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Breast Implants

As a board-certified plastic surgeon who specializes in breast augmentation, Dr. Paul G. Ruff IV offers the latest choices in saline and silicone breast implants at his practice in Washington, D.C. He takes the time to help each patient understand all of her options and choose the implants that will provide beautiful results that look and feel natural.

If you're considering breast augmentation in Washington, D.C. and want to find out more about breast implants, request a consultation online to meet with Dr. Ruff, or call our office at (202) 785-4187 to speak with a member of our staff to schedule a consultation.

What's the Right Size for Me?

One of the first things women ask about when choosing breast implants is which size is right. Dr. Ruff makes this decision easy and often fun for his breast augmentation patients. He can help you figure this important choice out using several different approaches:

  • Reviewing photos of women who are the size you want to be.
  • Using a 3-D imaging software system that takes digital images of you and creates a simulation of what you might look like with various types and sizes of implants.
  • Providing breast implant "sizers" for you to try on. These are like temporary silicone implants of varying sizes that can be placed into a stretchable bra and worn under a fitted, solid-color T-shirt. It's a good way to visualize how you might look in clothes.

Once Dr. Ruff has a clear understanding of the size you want to be, he will determine the implant size that will get you there by accounting for your existing breast tissue, breast skin, and chest wall anatomy.

Should I Choose Saline
or Silicone Breast Implants?

All breast implants available in the U.S. today have a silicone outer covering called the shell. The choice comes down to the fill material, which can either be saline (a sterile saltwater solution) or silicone. The following table answers common questions for each type of implant.

When are they filled?

Saline

Filled after placement, so the volume can be adjusted and incisions can be tiny

Silicone

Pre-filled and therefore require slightly larger incisions than saline

VS
How old do I have to be?

Saline

At least 18, or any age for breast reconstruction

Silicone

At least 22, or any age for breast reconstruction

VS
What do they feel like?

Saline

Firmer than silicone

Silicone

Soft, doughy, and more like real breast tissue than saline

VS
What makes these a good choice?

Saline

If you want the smallest incisions or have sufficient breast tissue to cover the implant

Silicone

If you have very little breast tissue, are thin, or want to minimize rippling

VS
What happens if there is a leak or rupture?

Saline

Deflate quickly

Silicone

May not deflate at all and require an MRI to detect

VS
How much do they cost?

Saline

About $1,000 less
than silicone

Silicone

About $1,000 more
than saline

VS

Silicone Implant Options

Silicone implants continue to increase in popularity whether for primary breast augmentation or an elective implant exchange through revision breast surgery. Dr. Ruff offers only FDA-approved silicone breast implants, which generally fall into the following 2 categories according to their consistency:

  • Cohesive silicone gel brands including Allergan Natrelle® and Mentor MemoryGel® feel soft and pliant, and they hold together even when cut (see image).
Mentor MemoryGel Implant cut in half

Mentor MemoryGel Implant Cut in Half

  • Highly cohesive or form-stable silicone implants (also called "gummy bear" implants) such as Sientra® Silimed-brand, Mentor MemoryShape®, and Allergan Natrelle® 410 shaped implants feel soft and slightly firmer than cohesive silicone gel implants, and they retain their shape better when the patient is standing upright (see demonstration video).

See how a Mentor MemoryShape highly cohesive breast implant holds together when cut.

Profile/Projection

Breast Implant profiles

Both saline and silicone breast implants are available in various profiles, also called projections. An implant profile is a term that describes the width and depth of the implant. A low-profile implant (top) is wider and flatter than a high-profile implant (bottom), which is more narrow and projects farther (is deeper from front to back). Depending on the implant brand, there are other projections that fall in between the high and low profiles.

These options enable Dr. Ruff to help you attain your desired breast shape in a way that fits naturally with your unique breast anatomy, the width of your chest, and the way your breasts sit on your chest. Properly chosen, the right implant profile can enhance your breasts in the way you want, such as increasing fullness at the top of the breasts or filling out the cleavage between the breasts.

Shape

Another option for both silicone and saline implants is the shape, which can either be round or shaped (also called anatomical, teardrop, or contoured). Round implants increase overall breast fullness and are a popular choice. Teardrop implants reflect a natural breast shape with a gentle slope and more fullness at the bottom.

Breast Implant shape options

Implant Surface

Breast implants are made with either smooth or textured surfaces. Smooth implants can slide around freely in the implant pocket. Textured implants are made to help the body to adhere to the implant surface and prevent the implant from shifting. Because shaped implants must be oriented with the narrower end at the top of the breast, they are made with textured surfaces. Round implants are available with textured surfaces as well, which may prevent a complication called capsular contracture.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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