Now that silicone is back... is it better?

Saline implants are filled during the surgery by the cosmetic surgeon , allowing them to be custom-filled in a range based on the size of the implant, usually about 20 cc's from the bottom of the range to the top. Implants that are under-filled may feel softer, but they also have a tendency to ripple and wrinkle.

On the other hand, implants that are over-filled (as is often recommended) are firmer and retain their shape. They have such a tendency to retain their shape that they maintain it regardless of the posture of the wearer: standing, sitting, reclining, leaning, or laying down. This can look and feel unnatural.

On the other hand, silicone implants, which come from the manufacturer pre-filled, are less likely to ripple, but are supple and pliable, shifting with the posture of the wearer just as natural breast tissue would. In fact, most people who have considered both think that the silicone implants feel much more like natural breast tissue than saline implants.

However, once implanted, the actual feel of the breast implant is determined not by the implant itself but by the scar tissue, or capsule, that forms around the implant. The more the scar tissue, the harder the feel. Therefore, the question is: how can scar tissue be reduced.

How and why different people's bodies respond with different levels of scarring is a difficult question, but a number of factors seem to impact the level of scarring. The only way to get a good idea about the level of scarring you might expect from your breast enlargement surgery is to consult with your plastic surgeon, but in general you will have more scarring if you:

· Are receiving a larger implant

· Are older

· Are in less-than-ideal health

· Receive an implant placed below the gland and above the muscle

· Are a smoker or heavy drinker

· Receive a silicone implant.