a special bra, worn under a fitted top. Standing in front of a mirror, you can compare several volumes and see how each changes your silhouette. At City Medical Centre the consultation includes result modelling, and the size, shape and profile are chosen together with the surgeon. Sizers give a good general idea, but the final look also depends on the pocket and on how your tissue settles after surgery.

Sagging, a narrow chest or asymmetry

If the breasts sag noticeably, an implant alone may only make them heavier; a lift is often combined with augmentation. With a narrow chest, a narrower base and a higher profile are often considered. Mild asymmetry is common, and the surgeon may use implants of different volumes or profiles on each side, although perfect symmetry cannot be promised.

Implant placement: over the muscle, under the muscle or dual plane

The implant can sit in front of the chest muscle, behind it, or in a combined position. The choice depends mainly on how much of your own tissue will cover the implant.

• Over the muscle (subglandular): the implant sits behind the breast tissue. Recovery is often a little easier, but with thin tissue the edges and ripples may show. It is usually considered when there is enough breast tissue.
• Under the muscle (submuscular): the upper part of the implant is covered by the chest muscle, which softens the upper edge. Discomfort in the first days is usually greater, and the breast may move slightly when the muscle contracts.
• Dual plane: the upper part of the implant lies under the muscle and the lower part under the breast tissue. It combines good coverage at the top with a natural lower curve, and many surgeons use it for slim patients.

Placement also affects breast screening. Tell the radiographer about your implants before every mammogram, whichever position is used.

Incision options and scars

Every augmentation leaves a scar; the question is where it is placed and how visible it becomes. The surgeon chooses the access based on your anatomy and the type and size of implant.

• Under the breast fold (inframammary): the most common approach. It gives the surgeon good control when creating the pocket, and the scar usually sits in the natural crease.
• Around the areola (periareolar): the scar follows the edge of the darker skin. It is suitable only when the areola is large enough, and it may affect nipple sensation more often.
• Through the armpit (transaxillary): no scar on the breast itself, but the approach is suitable for fewer implant types and gives less direct access.

Scars are usually red at first and fade gradually over six to twelve months. How they finally look depends on your skin and on following the aftercare advice. You can find out how the operation is organised on our breast augmentation page.

How long implants last, check-ups and BIA-ALCL

Breast implants are not lifetime devices. Many people keep the same implants for 10 to 15 years or longer, but the longer implants are in place, the more likely it is that another operation will be needed to replace or remove them. Common reasons include capsular contracture, where scar tissue tightens around the implant, rupture and changes in the breasts with age, weight or pregnancy.

• Keep your implant card with the model, size and serial number: you may need it for check-ups or future surgery.
• A silicone implant can leak without symptoms. Regulators such as the FDA recommend periodic imaging, such as ultrasound or MRI, to detect a silent rupture; your doctor will advise on the schedule.
• Keep up regular breast screening and always tell the doctor about your implants.

BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) is a rare cancer of the immune system that can develop in the scar tissue around an implant. It is not breast cancer. According to the FDA and the NHS, only a very small number of people with implants develop it, and the risk is higher with textured implants than with smooth ones. The typical sign is new swelling or a collection of fluid around the implant, often years after surgery. Regulators do not recommend removing implants in people without symptoms, but any late swelling, lump or pain should be checked by a doctor.

Choosing your implants at City Medical Centre

City Medical Centre works with international patients. The first consultation is free and can be held online: you can send photos by WhatsApp and discuss the shape, size and placement you are considering. After examining your breasts and assessing your anatomy and expectations, the surgeon suggests suitable implant options and explains the reasons for each choice.

The doctor names the cost after the assessment, and it is fixed in the contract. A personal coordinator stays with you from your first message to the end of recovery, and follow-up check-ups with the plastic surgeon continue after the operation. Learn more on the breast augmentation page.

Sources

• FDA — Types of breast implants
• FDA — Questions and answers about breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
• NHS — Breast enlargement (implants)

Frequently asked questions

Are round or teardrop implants more natural?

Both can look natural when they suit your body. Teardrop implants copy the slope of the breast and may help slim patients with little tissue, while round implants give more upper fullness. With enough soft tissue cover and a moderate size, round implants often look natural too. The surgeon advises after the examination.

How do I choose my implant size?

Size is chosen in millilitres, not in bra cups. The surgeon measures the breast base width, skin stretch and tissue thickness, then suggests a range that fits your chest. Trying on sizers and discussing photos of results you like helps you pick a volume within that range.

What does implant profile mean?

Profile is how far the implant projects forward compared with the width of its base. At the same volume, a low-profile implant is wider and flatter, while a high-profile implant is narrower and projects more. The right profile depends mainly on the width of your chest.

Are silicone implants better than saline?

Silicone gel implants usually feel softer and more like natural breast tissue, so they are chosen more often for cosmetic augmentation. Saline implants can feel firmer and show ripples more easily. Both types carry similar main risks, such as capsular contracture and the need for future surgery.

Should I worry about BIA-ALCL?

BIA-ALCL is a rare lymphoma that develops in the scar tissue around an implant, mainly with textured implants. Regulators do not advise removing implants without symptoms. See a doctor if you notice new swelling, a lump or pain around an implant, even many years after surgery.

Can implants correct breast asymmetry?

Implants can often reduce a difference in breast size, because the surgeon may use different volumes or profiles on each side. When the difference is in shape or nipple position, a lift may be added. Complete symmetry cannot be promised, since natural breasts are rarely identical.