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Breast Implant Options

Guide to breast implant decisions — size, profile, shape, surface, incision, and placement. Centre for Surgery uses Silimed silicone exclusively — CE-marked with a 10-year warranty. CQC-regulated Baker Street facility.

Your Breast Implant Options at Centre for Surgery

Breast implants are used for , , and surgery. Choosing the right implant for your anatomy and goals is one of the most important decisions in the process. There is no single correct answer — the appropriate implant depends on your measurements, existing tissue, goals, and lifestyle.

The main decisions to be made about breast implants are:

At Centre for Surgery, we use Silimed implants exclusively — a globally recognised brand with over 40 years of manufacturing history, CE-marked to the highest EU standards, and backed by a 10-year warranty covering both capsular contracture and implant rupture. All breast implant surgery is performed by consultant plastic surgeons on the GMC Specialist Register at our CQC-regulated Baker Street facility under TIVA.

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Breast Implant Fill — Silicone vs Saline

All breast implants have a rubbery outer silicone shell regardless of the internal fill material. There are two main fill types:

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Saline-filled implants are filled with sterile saltwater. They tend to feel firmer and less natural than silicone, and have a higher risk of visible rippling — particularly in patients with limited overlying tissue. Saline implants were commonly used approximately 20 years ago when surgeons had concerns about early-generation silicone; they are now rarely used in the UK. If a saline implant deflates, the saltwater is safely absorbed by the body, but the breast immediately changes shape. Saline implants have a higher risk of capsular contracture and bottoming out compared to modern cohesive silicone implants.

Silicone gel implants have a significantly more natural look and feel than saline — the cohesive gel closely resembles natural breast tissue in consistency. They have a much lower risk of rippling and maintain their shape more reliably. Modern cohesive gel implants are designed so that if the outer shell is damaged, the silicone gel remains substantially contained rather than migrating freely. The risk of rupture with modern fourth-generation implants is less than 1% per year. Silicone implants are the standard of care for breast augmentation in the UK.

Centre for Surgery uses Silimed silicone cohesive gel implants exclusively. Saline implants are not routinely used; if you have a specific clinical reason to request saline, this can be discussed at consultation. For the majority of patients, Silimed silicone implants are the appropriate and recommended choice.

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Breast Implant Size

Breast implant size is measured in cubic centimetres (cc) — not cup size. Cup size varies between bra brands and is not a reliable surgical measurement. Silimed manufactures hundreds of implant sizes across all shapes and profiles; the appropriate size for any individual patient is determined by clinical assessment, not preference alone.

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You will have a wide choice of breast implant sizes and projection options to choose from at your in-person consultation, where your surgeon will take precise measurements of your breasts — including base width, height, soft tissue thickness, skin elasticity, and nipple position — and use these to guide implant selection. A breast-torso ratio analysis may be used to identify the implant most proportionate to your frame.

Choosing an implant that is too large for your anatomy carries specific risks: skin stretching, reduced skin elasticity over time, bottoming out, and accelerated ptosis. Choosing an appropriately sized implant for your anatomy — rather than the largest implant possible — produces a better long-term result with lower complication rates. Implant size is confirmed at your final pre-operative appointment.

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Breast Implant Texture and BIA-ALCL

Breast implants come in smooth, textured, and polyurethane-coated surface varieties. The surface texture relates to the outer implant shell.

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Smooth implants have no surface texture and have the most natural feel. They can rotate within the breast pocket, which is not a concern for round implants but would be problematic for anatomical (teardrop) implants. Smooth implants are technically easier to insert and have the lowest surface roughness.

Textured implants have a rough surface designed to allow surrounding tissue to grip the implant, reducing rotation within the pocket. This is important for anatomical implants, which must remain correctly oriented. Over the past decade, macro-textured implants have been associated with BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) — a rare immune cell lymphoma. The use of highly textured implants has dramatically reduced since this link was established.

