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Breast Implant Options


Breast Implants in the 21st Century

Breast Implants Explained

Dr. Stephens is known as one of the Northwest’s experts and pioneers in utilizing innovative techniques for breast augmentation. Having performed thousands of breast augmentation procedures, he has an intimate knowledge of the available implants.

The type and the size of breast implants are unique for each individual woman. During your consultation, Dr. Stephens and his staff will spend an extensive amount of time educating you about the current implants and about his techniques. They will help guide you in selecting the ones that suit your specific goals.

Saline vs. Silicone? Now Gummy Bear? What’s the Deal? What about the IDEAL IMPLANT®?

Well Here’s the Deal

Image of Implant shapes
First, all breast implants are “silicone based” in that they have an outer shell made of silicone. What distinguishes breast implants, in general, is the material they are filled with. In the past 10 years, advances in silicone technology have made the silicone gel implant material safer. The development of the IDEAL IMPLANT® has made the “saline based” implant more like the silicone implant in its “feel.”

  • Silicone Implants: These are the “traditional” breast implants that we think of in that they are filled with silicone gel. It is agreed within the industry that silicone implants feel more natural than saline. They come in “natural-shaped” and “round-shaped” styles. Specifically, they are selected by considering their “ideal width” and “projection” from the body for the unique goals of the woman. While adjustments cannot be made to them once they are placed, there are now so many different sizes and dimensions that this isn’t really a problem. The incision needed to insert this type of implant is also a bit longer than would be necessary for saline implants; however, Dr. Stephens uses the Keller Funnel® to place all of his implants, which reduces the length of the scar.
  • Gummy Bear; Cohesive Breast Implants: This describes a generic term for the latest and safest implants that have been developed by all of the current manufacturers utilizing the newest gel materials. Sientra® first coined the term for their “gummy bear” implant, but Allergan, who initially called theirs “gummy” to distinguish their “form-stable” shaped implant, now use the term “gummy” to describe all of their round gel implants. A better way to look at these new and vastly safer implants is that they are cohesive. Cohesive implants consist of gel that sticks very well to itself to provide a more stable shape to the implant. In the case of the Sientra® implant, the gel doesn’t escape the shell of the implant due to the unique design of the implant gel to the shell interface. Dr. Stephens uses these safe cohesive gel implants in over 90 percent of all of his breast implant procedures.
  • Saline Implants: All saline implants are filled with a natural, sterile “saline” solution. These are filled with saline to the manufacturers’ specifications once they have been placed in the breast pocket. Saline implants are firmer and typically have more risk of rippling around their edges than silicone gel implants. They can be placed through smaller incisions, and minor adjustments in size can be made in them. The newest saline-based implant is the IDEAL IMPLANT®, which is a unique structured device designed to be softer and emulate silicone with less rippling. We recommend them for any woman who doesn’t want to use silicone gel.

Round vs. Teardrop, “Anatomical” Shaped Breast Implants

Round breast implants are by far the most common choice for breast augmentation and are used in over 90 percent of cosmetic breast implant cases in the United States, even though the manufacturers have heavily promoted the “shaped” teardrop-type implant. They are typically softer than most teardrop-shaped implants. They will “teardrop” when placed under the pectoral muscle, and they feel more like the natural breast due to their softer gel (in all but the stiffest implants), and there is no possibility of a deformity should they rotate in the breast pocket.

Teardrop, or “anatomical” shaped breast implants were developed to mimic the “natural” shape, or the contour, of the breasts. While they are available in both saline and silicone, currently the silicone are much more commonly used these days. The Allergan “anatomical” shaped implants are made of the thicker and stiffer “gummy bear” material, whereas the Sientra® “anatomical” shaped implant is softer but is still designed to maintain its shape, so it is a bit stiffer than its “round” implant.

Smooth vs. Textured

The shell of a breast implant can be either smooth or textured. Smooth implants are slick and move within the breast pocket, whereas the textured implants are designed to grip the breast pocket to retain their position. Teardrop implants are textured to prevent them from rotating in the breast implant pocket and to hold their position.

Currently, the Allergan textured implant has been discontinued in Europe, Brazil, Australia, and most recently, Canada due to the possible relationship between their type of texturing process and the rare risk of a type of cancer called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) that has been found in one of 30,000 cases over the past 15 years. Neither the textured surface of the Sientra® nor the Mentor® implant has been implicated in this. For more on this, see our blog article on BIA-ALCL.

Base Width Diameter and Profile

Breast implants come in different profiles or projections as well as in different diameters from very narrow to very wide widths. A concept called the “base width diameter”(BWD) describes the width of your breast from the inner part of the natural breast near the middle of your chest to the outer fold of your breast next to your armpit (axilla). This is the breast “shadow” that is cast on your chest called your breast “footprint,” which is used to decide the width of the breast implant for your chest. Your frame or your chest circumference and the amount of breast tissue you already have are important factors when choosing the recommended implant width and profile for you. This is called dimensional analysis of breast implant sizing. Dr. Stephens will work with you to review and assess the best implant choice to help you decide on the one for you based on your idea of your desired breast shape during your consultation.

