Aesthetic Plastic Surgery

, Volume 43, Issue 2, pp 354–365 | Cite as

Effects of Silicone Implants on the Mammary Gland: Ultrasonographic and 3D Study

  • Jesus Benito-RuizEmail author
  • Francisco de Cabo
  • Marisa Manzano
  • Laura Salvador
Original Article Breast Surgery



Breast implants may be responsible for secondary deformities produced by parenchymal atrophy. However, few studies in the literature have reported changes in breast tissue after augmentation surgery. In this study, the breast thickness of patients undergoing breast augmentation was monitored by ultrasound, and correlations with surface, volume and projection measurements were examined.


We studied the parenchymal thickness at the lower pole of the breast with ultrasound in 36 women (72 breasts). In another group of 33 patients (66 breasts), we studied the thickness at the upper and lower poles along the meridian of each breast by ultrasound and measured the anthropometric metrics, volume and projection of the breast with a 3D camera.


Midline measurements close to the areola showed reduced thickness at the lower pole, with 31.8% at the midpoint of the lower pole and 42% at the infra-areolar level (p < 0.0001). At the upper pole, there was a decrease of 14.6% (p < 0.001), but the thickness was increased by 6% and 38% at more cranial levels. No correlations with volume were found. Anatomical implants produced more atrophy at the lower pole, and round implants at the upper pole. More atrophy was found with subfascial than submuscular augmentation. Compared with the expected values, the final volume was very similar, but the projection was 29% less. Surface measurements changed significantly up to 4 months postoperatively and remained stable thereafter.


Implants affect significatively the thickness of the glandular tissue. All changes occur very soon postoperatively but stabilize after 4 months.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Breast augmentation Breast implants Breast atrophy Ultrasonography 3D 



The authors declare that they have no conflicts of interest to disclose.


  1. 1.
  2. 2.
    Tebbetts JB (1998) Use of anatomic breast implants: ten essentials. Aesthet Surg J 18:377–384CrossRefGoogle Scholar
  3. 3.
    Vegas MR, Del Yerro JLM (2013) Stiffness, compliance, resilience, and creep deformation: understanding implant-soft tissue dynamics in the augmented breast: fundamentals based on materials science. Aesthet Plast Surg 37:922–930CrossRefGoogle Scholar
  4. 4.
    Roxo AC, Nahas FX, Bazi F, de Castro CC, Aboudib JH, Marques RG (2015) Evaluation of the effects of silicone implants on the breast parenchyma. Aesthet Surg J 35:929–935CrossRefGoogle Scholar
  5. 5.
    Roxo AC, Nahas FX, Salin R, de Castro CC, Aboudib JH, Marques RG (2016) Volumetric evaluation of the mammary gland and pectoralis major muscle following subglandular and submuscular breast augmentation. Plast Reconstr Surg 137:62–69CrossRefGoogle Scholar
  6. 6.
    Roxo AC, Nahas FX, Rodrigues NCP, Salles JI, Cossich VRA, de Castro CC et al (2017) Functional and volumetric analysis of the pectoralis major muscle after submuscular breast augmentation. Aesthet Surg J. 37:654–661Google Scholar
  7. 7.
    Benito-Ruiz J, de Cabo F (2014) Ultrasonography: a useful tool for plastic surgeons. Aesthet Plast Surg 38:561–571Google Scholar
  8. 8.
    Sieber DA, Stark RY, Chase S, Schafer M, Adams WP Jr (2017) Clinical evaluation of shaped gel breast implant rotation using high-resolution ultrasound. Aesthet Surg J 37:290–296CrossRefGoogle Scholar
  9. 9.
    Tebbetts JB, Teitelbaum S (2010) High- and extra-high-projection breast implants: potential consequences for patients. Plast Reconstr Surg 126:2150–2159CrossRefGoogle Scholar
  10. 10.
    Handel N (2006) Secondary mastopexy in the augmented patient: a recipe for disaster. Plast Reconstr Surg 118:152S–163S (discussion 164S-165S, 166S-167S) CrossRefGoogle Scholar
  11. 11.
    Eder M, Waldenfels F, Sichtermann M, Schuster T, Papadopulos NA, Machens HG et al (2011) Three-dimensional evaluation of breast contour and volume changes following subpectoral augmentation mammaplasty over 6 months. J Plast Reconstr Aesthet Surg 64:1152–1160CrossRefGoogle Scholar
  12. 12.
    Tepper OM, Small KH, Unger JG, Feldman DL, Kumar N, Choi M et al (2009) 3D analysis of breast augmentation defines operative changes and their relationship to implant dimensions. Ann Plast Surg 62:570–575CrossRefGoogle Scholar
  13. 13.
    Govrin-Yehudain J, Dvir H, Preise D, Govrin-Yehudain O, Govreen-Segal D (2015) Lightweight breast implants: a novel solution for breast augmentation and reconstruction mammaplasty. Aesthet Surg J 35:965–971CrossRefGoogle Scholar
  14. 14.
    Montemurro P, Cheema M, Heden P, Ferri M, Li AQ, Avvedimento S (2017) Role of macrotextured shaped extra full projection cohesive gel implants in primary aesthetic breast augmentation. Aesthet Surg J. 37:408–418Google Scholar
  15. 15.
    Caplin DA (2014) Indications for the use of memory shape breast implants in aesthetic and reconstructive breast surgery: long-term clinical outcomes of shaped versus round silicone breast implants. Plast Reconstr Surg 134:27S–37SCrossRefGoogle Scholar
  16. 16.
    Heden P, Montemurro P, Adams WP Jr, Germann G, Scheflan M, Maxwell GP (2015) Anatomical and round breast implants: how to select and indications for use. Plast Reconstr Surg 136:263–272CrossRefGoogle Scholar
  17. 17.
    Montemurro P, Cheema M, Heden P, Agko M, Li AQ, Avvedimento S (2018) Do not fear an implant’s shape: a single surgeon’s experience of over 1200 round and shaped textured implants in primary breast augmentation. Aesthet Surg J 38:254–261CrossRefGoogle Scholar
  18. 18.
    Auclair E, Blondeel P, Del Vecchio DA (2013) Composite breast augmentation: soft-tissue planning using implants and fat. Plast Reconstr Surg 132:558–568CrossRefGoogle Scholar
  19. 19.
    Ozalp B, Aydinol M (2017) Breast augmentation combining fat injection and breast implants in patients with atrophied breasts. Ann Plast Surg 78:623–628CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Antiaging Group BarcelonaBarcelonaSpain
  2. 2.Unidad de Ecografia EstéticaBarcelonaSpain

Personalised recommendations