BIA-ALCL is a rare condition — with only approximately 500 cases reported worldwide from an estimated 50 million+ women with breast implants. It is primarily linked to macro-textured implant surfaces. We recommend reading the . This will be discussed in full at your consultation.

Silimed manufactures polyurethane-coated implants — a distinct category where the outer surface of the implant is coated with a thin layer of polyurethane foam. Polyurethane-coated implants have a very low surface roughness (micro-texture level) and have not been linked with BIA-ALCL. Over 30 years of clinical data support their safety and confirm a significantly reduced risk of capsular contracture compared to standard smooth or textured implants. Polyurethane-coated Silimed implants are the recommended option at Centre for Surgery for patients where reduced capsular contracture risk is a clinical priority — including patients having revision surgery for recurrent contracture.

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Breast Implant Shape — Round vs Teardrop (Anatomical)

The shape of breast implants is another factor that must be considered when choosing the right breast implant. Breast implants come in both round shapes and anatomical (teardrop) shapes. For women with moderate pre-existing breast tissue, it can be difficult to determine whether breast augmentation has been carried out with round or teardrop implants. Most surgeons are unable to tell the difference as a well-performed breast augmentation produces results that appear natural. The breasts will adopt a natural teardrop shape over time.

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Many patients choose teardrop implants to increase the height of the augmented breast and for greater contrast between the lower and upper portions of the breast. The versatility of anatomical implants makes them a popular option for many patients, depending on the look they hope to achieve. Teardrop implants aim to follow the natural profile of the breast. Round implants can produce just as natural-looking results as teardrop implants in most cases as long as the correct breast implant placement is chosen. The breast skin and its elasticity can significantly impact choosing the correct size and shape of the implant. Some patients may require a breast lift or a breast lift with implants to correct loose breast skin.

All anatomical implants come with a textured surface to minimise the degree of implant rotation inside the breast pocket. The appearance of the breast may appear deformed if an anatomical implant rotates. Round implants come in both smooth and microtextured surfaces. If round implants were to rotate in the breast pocket, this is not of great concern as the breast shape would not be affected. If an anatomical implant rotates within the breast pocket, it must be repositioned either non-surgically with external manipulation or surgically in some cases to correct its position.

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Breast Implant Projection and Profile

Breast implant projection refers to the distance the implant protrudes outward from its base or its height when placed on a table.

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Your surgeon will provide customised recommendations on the most appropriate implant profile to help you achieve optimal results. Breast implants come in a wide variety of profiles, which helps to determine overall breast projection. High-profile implants are popular in the UK and are more likely to produce a perkier appearance. Low-profile implants may be more suitable for women who would like to achieve a more subtle-looking breast enlargement.

The same volume of implant (the same number of cc) can be configured in different profiles — a low-profile implant has a wide base and shallow projection; a high-profile implant has a narrower base and more forward projection. Your chest base width is the primary determinant of which profile suits your anatomy: a high-profile implant on a wide chest can look under-projected, and a low-profile implant on a narrow chest can spill laterally.

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Breast Implant Incision Options

There are three main types of breast implant incisions. The most common type of incision used for breast implant surgery is the located in the lower breast crease. It is important to remember that all surgical incisions will result in a scar. Patients who follow their post-operative instructions can expect the scars to fade gradually. After three months, most scars are barely visible when wearing most types of clothing or when the arms are at rest by the side of the body. Your surgeon will be able to explain how potential scars could look after each incision option and will recommend the best choice for you. However, in virtually all cases, the inframammary approach is considered the gold standard technique.

