Breast Implant Options

Women considering breast augmentation with implants in Austin, New Braunfels, Laredo, Wimberley, Dripping Springs, Kyle, and throughout Texas have many options when it comes to choosing the right breast implants for them. Saline implants have been available consistently since 1992, and since the FDA approved a new generation of silicone gel implants in 2006, their use has grown rapidly. In 2012, the FDA approved the first type of form-stable silicone gel implant for use in the United States. This fifth-generation silicone gel implant has been nicknamed the “gummy bear implant,” because its texture is similar to that of a gummy bear candy, and it holds its shape even when cut and squeezed.

At The Piazza Center, we believe that beautiful surgical results are enhanced by following a healthy lifestyle. Our aim is to help you achieve your cosmetic goals and desires. If you would like to find out more about breast surgery, you can request an in-person or virtual consultation online, or call our office at (512) 288-8200.


Saline Implants Round Silicone Shaped Silicone
A silicone shell filled with sterile saltwater A silicone shell filled with cohesive silicone gel An anatomically shaped silicone shell filled with cohesive silicone gel
Inserted empty and filled once in place Inserted full size; cannot be filled once in place Inserted full size; cannot be filled once in place
More prone to rippling or wrinkling Slightly less prone to wrinkling than saline Less prone to wrinkling than saline or round silicone
Generally less expensive than silicone Generally more expensive than saline Generally more expensive than saline
Appropriate for patients who have more existing breast tissue Appropriate for patients who have less existing breast tissue Appropriate for patients who have less existing breast tissue
Slightly higher risk of rupture Lower risk of rupture Lower risk of rupture
Feels firm; check out this video to see more differences between saline and silicone Feels softer than saline Feels softer than saline; shape mimics the shape of a natural breast

Saline Breast Implants

Saline breast implants have been an option for breast augmentation patients for more than 30 years in the United States. According to FDA regulations, women who are 18 or older may choose saline implants for breast augmentation. In Austin, this has been a very common choice for young women that are between the ages of 18 and 22. For women who are 22 or older, either saline implants or silicone gel implants may be used for breast enhancement. The newest generation of silicone gel implants represents a significant step forward in terms of achieving a natural look and feel with breast enhancement surgery.

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Silicone Breast Implants

In 2006, the FDA removed its ban on silicone gel implants because the new generation of silicone implants was determined to be much safer than earlier models. In 2012, the FDA began approving shaped silicone gel implants. The Allergan Natrelle® 410 highly cohesive anatomically shaped silicone gel breast implant, the type of gummy bear implant Dr. Piazza uses almost exclusively in his cosmetic and reconstructive breast practice, was approved in February 2013. Mentor MemoryShape™ Breast Implants followed with their FDA approval in July 2013. These implants have a new type of silicone filling that clings to itself so that it will hold its shape even if cut or torn. The consistency is similar to gummy bear candies, which is why the cohesive gel options are commonly called “gummy bear” implants. This greatly reduces the risk of silicone from a damaged implant migrating through the body. The FDA continues to monitor silicone implants as part of a post-approval study in order to ensure their ongoing safety and reliability. To learn more about the FDA’s approval of this new fifth-generation silicone implant, read the FDA’s statement about its decision.

Choosing Gummy Bear Implants

Many women prefer the new silicone gel implants because they have a more natural look and feel than saline implants. Dr. Piazza is even seeing a number of women who choose to replace their saline implants with the newer cohesive gel silicone options. Among the options offered by Dr. Piazza are the Natrelle® 410, made by Allergan, and others. Dr. Piazza believes that selecting the ideal size and shape of a gummy bear implant is critical because, unlike a standard silicone implant, its form stable nature means that it will not distort according to the shape of the breast; rather, it will shape the breast. This is revolutionary and has allowed him to create a more natural shape to the breast while increasing projection of the nipple-areola complex and creating long-term fullness to the upper portion of the breast.

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Implant Profile Options

Breast implants are available in a range of profiles that describe the degree of projection they provide (the specific names vary between manufacturers). While an implant’s volume increases breast size, its projection affects breast shape. High profile implants make the breasts stick out farther from the chest than moderate or low profile implants. In addition, the width (base) of an implant decreases as its profile increases. So, high profile implants are narrow at the base making them well suited to women with slim, petite frames. Low profile implants are broader at the base for women with wider frames.

Dr. Piazza Answers Common Questions

Are breast implants safe?

