Which breast implants are the best?
At a Glance
- 🏥Leading manufacturers compared
- 🔬Silicone vs. saline implants
- ⚙️Shapes, projections & surfaces
- 📍Placement above/below the muscle
- ⏱️Longevity: 10–15 years
"Is there THE best breast implant? That is a very good question, but unfortunately it cannot be answered quite so simply."
There are very good breast implants from a variety of leading manufacturers, such as Motiva, Polytech, Allergan Mentor, or B-Lite breast implants. However, various factors are important when choosing the best and, above all, the right breast implants for each woman.
Let us be honest – most women do not want their breast augmentation to be immediately obvious. And even in intimacy, the breast implant should not feel like a foreign body, but rather soft and natural. So how do I find the breast implant that will make me happy when having a breast augmentation?
Which brand implants are available?
In terms of product safety for breast implants, great advances have been made in breast augmentation in recent years. Today there are various high-quality and safe breast implants for a beautiful bust and a good, natural feel after breast surgery.
Polytech
German quality with a long tradition
Mentor (Allergan)
World-leading manufacturer
Motiva
Innovative technology and design
B-Lite
Lightweight implants for greater comfort
What are breast implants actually made of?
In breast augmentation with implants, there are fundamentally two types of breast implants: silicone gel-filled breast implants and saline-filled breast implants.
Silicone Implants
- ✓Multi-layer cross-linked silicone gel
- ✓Very stable and resilient
- ✓No leakage if damaged
- ✓Softer, more natural feel
- ✓Similar to natural breast tissue
Saline Implants
- ✓Filled with saline solution
- ✓Similar to bodily fluid
- ✓Fill volume adjustable during surgery
- ✓Firmer feel
- ✓Also suitable for tissue expansion
Surface texture of breast implants
Breast implants are available with various surface textures. The implants may have a smooth, soft-textured, or highly textured surface.
Smooth
Softer shell, less palpable
Soft-textured
Balanced properties
Highly textured
Lower capsule risk
Which features are important when selecting?
The volume of the implants
🔵 Round implants
Even volume distribution, more fullness above the nipple, more upper pole fullness
💧 Teardrop shape (anatomical)
More natural shape, fullness decreases towards the top, mimics female anatomy
The projection of breast implants
Projection refers to the distance between the base of the breast implant and the outward-facing surface of the implant – the "curvature" of the implant.
Low
Moderate
High
Extra high
The firmness of breast implants
Firmness is crucial for the tactile feel of the breast. Saline-filled breast implants are firmer and feel more rigid. Modern silicone breast implants enable a harmonious and completely natural-looking result – the breast feels entirely natural and soft.
Placement: Above or below the pectoral muscle?
In breast augmentation with silicone implants, the breast implant can be positioned in different ways. The choice of the correct placement depends on various factors: the patient's anatomy, the size of the desired implant, the existing breast tissue, and individual goals.
✅ Below the pectoral muscle (submuscular) – RECOMMENDED
As a rule, implants are placed beneath the pectoral muscle during breast augmentation, i.e. submuscularly. The implant lies entirely beneath the pectoralis major muscle.
Advantages:
- ✓Lower complication risk: Better coverage reduces risks
- ✓Easier breast cancer screening: Mammography images are more informative
- ✓Lower capsular contracture risk: Significantly reduced probability
- ✓Implant less palpable: Muscle provides additional padding
- ✓Edges less visible: Particularly important with little native tissue
- ✓More natural result: Soft transition to the décolletage
Disadvantages:
- ✗Longer recovery time: Muscle must adapt
- ✗More postoperative pain: Muscle is stretched
- ✗Size limitation: Muscle not very extensible, better suited for smaller implants
- ✗Animation deformity: Implant may move when the muscle contracts
- ✗Exercise restriction: Weightlifting can distort the implant
Particularly suitable for:
Slender women with little native tissue, smaller breast implants, patients with thin skin, younger women with firm tissue
Above the pectoral muscle (subglandular)
With this method, the implant is placed between the pectoral muscle and the glandular breast tissue. The implant sits directly behind the mammary gland, but in front of the pectoral muscle.
Advantages:
- ✓Shorter operating time: Technically simpler to perform
- ✓Less pain: Muscle is not affected
- ✓Faster recovery: Shorter recuperation time
- ✓Larger implants possible: No muscular restriction
- ✓More upper pole fullness: Fuller shape in the upper area
- ✓No animation: Implant does not move when the muscle contracts
Disadvantages:
- ✗Higher capsular contracture risk: Up to 3-fold increase
- ✗Implant palpable/visible: Problematic with little native tissue
- ✗Visible rippling: Rippling with thin skin
- ✗Mammography more difficult: Breast cancer screening more complicated
- ✗Faster ptosis: Weight pulls the skin downward more
Particularly suitable for:
Women with sufficient native tissue, mild breast ptosis (for lifting), athletes (bodybuilding/weightlifting), larger implants desired
⭐ Dual-plane technique (Dual-Plane / subpectoral)
With the dual-plane technique, the pectoral muscle is placed over the upper two thirds of the breast implant. The lower third remains uncovered and is covered only by the glandular and fatty tissue – as with the subglandular method. This technique combines the advantages of both placements.