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The inframammary approach involves making an incision in the lower breast crease and is viewed as the best technique for breast implant insertion. Women who would like to breastfeed their child when they get pregnant most commonly choose this technique to retain the ability to breastfeed. This approach allows optimal control over implant selection and positioning. The inframammary incision is the most common approach for breast augmentation surgery in the UK. Choosing this approach will enable surgeons to achieve optimal symmetry. The scar is relatively short and most commonly measures between 3.5 cm and 5 cm. The size and shape of the implant may affect the length of the required incision. Other factors that may determine the incision size include previous surgery, skin elasticity and whether a breast funnel is used to insert the implant. For women concerned about scarring in the inferior breast crease, a periareolar approach can be chosen instead.

This incision is located around the full circumference of the nipple. Neither patients nor surgeons prefer this approach. Achieving optimal implant placement with this incision can be technically challenging. If patients have a combined breast lift with breast implants, the surgeon can gain greater control as an inframammary incision will be performed simultaneously. The periareolar approach has a higher risk of affecting future breastfeeding ability. The incision is made around the areola at the border between the breast skin and the areola. This helps to minimise the visibility of the scar. The major drawback of this approach is the higher risk of altered nipple sensation and the risk of being unable to breastfeed.

This approach is the least commonly used in the UK. The incision is made through natural skin folds in the armpit. This approach is only recommended for individuals at risk of excessive scarring, including those with keloid scars, which commonly occur on the chest in individuals with darker skin. This technique has a high risk of complications, and revision surgery rates are higher with the transaxillary approach. The incision must also avoid essential nerves and blood vessels whilst achieving optimum implant placement. A channel is created from the armpit to the breast to insert the breast implant. Although the scar is virtually invisible as the incision is hidden within the armpit, it may still be visible, especially when people place their arms in certain positions.

The approach may be recommended in some instances for women who would like to breastfeed their children and those with darker skin who are at a high risk of keloid scarring. This approach cannot be used for revision surgery. All breast revision surgery is carried out via the inframammary approach. The risk of complications with this approach outweighs the potential benefits, and our surgeons rarely perform this breast augmentation technique through the armpit.

Breast Implant Placement

Breast implants can be placed either in front of the pectoralis muscle, behind the breast tissue (over the muscle), or behind both the breast and the pectoralis muscle (under the muscle).

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The subglandular approach is suitable for women with sufficient soft tissue coverage around the cleavage area. The breast implant is positioned between the pectoralis muscle and the breast tissue. Subglandular breast augmentation has a quicker recovery compared with the dual-plane approach. Women can achieve enhanced breast cleavage. Mild to moderate degrees of breast ptosis can be corrected with this approach. Unlike under the muscle approach, over-the-muscle insertion does not result in the double bubble deformity seen when women lift weights in the gym.

A new variant of the over-the-muscle approach is . This approach combines the benefits of the subglandular approach with elements of the dual approach, eliminating the need to split the pectoralis muscle.

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The dual plane approach involves placing the breast implant between the pectoralis muscle and the underlying rib cage. In this approach, only the upper half of the breast implant is covered by the pectoralis muscle. The lower half of the implant is in direct contact with the breast tissue. This approach is ideal for women who have little or no breast tissue. The pectoralis muscle provides coverage to the upper portion of the breast implant, helping women conceal the edges of the implants.

The submuscular approach is most commonly used for and is not widely used for cosmetic breast augmentation.

Breast Augmentation with Implants or Fat Transfer

Breast augmentation can be performed with implants, fat transfer, or both techniques combined in the same procedure.

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Breast augmentation with implants remains the most commonly performed method of increasing breast size in the UK. Implants provide a predictable, significant volume increase — from a subtle half cup to several cup sizes, depending on the implant chosen. Placement can be subglandular (over the muscle) or dual plane (under the muscle). Implants are appropriate for patients wanting a reliable, significant size increase.

, also known as fat grafting or lipofilling, involves harvesting fat from another area of the body (typically the abdomen, flanks, or thighs) via liposuction and injecting it into the breasts. Fat transfer cannot achieve the same degree of volume increase as implants — it typically produces half to one cup size per session — and approximately 30–40% of transferred fat is naturally reabsorbed. However, it uses only the patient’s own tissue, carries no implant-related risks, and produces a very natural feel.

