Breast implants

Three implant shapes

The implants used in breast augmentation are filled with silicone gel. They differ first by their shape. Put simply, the round implant works on volume, the anatomical one sculpts the shape.

The round implant

Its gel is usually softer. It suits a wish for full, round breasts, or a breast with supple skin that is already harmonious and well shaped. It also suits implant replacements.

The ergonomic implant

Its base is round, its gel soft and elastic. It takes on a natural shape, standing as well as lying down. Its results lie halfway between older-generation round implants and anatomical implants. It is the implant most often offered today. Its shell is nanotextured.

The anatomical implant

Teardrop-shaped, it has a more cohesive gel and keeps a stable shape. It allows precise control of the shape: straight cleavage, controlled breast projection, harmonious lower curve. It is used to shape a new breast: small, youthful breasts with tight skin, malformed or asymmetric breasts, slightly sagging breasts. In cosmetic surgery, it is reserved for particular or difficult cases.

Shell and gel

Two features matter as much as the shape: the surface of the shell, and the consistency of the gel.

Smooth, nanotextured or microtextured

The surface of the shell is called its texturing. It can be smooth, nanotextured or microtextured. Ergonomic implants have a nanotextured shell. Anatomical implants are microtextured: their surface gives good stability, with a very low rotation rate.

Since 4 April 2019, the French medicines agency (ANSM) has banned all macrotextured surfaces as a precaution, as they may induce chronic inflammation in the capsule.

A more or less cohesive gel

The gel is soft in the round implant, soft and elastic in the ergonomic one, more cohesive in the anatomical one, which therefore keeps its shape. With the very soft shells and gels available today, the subfascial plane is used more and more.

Ranges have evolved: profiles, gel cohesiveness, texturing. An implant replacement is an opportunity to review an earlier choice in the light of the implants available today.

Choosing your implant

The choice is made at the consultation, from your measurements, like a made-to-measure garment.

The examination looks at skin quality, the thickness of the tissue under the skin, the volume of the gland, the position of the areolas and of the inframammary fold, the pectoral muscles, the rib cage and any asymmetry.

The width, height and projection of the implant are chosen from these measurements. A sizer, slipped into a trial bra, shows you the size. A Crisalix 3D simulation reconstructs your bust from three photographs and shows the shape and volume. It is a decision aid, which can in no way be contractual.

To give an idea, a standard breast augmentation takes you from an A cup to a C cup with a 320 cc implant.

In front of or behind the muscle

The plane depends on tissue coverage, that is, the thickness of the gland in the cleavage. Behind the muscle, the pocket is now made as a dual plane, with the upper half of the implant is covered by the muscle and the lower half by the gland. In front of the muscle, the implant is placed under the fascia that covers it: this is the subfascial plane.

Where the tissues are thin, the edges of an implant can show. A fat transfer can then thicken the coverage and soften the edge of the implant, which is chosen smaller: this is composite breast augmentation.

How the implant goes in

Through an incision in the fold under the breast, along the edge of the areola or in the armpit: the choice is explained on the Breast augmentation page. With the Preservé technique, the incision is two centimetres long, and Motiva Preservé implants go up to 320 cc.

Lifespan and follow-up

An implant has no expiry date, but it wears. Its lifespan is at least ten years.

Follow-up includes a visit and examination by your surgeon every year, with an ultrasound on request. After ten years, an ultrasound every year checks that the implant is intact.

Replacement is considered for wear, from ten years, or for a change that has occurred over time: capsular contracture, malposition, asymmetry, slackened skin. It can also meet a wish to change volume or shape. See implant replacement.

Contracture, rupture and warranty

A fibrous envelope, the capsule, forms naturally around the implant.

Its hardening is called capsular contracture. It is unpredictable. The inframammary approach reduces its rate; the areolar approach, which crosses the gland, carries a higher risk.

A ruptured implant can be replaced in the same operation. In the event of a repeat operation, implants are guaranteed by the manufacturer for ten years, notably for early rupture or capsular contracture. If the rupture occurs within ten years, cover can be requested from the manufacturer under materiovigilance. Examined case by case, it covers the implants and the clinic costs, according to the terms of the implant purchase contract.

Fees

Prices are starting prices. They include the implants.

• Breast augmentation with implants: from €4,900.
• Breast implant replacement, without capsulectomy: from €4,900.
• Breast implant removal, without replacement: from €2,900.
• Implant removal with mastopexy and fat transfer: from €7,400.

They also include the surgeon’s and anaesthetist’s fees, operating theatre and hospital stay costs, and follow-up for three months. The cost of your operation is set out in a written, detailed quote, given at the consultation. French law then requires a cooling-off period of at least fifteen days before the operation. All amounts are on the Fees page.