In today’s breast augmentation surgery, women have the option of either saline or silicone gel implants. Both work effectively at enlarging one’s breasts although there are some minor functional differences between them due to their different fill materials. Amongst the options beyond the type of implant are what size and what projection. While every woman focuses a lot on the decision of implant size, the issue of projection is less well known or understood.
Projection (some call it profiling) is how much the breast implant comes forward. All breast implant sizes come in three projections from low to high. The differences in projection are evident when one views them lying flat on a table. The higher projecting implant sits up higher and looks more round. Careful inspection of all three projections of implants lying side by side will reveal that the higher the projection, the more narrow is the implant width. Given that they are all the same volume, it would make sense that to get more to come forward this would have to be done at the expense of a less breast implant width.
But what does this mean for the patient? The benefits of implant profiling are not what it looks like on a table top. Implants must be viewed from the perspective of what they will look like on a chest when one is standing. When viewed this way, one can appreciate that a round implant (lying on a table) has a teardrop shape when in an actual patient when they are vertical. (it will look round when one is lying down but so do natural breasts) Increasing the projection of a breast implant allows it to look less teardrop-shaped in the standing position as the modified implant shell allows slightly more to remain in the upper pole of the breast. Therefore, if one desires a more round breast shape rather than a teardrop, think of a high projection breast implant.
Not to matters more complex, but there are projecting differences between saline vs silicone gel breast implants. This is a subtle issue that I do not see discussed. Saline implants, because they are essentially filled under the pressure of a fluid fill, have a higher projection than that of silicone implants. This means that a medium projection saline implant will really have the shape of a high projection silicone implant. Therefore, the highest projecting breast implant is that of saline…or to put it another way…high projection saline and high projection silicone implants (at the same size) will not look exactly the same.
But don’t get overly hung up on the projection issue. It is much less important than the selection of implant type and size. How an implant will make the breast look is also significantly influenced by the quality of breast skin and the size of the implant pushing out behind it. And in my Indianapolis plastic surgery practice this has a greater influence on shape than does the implant’s projection.
Dr. Barry Eppley
Indianapolis, Indiana