Advantages:
- ✓Best of both worlds: Combines advantages of both methods
- ✓Natural shape: Particularly harmonious transition
- ✓Good upper coverage: Muscle protects the upper half of the implant
- ✓Lower pole volume: Lower pole appears naturally full
- ✓Flexible: Suitable for various implant sizes
- ✓Less animation: Reduced movement when the muscle contracts
Disadvantages:
- ✗Technically demanding: Requires considerable experience from the surgeon
- ✗Longer operating time: More complex dissection required
- ✗Moderate pain: Muscle is partially released
- ✗Asymmetry risk: Precision in muscle detachment is important
Particularly suitable for:
Medium to large implants, mild breast ptosis (combines lifting and augmentation), women with moderate native tissue, when a natural result with good volume is desired
Comparison at a glance
| Criterion | Submuscular | Subglandular | Dual-Plane |
|---|---|---|---|
| Capsular contracture risk | Low | Elevated | Moderate |
| Postoperative pain | More | Less | Moderate |
| Recovery time | Longer | Shorter | Moderate |
| Natural result | Very good | Good* | Very good |
| Implant palpable | Rarely | Often | Rarely |
| Implant size | Small–Medium | All sizes | Medium–Large |
| Mammography | Feasible | More difficult | Feasible |
*With sufficient native tissue
How is the breast implant inserted?
The surgical access for inserting the breast implant can be performed using different techniques:
Axilla
(transaxillary)
Inframammary fold
(inframammary)
Areola
(periareolar)
The most appropriate surgical technique must be determined in an individual consultation.
How long do breast implants last?
Breast implants generally need to be replaced after 10–15 years.
Sometimes an implant exchange may need to be carried out earlier if complications arise, for example due to deformation of the breast or as a result of capsular contracture.
What is capsular contracture?
Capsular contracture is a hardening of the tissue surrounding the breast implant. With every breast augmentation, a tissue capsule forms around the breast implant. This is a natural process, as every breast implant is initially a foreign body to the body.
If this immune response is too intense, a thick, firm capsule forms around the breast implant, constricting and deforming it. Hardening, deformation, and pain are the consequences.
💡 Prevention:
To avoid capsular contracture as far as possible, the position of the implant is crucial. If the implant is placed beneath the pectoral muscle, the likelihood of capsular contracture is lower than with placement above the pectoral muscle.
Breast implants with Dr. Karl Schuhmann
Breast augmentation with implants is one of the most sought-after breast surgery procedures and has been my primary area of expertise for many years.
Your dream of a new feeling in your body – I would like to support you in achieving it.
Frequently asked questions
Which breast implants are the safest?
All reputable manufacturers such as Polytech, Mentor (Allergan), Motiva, and B-Lite offer safe, CE-certified implants. What matters is not just the brand, but the correct selection based on your individual anatomy and wishes. Your surgeon should have demonstrable experience with the chosen implant type.
Silicone or saline – which is better?
Modern silicone implants are the preferred choice in most cases, as they feel more natural and are more similar to real breast tissue. Saline implants have the advantage that the size can be adjusted during surgery, but they feel firmer. Your surgeon will recommend the best solution based on your initial findings.
Round or teardrop-shaped – which shape should I choose?
Round implants create more fullness in the upper breast area (upper pole) and are more versatile. Teardrop-shaped (anatomical) implants look more natural as they mimic the natural breast shape. The choice depends on your starting point, your desired result, and your lifestyle. During the consultation we will find the best option for you.
What does projection mean and which is right for me?
Projection describes how far the implant protrudes forward. Low projection for a subtle, flatter look; high or extra-high projection for a more pronounced, voluminous bust. The correct projection depends on your build, breast width, and desired result. Narrow breasts often require a higher projection to achieve the desired volume.
Why is placement below the muscle recommended?
Submuscular placement offers several advantages: lower risk of complications and capsular contracture, better results for breast cancer screening (mammography), a more natural feel, and less visible implant edges. This method is particularly ideal for slim women with little native breast tissue. With larger implants, a dual-plane technique may be more appropriate.
How can I avoid capsular contracture?
The best prevention is choosing an experienced surgeon, sterile operating conditions, and submuscular placement. In addition, the following can help: regular follow-up examinations, implant massage (if recommended), avoiding nicotine, and choosing textured implants. Despite all precautions, the risk cannot be completely ruled out – it is approximately 1–10% depending on the study.
Do I really have to replace the implants after 10–15 years?
Modern implants no longer have a fixed "shelf life", but 10–15 years is a common recommendation. As long as no problems arise (deformation, capsular contracture, damage) and regular check-up examinations are unremarkable, replacement is not strictly necessary. Many women nevertheless choose to have them replaced after this time to adjust the size or shape.
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Über den Autor
Facharzt für Plastische und Ästhetische Chirurgie & Handchirurg
Mit mehr als 30.000 Eingriffen und mehrjähriger Tätigkeit als Chefarzt führt Dr. Schuhmann seit 2016 als Gründer von artethic® seine Praxen in Düsseldorf und Berlin.