Breast implants differ in four ways: fill (silicone gel or saline), shape (round or teardrop), shell surface (smooth or textured) and profile (how far the implant projects). No single type suits everyone. The right implant depends on your frame, your breast tissue, the result you want and your willingness to keep up long-term checks, which Dr. Mughni works through with each patient in Dhanmondi, Dhaka.
Reviewed by Dr. Chowdhury Rashedul Mughni, BMDC reg. A 41174. This page is for general educational purposes and is not a substitute for in-person clinical assessment by a qualified plastic surgeon. Treatment decisions depend on individual factors that can only be evaluated during a consultation with Dr. Mughni.
A breast implant is a silicone-shelled medical device, filled with silicone gel or saline, that adds breast volume or restores the breast’s form after surgery. This guide explains each type, who it suits and how Dr. Mughni approaches the choice with patients in Dhanmondi, Dhaka. It sits within our wider guide to breast surgery in Dhaka.
At a glance: how the main implant types compare
Silicone and saline differ most in feel and in how a rupture shows. Round and teardrop implants differ in shape and in the risk of rotation. Every type shares the same outer layer: a flexible silicone shell, made smooth or textured.
Fill: silicone gel vs saline
| Silicone gel | Saline | |
|---|---|---|
| What fills it | Silicone gel, including firmer cohesive (“gummy bear”) gel | Sterile salt water |
| Feel | Closer to natural breast tissue | Firmer; more likely to ripple visibly in slim patients with little breast tissue |
| If the shell breaks | Often silent: the implant keeps its shape | Collapses noticeably; the body absorbs the saline |
| Long-term checks | The US FDA advises MRI or ultrasound 5–6 years after surgery, then every 2–3 years | Rupture is usually visible without a scan |
| US FDA approval age (augmentation) | 22 and over | 18 and over |
| How long it lasts | Not a lifetime device | Not a lifetime device |
| Often suits | Slim patients with thin tissue cover | Patients who want any rupture to be obvious |
Shape: round vs teardrop
| Round | Teardrop (anatomical) | |
|---|---|---|
| Shape | The same in every direction | Fuller at the bottom, tapered at the top |
| If it turns in the pocket | The look does not change | The breast can look distorted and may need further surgery |
| Often suits | Patients who want volume without rotation risk | Patients with specific shape goals who accept the rotation risk |
Implants are priced separately from the surgeon, theatre and anaesthesia fees, as set out in our guide to breast surgery costs in Bangladesh.
When is silicone gel the right choice?
Silicone gel suits patients who want a softer, more natural feel and who are prepared to keep up long-term imaging.
The softer feel matters most when there is little natural tissue to cover the implant, because saline is more likely to show through thin skin as rippling. Body frame matters too: a systematic review of breast augmentation in Asian women concluded that distinct anatomical and cultural features call for an approach planned around the individual patient.
The trade-off is monitoring. A ruptured silicone implant often looks and feels the same, which is why the US FDA recommends scheduled scans.
When is saline the right choice?
Saline suits patients who would rather a rupture be obvious than silent, and who have enough natural tissue to cover the implant well.
A saline implant is filled with sterile salt water, either before or during surgery. If it leaks, it collapses and the body absorbs the saline. Patients usually notice because one breast looks smaller than the other. There is no hidden rupture to find on a scan.
With generous tissue cover, the firmer feel matters less. In the few studies that compared them, a 2025 meta-analysis found no significant difference in capsular contracture between saline and silicone.
Round vs teardrop: which shape suits you?
Round implants are widely used, and turning in the pocket does not change their look. Teardrop implants give a sloped profile but can rotate, and blinded research has not shown a visible advantage.
Teardrop implants are fuller in the lower part, like a natural breast, but if one turns, the fuller part ends up in the wrong place and correcting it can mean another operation.
In a randomised trial, 75 women had a round implant on one side and a teardrop implant of similar volume on the other. Blinded plastic surgeons identified the shape correctly in only about one case in four, and neither surgeons nor lay reviewers consistently preferred the teardrop side. That is why size, profile and pocket placement deserve as much attention as shape.
Smooth vs textured shells: what is the difference?
