Breast implants used in breast augmentation surgery are available in different shapes, profiles, and gel consistencies. For patients considering breast augmentation in Perth, understanding the differences between silicone gel implants and highly cohesive silicone implants may help support more informed consultation discussions.
This article explains the implant types commonly discussed during breast augmentation consultation, including implant feel, shape, surface characteristics, long-term considerations, and current safety information relevant to breast implants in Australia.
| This article has been written by Dr Mark Hanikeri, FRACS (Plastic and Reconstructive Surgery), based on clinical experience working with breast implants for over two decades. It is intended as general educational information and does not constitute medical advice. Implant selection is made at consultation based on individual anatomy and goals. Outcomes vary between individuals. |
Silicone Gel Breast Implants
Silicone gel implants consist of a silicone outer shell filled with cohesive silicone gel. They are among the most commonly discussed implant types during breast augmentation consultation in Australia and are available in a range of dimensions, profiles, and shell surface characteristics.
Characteristics commonly discussed during consultation include:
- Filler: cohesive silicone gel
- Shell: silicone outer shell, available in different surface types
- Feel: generally softer and closer to natural breast tissue consistency
- Profile options: low, moderate, high, and extra-high projection options
- Shape options: round and anatomical implant designs
- Rupture behaviour: implant rupture may not always be externally visible and may require imaging assessment
Modern silicone implants use cohesive gel technology, meaning the gel tends to maintain its consistency rather than dispersing freely if shell compromise occurs.
Implant selection depends on factors such as chest wall dimensions, breast tissue characteristics, skin quality, and the surgical plan discussed during consultation.
Highly Cohesive Silicone Implants
Highly cohesive silicone implants represent a further development of standard cohesive silicone gel implants and are sometimes referred to as form-stable implants.
The gel used in these implants is firmer and designed to maintain its shape more consistently. Highly cohesive implants are available in both round and anatomical designs and may be discussed where greater shape stability forms part of the surgical planning considerations.
Characteristics commonly discussed during consultation include:
- Filler: highly cohesive silicone gel
- Feel: firmer consistency compared with standard cohesive gel implants
- Shape retention: designed to maintain implant form more consistently
- Shape options: round and anatomical implant styles
- Rupture behaviour: the gel generally maintains its structure if shell compromise occurs
- Surgical planning considerations: may be discussed depending on chest wall anatomy, skin quality, and tissue characteristics
Implant selection is individual and depends on multiple factors assessed during consultation.
Implant Shape: Round Versus Anatomical
Implant shape is considered separately from implant filler type. Both standard silicone gel and highly cohesive implants are available in round and anatomical configurations.
Discussion points during consultation commonly include:
Round Implants
Round implants maintain the same shape regardless of orientation and may produce different upper pole projection characteristics depending on implant dimensions and placement.
Anatomical Implants
Anatomical implants are designed with greater lower pole projection and are intended to provide a tapered implant shape.
Because anatomical implants have a directional shape, maintaining implant orientation is an important part of surgical planning.
Suitability for either shape depends on:
- Chest wall anatomy
- Existing breast tissue
- Skin quality
- Implant dimensions
- The patient’s surgical goals discussed during consultation
Implant Surface Characteristics
Breast implants are available with different shell surface characteristics, including smooth and textured surfaces. Surface selection forms part of the overall surgical planning process.
Patients should be aware that certain textured implant types have been associated with Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare form of lymphoma involving the scar tissue surrounding implants.
The Therapeutic Goods Administration (TGA) continues to monitor implant safety data in Australia and has previously taken regulatory action relating to specific textured implant types.
Current implant options available in Australia are subject to ongoing regulatory review and approval.
Discussion regarding implant surface characteristics, current evidence, and relevant safety considerations forms part of the informed consent process during consultation.
BIA-ALCL and Implant Safety
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of lymphoma associated primarily with certain textured breast implant surfaces.
Current evidence indicates:
- BIA-ALCL is uncommon
- Risk varies depending on implant surface type
- Certain textured implant types have demonstrated higher association rates
- Early assessment and management are important where symptoms develop
- The TGA continues to publish updated information relating to breast implant safety in Australia
Patients with breast implants are encouraged to seek medical assessment if they notice changes such as swelling, fluid accumulation, or changes around the implant area.
Discussion regarding implant safety, current evidence, and long-term monitoring recommendations forms part of the consultation and informed consent process.
Implant Longevity and Long-Term Considerations
Breast implants are not considered lifetime devices. Some patients may require revision surgery at some stage following breast augmentation.
Long-term considerations may include:
- Implant shell integrity over time
- Changes in breast tissue related to ageing, pregnancy, or weight fluctuation
- Capsular contracture
- Change in implant preference or surgical goals
- Implant manufacturer warranty considerations
Revision surgery may involve implant exchange, implant removal, capsulectomy, or additional breast procedures depending on the clinical findings and individual circumstances.
These long-term considerations are discussed as part of surgical planning and informed consent.
Frequently Asked Questions
What are cohesive gel breast implants?
Cohesive gel breast implants contain silicone gel designed to maintain its consistency more effectively than earlier implant generations. Different levels of gel cohesiveness are available depending on the implant type discussed during consultation.
What is the difference between silicone gel and highly cohesive implants?
Highly cohesive implants use a firmer, more form-stable silicone gel compared with standard cohesive silicone implants. The choice between implant types depends on anatomy, tissue characteristics, implant dimensions, and surgical planning considerations discussed during consultation.
Are breast implants safe in Australia?
Breast implants currently available in Australia are regulated by the Therapeutic Goods Administration (TGA). The TGA continues to monitor implant safety data and publishes updated information regarding implant-related risks and regulatory decisions.
What is BIA-ALCL?
Breast Implant Associated Anaplastic Large Cell Lymphoma is a rare form of lymphoma associated primarily with certain textured breast implant surfaces. It develops in the scar tissue surrounding implants rather than in breast tissue itself. Patients are encouraged to discuss current evidence and implant-related safety considerations during consultation.
How long do breast implants last?
Breast implants are not considered permanent devices. Some patients may require revision surgery over time due to implant-related changes, tissue changes, or personal preference. The timeframe varies considerably between individuals.
Next Steps for Perth Patients
Understanding the different categories of breast implants may assist discussion during breast augmentation consultation.
A consultation with Dr Mark Hanikeri includes discussion of implant types, implant dimensions, breast anatomy, surgical planning considerations, recovery expectations, and long-term factors relevant to breast implants in Perth.
Dr Mark Hanikeri holds FRACS in Plastic and Reconstructive Surgery and consults at accredited facilities in Perth.
Further Reading on Plastic Surgery in Perth
- About Dr Mark Hanikeri – markhanikeri.com/about-us/
- Breast Surgery Procedures – markhanikeri.com/breast/
- Facial Surgery Procedures – markhanikeri.com/face/
- Body Surgery Procedures – markhanikeri.com/body/
- Surgery Risks and Complications – markhanikeri.com/surgery-risks-and-complications/
| Written by Dr Mark Hanikeri – Specialist Plastic Surgeon, Perth WA. Dr Hanikeri holds Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery and has practised in Perth for over two decades. Consultations are conducted at accredited facilities in Subiaco and Murdoch. |