When FDA-approved breast implants are placed in an appropriately screened patient by a qualified plastic surgeon, they are very safe. We fill saline implants with sterile salt water that is harmless if there is a leak. Today’s silicone implants have a cohesive silicone gel filling that stays together if the outer shell ruptures.

How will I know if my saline breast implant has ruptured?

The saline solution in a breast implant is very similar to what patients get in their IVs when they need IV fluids at the hospital. When a leak occurs with a saline implant, it most often occurs at the valve on the device. This leak can happen slowly over the course of weeks or months, or it can happen more rapidly over the course of several days. A woman may notice that she has lost volume in her breast and may be asymmetric. This often leads a patient to consult with her plastic surgeon to discuss removal and replacement of the implant.

How will I know if my silicone breast implant has ruptured?

The rupture rate of silicone gel breast implants is very low, and ruptures can be difficult to detect. The FDA recommends that women who have silicone breast implants have an MRI of the breasts 3 years after placement, and then every 2 years thereafter, to confirm the integrity of the implant. Patients who come to my office with concerns about a silicone breast implant rupture most often do so because of incidental findings on a routine mammogram. When a rupture occurs, the options include simply removing the implant, or removing the implant and replacing it with the newest generation silicone gel type. At my Austin plastic surgery practice, I often perform short-scar breast lift procedures to enhance the shape and appearance of the breast.

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Board-certified plastic surgeon Dr. Rocco C. Piazza looks forward to meeting with you to help you discover how you can achieve your cosmetic goals and desires.

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Do I need my breast implants replaced every 10 years?

Implants do not have an expiration date, but you should have your implants replaced if you experience a rupture or if you are having problems such as capsular contracture. I often perform elective implant exchange for women who do not have any concerns but want to change the size or type of their implants.

The current generation of implants should last for about 15 years. There is only about a 1% per year chance of your saline implants leaking, but the older the implants get, the higher the risk may become. It has been well documented that a leaking implant will not affect your health. However, it is usually not advisable to have a medical device remain in your body if it is damaged in any way.

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What is the difference between round and shaped implants?

Generally speaking, breast implants come in 2 main shapes: round and shaped, which are sometimes called “anatomic” or “teardrop” implants.

Although they’re called “round,” round implants are not perfectly spherical. Instead, they’re more or less disk-shaped and can vary in appearance based on their profile (how far they stick out from the body). Round implants are popular choices with women who want increased fullness throughout the entire circumference of the breast, which creates a more voluptuous appearance with more cleavage. Round implants can be either saline or silicone.

Shaped implants have a tapered appearance, with more volume toward the bottom, mimicking the shape of natural breast tissue. Shaped implants increase the size of the breasts and contribute to a more natural-looking outcome. Most shaped implants are silicone.

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Can implants provide lift as well as enlargement?

For women with very mild breast ptosis, or drooping, implants alone, especially form-stable shaped implants, also called “gummy bear” implants, can provide a small amount of lift. But most women who wish to lift their breasts require more than just augmentation. For these patients, I recommend combining breast augmentation with breast lift — 2 distinct surgeries that can be performed at the same time. My patients who undergo both these procedures are often impressed by the improvement in the shape, size, and the placement of their breasts. This approach is especially popular for mothers who sometimes combine the surgery with liposuction and a tummy tuck, a procedure called a mommy makeover. However, any woman who feels that her breasts are both small and sagging may benefit from this combined technique.

Will my implants look natural?

I have many years of experience personalizing breast augmentation surgery to the unique cosmetic goals of the individual patient. If looking natural is important to you—as it is with many patients—I will recommend the implant type, size, shape, and profile that will best achieve this goal for you.

Are silicone or saline implants more popular?

Silicone implants are generally the more popular options at plastic surgery practices throughout the country. Many people think that silicone implants, especially today’s gummy bear varieties, look and feel more natural than saline. Silicone implants also stronger and hold their shape even when damaged.

But this doesn’t mean they’re right for everybody. Saline implants have their own set of benefits, too. They often require smaller incisions. Additionally, saline implants are often appropriate when a patient already has a good amount of existing breast tissue and desires only a subtle improvement in size.

Today’s breast augmentation patients have a lot of choices when it comes to implant options. I strive to ease the decision-making process by providing plenty of guidance every step of the way.

Melissa Cady, Anesthesiologist

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At The Piazza Center, our patients come first. We have listened to our patients and in an effort to reduce the uncertainty with the anesthesia experience, The Piazza Center has developed a collaborative relationship with Dr. Cady to deliver an exceptional anesthesia experience for patients like you.

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