Smooth shells move freely and feel soft. Textured shells grip the surrounding tissue but carry most of the known risk of a rare lymphoma.
| Smooth shell | Textured shell | |
|---|---|---|
| Surface | Soft, slippery | Rough, so tissue grips it |
| Position | Moves with the pocket | Less likely to shift |
| Capsular contracture | Higher in pooled data | Lower in pooled data |
| BIA-ALCL | No confirmed case reported with smooth implants alone (ASPS, FDA) | Linked to most reported cases |
The contracture finding comes from a 2025 meta-analysis of 16 studies, which the authors rated as low-quality evidence.
The main concern with textured shells is BIA-ALCL, a rare lymphoma of the scar capsule. In 2019, one specific macro-textured implant line was recalled worldwide after US FDA analysis found its risk to be around six times higher than other textured implants.
What is implant profile, and how does it change the result?
Profile is how far an implant projects forward for its width. Higher profiles look fuller; lower profiles look subtler.
Manufacturers name profiles differently (low, moderate, high, extra full). Two implants of the same volume can look very different: one wide and flat, the other narrow and projecting.
Cup size is not a reliable guide, because bra sizing is not standardised. Tissue-based planning, set out by Tebbetts and Adams, matches the implant to measurements of the breast base width, the skin envelope and the thickness of soft tissue. The same measurements guide whether the implant sits above or below the muscle, which is explained on the breast augmentation procedure page.
Which implant type suits which patient?
The right type follows from your tissue cover, age, goals and attitude to long-term checks.
| Your situation | Options usually discussed | Why |
|---|---|---|
| Slim, with little breast tissue | Silicone gel, often under the muscle | Saline shows through thin skin more readily; thin cover favours a pocket under the muscle |
| You want any rupture to be obvious | Saline | A leaking saline implant collapses visibly |
| Aged 18 to 21 (US FDA rules) | Saline | Silicone is approved for cosmetic augmentation from 22 |
| Unlikely to attend scans for years | Saline, or silicone only after weighing the scan schedule | Silicone rupture is often silent |
| You want a subtle change | A lower profile | Lower profiles project less for the same width |
| You want a fuller look | A higher profile | Higher profiles project further forward |
| Concerned about BIA-ALCL | A smooth shell | Reported cases are linked to textured shells |
The final choice is made after examination and measurement, not from this table alone.
How Dr. Mughni decides which implant is right for a patient
He starts from the patient’s own body: her frame, her breast base, her tissue cover and the result she describes. The implant is matched to that, not the other way round.
Dr. Chowdhury Rashedul Mughni notes:
“I prefer preserving cultural features and natural body-structure, for rhinoplasty and also for other body reshaping surgeries. Always a pre-operative discussion with the patient is a must to task for me.”
Patients often come to Dr. Mughni with a cup size or a photograph in mind. The consultation moves that conversation to what their own frame and tissue can carry naturally. Measurements decide which widths and profiles will sit well; the patient’s wishes decide where in that range the final choice falls. That discussion covers every choice on this page: fill, shape, surface, profile and pocket placement.
Published local data are limited. A Bangladesh Journal of Plastic Surgery series of 30 women given round textured cohesive silicone gel implants above the muscle reported no serious complications over at least six months. Those results describe that group only, not any individual surgeon’s practice.
Trade-offs honestly stated
Every implant shares some risks, and none is free of scarring, maintenance or the chance of future surgery. Dr. Mughni adds:
“The first step is to accept that, without scar no surgery is possible. Post-surgery weight management is very important.”
The most common problems with any implant are capsular contracture (tightening of the scar tissue around it), reoperation and removal. Implants are not lifetime devices, and the longer they stay in, the more likely further surgery becomes.
Beyond the type-specific points in the tables above:
• Textured: a link to BIA-ALCL. Published estimates vary widely by implant type; one review puts the overall risk at roughly 1 in 30,000 women with implants, and it usually appears as swelling around 8–10 years after surgery. Most patients are cured by removing the implant and its capsule. The US FDA does not recommend removing implants in women without symptoms.
• Any implant: rare cases of squamous cell carcinoma in the scar capsule have been reported with smooth and textured, saline and silicone implants, diagnosed 7–42 years after surgery.
Any new swelling, lump, pain or skin change around an implant, at any time, should be checked by your surgeon.
Frequently asked questions
Which type of breast implant is best?
