Surface of breast implants
Breast implants with a smooth surface texture can move freely in the implant bed and can be optimally shaped with push-up bras. However, one disadvantage of this implant form is that the implant site widens over time, increasing the risk of dislocation. Smooth surfaces are only used for round implants.
Breast implants with textured surfaces are characterized by their ability to fix the implant in the intended position. This significantly reduces the risk of slipping or twisting. Textured surfaces of breast implants also reduce the risk of developing capsular fibrosis.
This complication, which often occurs in the context of breast implants, is an immune reaction of the body against the implant. A fibrous capsule forms around the implant and compresses it. In addition to states of tension and severe pain, there are also deformations of the breast. In addition, a distinction is made between microtextured (slightly roughened) and macrotextured (strongly roughened) surfaces in terms of the size of the texture.
Implant filling
Breast implants can be filled with different materials and fluids. Most of the available implants are filled with silicone gel (approx. 90 percent) or saline solution (approx.
10 percent in Germany, in the USA eta 50 percent). Compared to saline fillings, silicone fillings offer a better tactile feeling (better haptics). Breast implants can be filled with two different types of silicone.
Either liquid silicone gel is used, which is not dimensionally stable, or dimensionally stable cohesive silicone gel. Cohesive silicone gel may leak from the breast implant shell, but it cannot leak. In case of implant rupture, this is a clear advantage over liquid silicone gel, which leaks in such a case and is difficult to remove from the tissue due to its adhesive properties.
In contrast to silicone gel, filling a breast implant with saline solution is less problematic, as saline solution is completely absorbed by the body, i.e. it is absorbed and excreted. However, a breast implant filled with saline solution can give an unnatural feeling, as the fluid in the sheath “wobbles” back and forth. Silicone gel, on the other hand, offers a comparable feeling to that of natural breast tissue.
In the past, other fillings have also been used for breast implants such as soybean oil, hydrogel or polypropylene. However, these filling materials either had significant weaknesses or could not establish themselves on the market. Hydrogel fillings were developed in the hope of combining the advantages of silicone and saline implants while avoiding the disadvantages.
Hydrogel is less harmful to health than silicone gel because the substance is water-based. It is also more dimensionally stable than saline solution and is very similar in consistency to silicone gel. Health risks could not be excluded despite the good compatibility of hydrogel.
Besides the typical breast implants, which are filled with only one material, there are also double-lumen breast implants. These consist of a large inner chamber filled with silicone gel and a smaller outer chamber with saline solution. In recent years, alternative filling materials have also been experimented with.
Soybean oil, for example, has not proven to be a suitable filling material for breast implants and is no longer used. In contrast, hydrogel implants, which consist of more than 95 percent water, which becomes viscous when mixed with cellulose, could be an interesting alternative to silicone fillings. The hydrogel filling feels similar to own tissue and can be completely degraded by the body in case of implant rupture. However, breast implants with hydrogel filling are rarely implanted in Germany.