In addition to measuring the BWD, the size of the breast you desire is the profile of the implant. Popular breast implant profiles are currently low, moderate, moderate plus, and high profile implants (with the moderate, moderate plus, and high profile being the most popular). Different brands may offer slightly different projection choices. The higher the profile of the breast implant, the further the implant will project the breast from the chest and the more round shape it will give the breast. Some patients may desire a smaller implant with a moderate profile or projection and fullness, where others may desire a larger profile and fullness. It all depends on your aesthetic goals, which you can discuss with Dr. Stephens and then decide on the best breast implant for you.

By offering many breast implant choices and with a thorough consultation and assessment, we can help you find the implant option that is perfect for you and your aesthetic goals!

The VECTRA® 3D Imaging System

We are proud to offer the VECTRA® 3D imaging system from Canfield. It consists of six cameras that take a precise topographical three-dimensional image of your body that is then input into the computer application that shows how you can look with breast implants of different widths and profiles as well as with round versus shaped implants. This amazing device proves the point that a picture is worth a thousand words; it truly provides a realistic image of your potential results. It is a great communication tool that allows Dr. Stephens to understand your desired result and allows us to understand your goals and provide recommendations for you. It is also very helpful to bring in photos with results you like.

Implant Brands

We offer implants from several manufacturers, including:


Sientra® silicone implants include a wide variety of widths and projections of round and “anatomical type” (teardrop) shaped breast implants. We are currently utilizing the Sientra® breast implants in over 90 percent of our silicone implant procedures, as they have demonstrated a uniquely strong interface bonding between the implant gel and the shell so that even if they break, they don’t “rupture,” in the sense that the implant material stays within the implant. They also offer an extensive limited warranty of 20 years against implant failure as well as a limited “capsular contracture” warranty. We love that they have a true, “Moderate Plus” projection style that fits between the high and moderate profile implant.

Sientra Logo


Boasting a wide variety of implant options and dimensions as well as being one of the long-time leaders in the breast implant industry with a long safety record, Allergan breast implants have the widest choices in implant widths and profiles, from the low profile, low plus, moderate, high, and ultra high choices. They offer both saline and silicone implants in a variety of sizes, projections, and shape choices as well as three different stiffness qualities (gummy) with their round implants for those who want a firmer, rounder breast. Dr. Stephens has been an Allergan user for 20 years due to their emphasis on quality and customer service.

Allergan Logo


IDEAL IMPLANT® is a new kind of saline-based breast implant that has a unique design that consists of a structured (or baffled) outer-chamber with a stable inner-chamber. The saline solution fills the baffled outer silicone shell chamber, which makes the implant behave more like a gel, being softer than a standard saline implant with less rippling over the outer diameter. The IDEAL IMPLANT® offers a soft feel that is somewhat similar to that of silicone gel implants. It has the peace of mind that should an IDEAL IMPLANT® rupture, it will go flat, causing the involved breast to lose its volume and shape. Unlike silicone-filled implants, an MRI is not required to check the status of your IDEAL IMPLANT®.

Ideal Implant Logo

Why Dr. Stephens?

Dr. Stephens is one of the top cosmetic breast surgeons in the Puget Sound area as well as the country. He has an intimate knowledge of how any type of breast implant works to shape your breast tissue and uses the most advanced, safest, and most reliable surgical techniques in breast surgery today. He has an exceptionally well-developed, critical eye and perspective and a distinctive artistic sensibility of proportion and shape. He is known to listen to his patients carefully in an unrushed manner to understand the uniqueness in every woman’s desires and goals. He and his award-winning staff are known to provide his patients a safe, friendly and professional experience from their consultation throughout their care. The VECTRA® 3D imaging technology will allow his patients to visualize their results prior to surgery. This as well as a full closet of implant sizes to try on if needed will help his patients achieve the transformation of their breasts and body that they desire.

Have more questions? Check out our breast augmentation FAQs here or to call our office at (425) 455-0444 to schedule a consultation.

Voted The BEST

Consecutively voted in the top 5 “Best Favorite Plastic Surgeon” in Evening Magazine’s Best of Western Washington and “Best Cosmetic Surgeon” in 425 Magazine.

Dr. David Stephens, Plastic Surgery | Medical Aesthetics

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Within easy access from all points in the Northwest, Bellevue makes the ideal location for all your cosmetic needs. Free parking included.

10687 NE 2nd Street
Bellevue, WA 98004

Phone: (425) 455-0444

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