Choosing Breast Implants: Key Points

Choosing implants at a glance

ShapesRound or ergonomic
FillingCohesive silicone gel
SurfaceSmooth, micro- or nanotextured
Most common volume200 to 300 cc
Lifespan12 to 15 years on average
ChoiceMeasurements, trial sizers, 3D

A breast implant is chosen on the basis of several criteria: its shape, profile, volume, surface and filling, then its placement and the incision through which it is inserted. Dr Médard de Chardon uses round or ergonomic implants, filled with cohesive silicone gel, with a smooth, microtextured or nanotextured surface. The volume is decided on the basis of measurements and trial sizers rather than a cup size: in France, most implants placed measure between 200 and 300 cc. Everything is decided at the consultation, with a 3-dimensional simulation.

Article from 2012, updated with the range of implants currently available in France.

1. Shape: round, ergonomic or anatomical?

Round: the most common; being symmetrical, it carries no risk of rotation. On a well-proportioned breast, it gives the same result as an anatomical implant. See: round implants.
Ergonomic (Motiva): round, with a softer gel; when you stand, it takes on a teardrop shape, then returns to an elongated round shape, with no risk of rotation.
Anatomical (teardrop): long used to change the shape of the breast; since the end of macrotextured implants (2019), it rotates much more often and Dr Médard de Chardon no longer recommends it. See: anatomical implants; rotation of anatomical implants.

2. Profile: low, moderate or high

The profile is the projection of the implant seen from the side. For the same width, a high-profile implant projects further and holds more volume than a low-profile one. It helps, for example, to fill a slightly deflated breast; a low profile, wider and less projecting, gives a more discreet result.

3. Volume

An implant is defined first of all by its base (its diameter) and its projection: it is these two dimensions, more than the figure in cc, that must match the breast. In France, 87% of surgeons place implants of 200 to 300 cc. For a woman of average height and weight, with a chest wall of normal shape, a 250 cc implant increases the bust by about one cup size, and a 300 cc implant by about two cup sizes. This is only an estimate: the result varies according to each patient’s anatomy (volume of the existing breast, width of the chest, profile of the implant). An excessive volume is not advisable: it stretches the tissues and speeds up the ageing of the breasts; in a slim patient, it is better not to exceed 350 cc. See: how to choose implant volume.

4. Surface: smooth or textured

The implants Dr Médard de Chardon uses today are smooth, microtextured or nanotextured. Since 5 April 2019, the ANSM (French National Agency for the Safety of Medicines and Health Products) has banned macrotextured and polyurethane-coated implants in France, because of a rare risk of lymphoma (BIA-ALCL); Allergan’s Biocell implants were also recalled worldwide in 2019. See: lymphoma and breast implants.

5. Filling: cohesive silicone gel

Dr Médard de Chardon uses cohesive silicone gel implants with a multi-layer shell: the gel stays inside the implant even if it ruptures. Saline implants are no longer marketed, nor are hydrogel implants. [Note: this refers to the French market.]

6. Placement: in front of the muscle, behind the muscle or dual plane

In front of the muscle (prepectoral): the implant moves naturally with the breast, but is more visible and more palpable in a very slim patient.
Behind the muscle (subpectoral): it hides the implant’s outline and reduces the risk of capsular contracture, but the implant moves slightly when the muscle contracts.
Dual plane: the upper part of the implant is behind the muscle, the lower part in front; this is the placement chosen in most cases.

7. The incision: armpit, areola or fold

Three approaches are possible: in a crease of the armpit, guided by a camera (endoscopic transaxillary approach), with no scar on the breast; along the lower edge of the areola, if it measures more than 3 cm; or in the fold beneath the breast (inframammary fold). The choice depends on the patient’s anatomy and preference.

Implant safety and follow-up

You leave with the implant card for your implants: their traceability is ensured by you, by the clinic and by Dr Médard de Chardon.
A silicone gel implant lasts 12 to 15 years on average. It is not replaced routinely: if imaging shows no rupture and the result remains satisfactory, regular monitoring is sufficient.
Follow-up: check-ups at 6 days, 3 weeks, 3 months, 6 months and 1 year, then every two years with imaging.
Possible complications, described on their own pages: capsular contracture, rippling, double bubble, rotation of anatomical implants, very rare lymphoma (BIA-ALCL).

Frequently asked questions

What is the best breast implant?

There is no best implant in absolute terms. The shape (round or ergonomic), profile and volume are chosen according to the patient’s build, measurements and wishes, after trial sizers and a 3-dimensional simulation.

How many cc to gain one cup size?

For a woman of average height and weight, with a chest wall of normal shape, a 250 cc implant adds about one cup size, and a 300 cc implant about two cup sizes. This is only an estimate: the result varies according to each patient’s anatomy, hence the importance of measurements and trial sizers.

Smooth or textured implants?

In France, only smooth, microtextured or nanotextured implants have been permitted since 2019; macrotextured and polyurethane implants are banned. The choice between them is discussed at the consultation.

Can saline implants still be used?

No, they are no longer marketed. Dr Médard de Chardon uses cohesive silicone gel implants.

Do implants need to be changed every 10 years?

No, not routinely. A silicone gel implant lasts 12 to 15 years on average; if imaging shows no rupture and the result remains satisfactory, regular monitoring is sufficient.

Choosing your breast implants: the key points