Combining implants with OnabotulinumtoxinAAbobotulinumtoxinAIncobotulinumtoxinAPrabotulinumtoxinALetibotulinumtoxinARimabotulinumtoxinBHyaluronic Acid FillersCalcium Hydroxylapatite FillersPoly-L-lactic Acid FillersPolymethylmethacrylate FillersAutologous Fat GraftingForehead Lines TreatmentGlabellar Frown Lines TreatmentCrow’s Feet TreatmentBunny Lines TreatmentChemical Brow LiftLip FlipGummy Smile CorrectionMasseter ReductionJaw SlimmingDimpled Chin SmoothingCobblestone Chin SmoothingNefertiti Neck LiftMicro-BotoxMesotoxHyperhidrosis TreatmentChronic Migraine ReliefBruxism TreatmentTMJ TreatmentCervical Dystonia TreatmentNeck Spasm TreatmentBlepharospasm TreatmentLip AugmentationLip ContouringCheekbone EnhancementTear Trough FillersNasolabial Fold SofteningMarionette Line FillersLiquid RhinoplastyNon-Surgical Nose JobJawline ContouringJawline DefinitionChin AugmentationTemple VolumisingHand RejuvenationAcne Scar Subcision Filling transfer in the same operation allows the implant to provide the primary volume while fat is used to soften the upper pole and cleavage area — producing a more natural result than implants alone. This is particularly beneficial for lean patients with limited overlying tissue. See and .

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Silimed Breast Implants at Centre for Surgery


At Centre for Surgery, we use Silimed breast implants exclusively. Silimed is a globally recognised implant manufacturer with over 40 years of manufacturing experience, used in more than 70 countries and CE-marked to the highest EU standards.

Silimed implants are manufactured using medical-grade silicone with a highly cohesive gel composition — providing a natural feel that holds its shape over time. The outer shell is manufactured to a consistent specification with a low rupture rate of less than 1% per year. Silimed offers the full range of implant options: round and anatomical shapes; smooth, textured, and polyurethane-coated surfaces; and a comprehensive range of sizes and profiles to suit all anatomies and goals.

All Silimed implants placed at Centre for Surgery come with a 10-year warranty covering both capsular contracture and implant rupture. The warranty terms are reviewed at your consultation. If a covered complication occurs within the warranty period, the replacement implant cost is covered by the manufacturer.

The latest generation Silimed implants use highly cohesive silicone gel — designed so that if the outer shell is damaged, the gel remains substantially contained within the shell rather than migrating. This significantly reduces the clinical impact of implant rupture compared to earlier-generation implants.

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Why Choose Centre for Surgery for Breast Implant Surgery?

All breast implant surgery at Centre for Surgery is performed by consultant plastic surgeons on the GMC Specialist Register — members of BAPRAS and ISAPS. We do not use cosmetic doctors or non-specialist practitioners for breast surgery.

We use Silimed implants exclusively — CE-marked, with a 10-year warranty covering both capsular contracture and implant rupture, included in all breast augmentation prices.

Surgery takes place at our purpose-built private hospital at 95–97 Baker Street, Marylebone, independently inspected and rated “Good” by the Care Quality Commission.

All breast implant surgery at Centre for Surgery uses TIVA (Total Intravenous Anaesthesia) — the safest form of general anaesthesia for day-case surgery. Faster recovery, less post-operative nausea, quicker discharge.

The Breast Funnel no-touch technique is used for all implant placements — minimising contamination risk and reducing capsular contracture rates compared to manual insertion.

A mandatory two-week cooling-off period applies after every consultation before surgery is booked.

24/7 surgeon-led support for the first 48 hours. Wound check at 7–10 days. Surgeon review at 6 weeks. 3-month assessment.

Your initial consultation is £100, redeemable against the cost of your procedure.


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