The concept of a “natural feel” in breast augmentation refers to the softness, pliability, and movement of the breast mound. Ideally, an augmented breast should mimic the suppleness of natural breast tissue and respond realistically to gravity and body position. The final result is a complex interplay of the implant’s internal material, its physical dimensions, the surgical technique used, and the patient’s own anatomy. Because numerous factors influence the outcome, the answer to which type of implant feels most natural depends on an individual’s unique physical characteristics and surgical plan.
Material Comparison: Saline Versus Silicone
The choice between saline and silicone gel implants is the first decision that significantly impacts the perceived softness and texture of the breast. Silicone gel implants are widely regarded as providing a feel that is closer to that of natural breast tissue. This is because the cohesive gel inside the implant shell is designed to simulate the viscosity and density of human fat and glandular tissue.
A key benefit of the silicone gel is its ability to reduce the visibility of rippling, which can be seen or felt when the implant shell folds or wrinkles. Silicone’s thicker consistency helps the implant maintain a smoother contour, making the tactile experience more uniform and soft to the touch. The exact feel of a silicone implant is determined by its specific gel density, or cohesiveness, a factor that varies between manufacturers.
Saline implants, which are filled with a sterile saltwater solution, tend to feel firmer than silicone gel implants. The liquid nature of the saline filler means the implant shell is more susceptible to palpable folds, known as rippling, especially at the edges. This rippling is often more noticeable to the touch, particularly in patients who have less natural breast tissue to provide a cushioning layer.
The firmness of a saline implant is also influenced by its fill volume. Ultimately, while saline implants are a safe and effective option, the texture of the internal liquid can create a feel that is less forgiving and more obviously different from un-augmented breast tissue compared to silicone.
How Shape and Gel Cohesiveness Influence Feel
Beyond the basic material, the specific design of the silicone gel and the shape of the implant refine the tactile result. Modern silicone implants are categorized by their level of gel cohesiveness, which measures the gel’s internal stickiness and firmness. Lower cohesivity gels are more fluid and pliable, offering a softer feel that moves more freely, closely mimicking the natural flow of breast tissue.
Higher cohesivity gels, sometimes referred to as “gummy bear” implants, are denser and maintain their shape even if the implant shell is cut. This density provides excellent shape retention for maintaining a specific contour. However, the trade-off is a firmer, more solid feel that may not move as naturally as softer gels.
Implant shape also dictates the final tactile impression. Round implants provide fullness across the entire breast and generally feel softer and more pliable due to the uniform distribution of the gel. Anatomical, or teardrop-shaped, implants are typically filled with a highly cohesive gel to ensure the device retains its specific contour, which can result in a more structured or firmer feel, particularly at the upper pole.
The Role of Surgical Placement
The physical location of the implant relative to the chest wall musculature determines how the device feels beneath the skin. Submuscular placement involves positioning the implant partially or entirely beneath the pectoralis major muscle. This layer of muscle and surrounding tissue provides a natural blanket of coverage over the implant, which effectively disguises the implant’s edges and texture.
For patients with minimal natural breast tissue, placing the implant beneath the muscle helps soften the feel and reduces the risk of the implant’s folds or wrinkles being palpable. This extra tissue coverage generally contributes to a more integrated and natural tactile result.
In contrast, subglandular placement positions the implant over the muscle and directly behind the existing breast tissue. This method offers less tissue coverage, meaning the implant’s edges and firmness are more easily felt through the skin. The implant is more exposed in this position, increasing the likelihood that its presence will be distinctly noticeable to the touch, especially in very thin individuals.
Patient Anatomy and Long-Term Feel
Factors inherent to the patient’s body significantly influence both the immediate and long-term natural feel of the augmented breast. A patient’s existing quantity of breast tissue and subcutaneous fat acts as a natural camouflage for the implant. The greater the layer of native tissue, the softer and more organic the implant will feel, regardless of its material, as the body’s own softness predominates over the implant’s texture.
The size and projection of the implant must also be proportionate to the patient’s chest anatomy and skin elasticity. Implants that are excessively large or have a very high profile can stretch the overlying tissue envelope. This stretching can make the breast tissue feel taut or thin, resulting in a less yielding and inherently less natural feel than a moderate-sized implant that is well-supported by the surrounding anatomy.
Over time, a significant factor that can compromise a natural feel is the complication known as capsular contracture. This occurs when the body’s natural scar tissue capsule, which forms around any foreign object, tightens and hardens around the implant. Capsular contracture causes the breast to feel abnormally firm, sometimes described as ball-like, and can develop regardless of whether the implant is filled with saline or silicone gel.