Breast Implant Types, Explained Without the Jargon

Most women researching breast augmentation hit a wall somewhere around the second paragraph of any clinic’s implant guide. The jargon starts fast (cohesive gel, elastomer shell, microtextured, projection ratio) and the marketing language does not help.

This is the version we wish existed when our own clients started reading. It is what your surgeon actually thinks about when choosing an implant, written for the human who will live with one.

Five things you are actually choosing

There are five decisions folded into “what implant”:

1. Fill (what is inside)
2. Shell texture (the surface)
3. Shape (round or anatomical)
4. Profile (how far it projects)
5. Size (measured in cc)

We will go through each one in the order they tend to matter.

1. Fill: saline, silicone, or cohesive gel

Saline is salt water in a silicone shell. It is filled after insertion, so the incision can be smaller. It feels firmer and can show rippling in thin patients. In our network of surgeons, saline is rarely the first choice for NZ and Australian patients, but it has its place if you have specific reasons.

Silicone gel is the most common choice worldwide. The gel is viscous, so it holds shape but still feels soft. Most modern silicone implants are safe at the levels we are using them. The brand matters: Allergan, Mentor, Motiva, and Sientra are the four our surgeons use, and each has its own safety record and warranty terms.

Cohesive gel (often called “gummy bear”) is a thicker silicone that holds its shape even if the shell is damaged. It tends to feel slightly firmer than standard silicone but is the safest option if shell failure is a worry, and anatomical (teardrop) cohesive implants are the standard for shaped augmentations.

In practice, the choice between silicone and cohesive gel is usually small. The bigger differences are shape and profile.

2. Shell texture: smooth vs textured

Smooth shells move slightly within the pocket. They tend to feel softer and have lower rates of a rare complication called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Textured shells (including microtextured) grip the surrounding tissue and stay in place. This matters more for anatomical implants, which would rotate in a smooth pocket.

Rough-textured implants (the older macrotextured kind) have largely fallen out of use because of the BIA-ALCL link. Microtextured shells from reputable brands have a much lower risk profile.

If your surgeon recommends a smooth round silicone implant, that is the most common choice today and there is a good reason for it.

3. Shape: round or anatomical (teardrop)

Round implants are symmetrical. They give a fuller upper pole and tend to look more augmented at the top. Most patients wanting a noticeable change go round.

Anatomical (teardrop) implants have more volume at the bottom. They give a more subtle, natural slope and are popular with patients wanting a result that does not look “done”. They are more expensive and require textured shells to stay in place.

This is the choice most worth spending time on with your surgeon. Both look fine in the right patient. Neither is universally better.

4. Profile: how far it projects

Profile is the implant’s projection relative to its base width. Low, moderate, high, and extra-high profiles are common.

A high profile implant on a narrow chest gives fullness. A low profile implant on a wider chest gives a softer look. The wrong profile on your body is what makes implants look obviously fake, not the size.

Your surgeon will measure your chest width and recommend a profile range. This is not where to push back hard.

5. Size: measured in cc, not cup

Every cc adds roughly the same volume, regardless of brand, but how that volume looks depends entirely on your starting anatomy. A 300cc implant on a tall woman with a wider chest can look like a small B cup. The same 300cc on a shorter, narrower frame can look like a full C.

Bring reference photos, not numbers. “I want to look like this photo” is a usable brief. “I want to be a C cup” is not, because cup sizes are not standardised.

What your surgeon will actually ask you

When our network surgeons sit down with you, they ask three things:

1. What look do you want? (Bring photos.)
2. How active are you? (A runner has different implant considerations than a sedentary patient.)
3. Are you planning a pregnancy in the next few years? (Implants and pregnancy are fine together, but timing matters.)

If your surgeon does not ask any of these and just offers you a menu of sizes, find another surgeon.

The single biggest mistake

The biggest mistake patients make is choosing size by trying on sizers in a bra in the clinic and going up one. The sizer in a padded bra tells you what you will look like in a padded bra. The implant under your muscle looks roughly 10 to 15% smaller in real life, and it does not get the help of a Wonderbra.

Trust your surgeon’s eye. If they say your frame can carry a particular size without looking fake, they are probably right.

Brand and warranty

Each brand offers a warranty, usually lifetime on the implant itself and 10 years on the surgical cost if a rupture is confirmed. Read the warranty terms before surgery and keep the implant card you are given. Your surgeon will register you with the manufacturer.

A summary you can take to your consult

Decision	Common choice	When to deviate
Fill	Silicone gel	Cohesive if you want shaped, or saline if you prefer smaller incisions
Texture	Smooth	Microtextured if you want anatomical
Shape	Round	Anatomical if you want subtle, natural slope
Profile	Moderate	High for narrow frames, low for wider frames
Size	250 to 350cc	Driven by your anatomy, not your goal cup

If you go to your consultation knowing you have a default in each column and a clear answer for the things you actually want to deviate on, you will make a better decision in 30 minutes than most people make in three clinic visits.

Want to talk it through with us before your consult? Book a free 30-minute call.