No single type is best for everyone. Silicone gel feels closer to natural breast tissue, while saline makes a rupture obvious. Round implants are widely used, and teardrop shapes have shown no proven visible advantage in blinded research. The right choice depends on your measurements, tissue cover and goals.
Which implants look and feel the most natural?
Silicone gel feels closer to natural breast tissue than saline, especially in slim patients with little tissue of their own. How natural the result looks depends more on choosing an implant width and profile that match your breast base than on the implant brand or shape.
Are silicone breast implants safe?
Silicone implants are approved as safe enough for use by the US FDA, but they are not risk-free. Risks include capsular contracture, rupture and future surgery. Because a rupture is often silent, the FDA advises an MRI or ultrasound 5–6 years after surgery, then every 2–3 years.
What is a gummy bear implant?
A gummy bear implant is filled with a firm, highly cohesive silicone gel that holds its shape even if the shell is damaged. Many teardrop implants use it, as do some round ones. It needs a slightly longer incision, and shaped versions can rotate in the pocket.
How long do breast implants last?
Breast implants are not lifetime devices, and there is no fixed date by which they must be replaced. The longer an implant stays in, the more likely it is that further surgery will be needed for rupture, contracture or a change in appearance. Regular follow-up helps catch problems early.
Further questions are answered in our breast surgery questions and answers.
Choosing with your own body in mind
An implant is chosen to fit a body’s own form, and to keep fitting it for years. The right answer comes from honest measurement and an honest conversation about scars, checks and expectations. You can read more about Dr. Mughni’s training and surgical background.
To talk through implant options for your own body, you can arrange a consultation with Dr. Mughni at EKAGRA Health, Dhanmondi.
References
1. US Food and Drug Administration. Types of Breast Implants. https://www.fda.gov/medical-devices/breast-implants/types-breast-implants
2. Schrager S, Lyon SM, Poore SO. Breast Implants: Common Questions and Answers. Am Fam Physician. 2021;104(5):500-508. https://www.aafp.org/pubs/afp/issues/2021/1100/p500.html
3. American Society of Plastic Surgeons. Breast implant options. https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/implants
4. American Society of Plastic Surgeons. Sizing up: Discover your options for breast implants. https://www.plasticsurgery.org/news/articles/sizing-up-discover-your-options-for-breast-implants
5. Hidalgo DA, Weinstein AL. Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial. Plast Reconstr Surg. 2017;139(3). https://vivo.weill.cornell.edu/display/pubid28234826
6. Haas E, et al. Capsular Contracture After Breast Augmentation: A Systematic Review and Meta-Analysis. Aesthet Surg J Open Forum. 2025;7:ojaf003. https://pmc.ncbi.nlm.nih.gov/articles/PMC11842228
7. American Society of Plastic Surgeons. BIA-ALCL Summary and Quick Facts. https://www.plasticsurgery.org/for-medical-professionals/quality-and-registries/bia-alcl-summary-and-quick-facts
8. US Food and Drug Administration. FDA takes action to protect patients from risk of certain textured breast implants (July 2019). https://www.fda.gov/news-events/press-announcements/fda-takes-action-protect-patients-risk-certain-textured-breast-implants-requests-allergan
9. US Food and Drug Administration. Update: Reports of Squamous Cell Carcinoma in the Capsule Around Breast Implants (March 2023). https://www.fda.gov/medical-devices/safety-communications/update-reports-squamous-cell-carcinoma-scc-capsule-around-breast-implants-fda-safety-communication
10. Asian Breast Augmentation: A Systematic Review. Plast Reconstr Surg Glob Open. 2015. PMID 26893980. https://pmc.ncbi.nlm.nih.gov/articles/4727707
11. Anam S, Khondokar MS, Rahman SA. Breast Augmentation in Bangladesh with Silicone Gel Implants: A Short Term Experience. Bangladesh J Plast Surg. 2014;4(1):20-28. https://www.banglajol.info/index.php/BDJPS/article/view/18689
12. Adams WP Jr. Tissue-Based Planning (Chapter 3). Thieme. DOI 10.1055/b-0039-166513. https://plasticsurgerykey.com/3-tissue-based-planning/
13. Tebbetts JB, Adams WP. Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg. 2005. https://utsouthwestern.elsevierpure.com/en/publications/five-critical-decisions-in-breast-augmentation-using-five-measure/fingerprints/
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