What's Best for Your Breasts

By: Ruth Donnelly
Created on 12th September 2011

What are the first things you’d think about when planning a breast augmentation?

Well, hopefully your primary concern would be the selection of a decent surgeon – someone with the necessary qualifications, experience and track record to give you confidence in their ability to produce the results you want.

Cost is always a major factor in the decision-making process – unless you’ve had a recent lottery win, cosmetic surgery usually represents a fairly substantial investment – and these days you might also be thinking about the recovery process and even the type of anaesthesia used.

But have you ever stopped to think about the implants themselves – the things that you’ll be carrying around inside you for a long time to come?

I don’t mean their size or shape – that’s a very individual choice, and your surgeon will be able to advise you on the best style to achieve the effect you are looking for. I’m talking about the actual brand of implant used.

Supply and demand
Since the introduction of silicone implants in the 1960s demand for the ‘boob job’ has increased exponentially, and the number of implant manufacturers on the market has risen to meet that demand.

There are now several competing manufacturers, each producing breast implants with slightly different qualities in an attempt to corner the market, so there can often be a bewildering array of implants, with seemingly little to choose between them. So where do you start?

Leading surgeons Anne Dancy and Vik Vijh decided to make the decision-making process a little easier for patients by carrying out a poll of their fellow plastic surgeons to find out how they would rank the commonly used manufacturers.

The respondents were provided with a summary sheet from the implant manufacturers, covering selected points about their product. They were then asked to score the company for several key features, using a scale of nought to ten.

What’s in a name?
Not convinced that there could be such a big difference between the brands? You might be interested to know that therewere 11 key points covered in the questionnaire – that’s a lot of differentiating factors.

Here’s what the surgeons were rating the implant manufacturers on:

Range of implants – a crucial factor for both patients and surgeons because the wider the range of options, the more an augmentation can be tailored to both the patient’s needs and expectations.

This can cover sizes, dimensions, the shape and the filling. To give you some idea what this means: across the three different implants offered by leading manufacturer Nagor – the Impleo round, the GFX and the CoGel anatomical – there are 184 different options.

Types of testing performed and quality certification – it is essential that implants are thoroughly tested and certified, for wear of the outer shell, gel bleed, rupture and capsular contracture.

Capsular contracture rate – capsular contracture (where the breast tissue hardens around the implant) is an unfortunate but not uncommon complication of breast augmentation.

The incidence is often quoted as being up to 30 per cent in the literature. However, with the current generation of implants, this troublesome complication seems to be greatly reduced to around three to five per cent.

Rate of return for implant rupture – with the advances in fourth generation implants, it is unlikely that implants will rupture. If a company has a high rupture rate, then one would suspect that there might be a design flaw.

Ability to retain shape – high viscosity means implants are able to retain their shape no matter what position they are in. Gel implants are liquid, which makes them soft and feel like breast tissue. However, they deform when lying flat.

Gel bleed rates – this is the process by whope, which was designed to contain the gel. In contrast to implant rupture, there is no definite break in the implant envelope. Once outside of the elastomer itich silicone gel particles penetrate and pass through the silicone envel is free to migrate through the body, although the implications of this remain controversial.

Training and support to surgeons – if a company offers a high level of training and support to their customers, the surgeons, it suggests that they take safety and efficacy very seriously.

Patient warranty – does it cover capsular contracture, rupture and small changes in implant volume? Not all companies offer patient warranties and those that do have very specific policies on what they will cover.

The other questions related to the manufacture and distribution of the implants in both the UK and abroad.

The winners

Nagor
Top of the pack was Nagor, with a mean score of seven out of 10. Nagor is the only UK-based implant manufacturer and they offer a lifetime guarantee on all their implants, which, along with a strong commitment to surgeon training, is what really made them stand out from the crowd.

Mentor and Allergan
Mentor and Allergan implants came a joint second, with six out of ten apiece. Mentor is part of the Johnson & Johnson family, while Allergan is better known as the manufacturer of Botox and the Juvederm range of fillers, so you’d expect them to know their stuff when it comes to aesthetics.

Food for thought
So if you’re considering breast augmentation surgery – or any operation that involves the use of an implant – it might be worth asking your surgeon what brand of implant they use, and why.

It may seem like just another thing to add to the endless list of pre-surgery checks, but think about it – this is something that’s going to be put inside your body, and it’s going to stay there a long time. Don’t you want to be sure it’s the best it can possibly be?

The results
Company Mean Score
Allergan .........6
Eurosilicone ....4
Mentor ...........6
Nagor .............7
Sebbin ............5
Silimed ...........5