Breast Implants: Types, Brands, Sizes and Costs Overview

Breast implants are medical products used for aesthetic augmentation or reconstructive restoration of the female breast. They rank among the most commonly performed plastic surgery procedures worldwide — in Germany alone, over 20,000 breast implantations are performed annually. The market is complex: different filling materials, shapes, surfaces, manufacturers and sizes make selection difficult without well-founded consultation. This comprehensive guide explains all essential aspects of breast implants — from material selection through CE certification and longevity to costs and risks.

What Are Breast Implants?

Breast implants are surgically inserted prostheses that change the volume and shape of the breast. They consist of an outer shell of medical-grade silicone and a filling material that varies depending on implant type. Breast implants are used for:

Aesthetic breast augmentation for small or asymmetric breasts
Breast reconstruction after mastectomy (e.g. for breast cancer)
Correction of congenital breast deformities such as tuberous breast
Restoration of breast volume after pregnancy or significant weight loss
Correction of pronounced breast asymmetry

Types of Breast Implants by Filling Material

Silicone Gel Implants

Silicone gel implants are by far the most widely used breast implants worldwide. Their shell consists of a multi-layered silicone elastomer, filled with a highly viscous silicone gel that feels very similar to natural breast tissue.

Advantages:

Very natural appearance and feel
Low risk of rippling compared to saline implants
Stable shape even with positional changes
Extensive long-term clinical experience and excellent safety profile
Available in a wide variety of sizes and shapes

Disadvantages:

In the event of a defect, a "silent rupture" is possible — gel remains in the capsule without immediate symptoms
MRI checks every 2–3 years recommended for rupture detection

Saline Implants

Saline implants consist of a silicone shell filled with sterile saline solution. In Europe they are considerably less common than silicone implants.

Advantages: If rupture occurs, the saline is harmlessly absorbed by the body — a defect is immediately recognisable through volume loss. Volume can be adjusted intraoperatively.

Disadvantages: Higher risk of visible rippling, especially in slim patients. Less natural feel compared to silicone gel.

Cohesive Gel Implants ("Gummy Bear Implants")

Cohesive gel implants contain a highly cross-linked, very firm silicone gel that maintains its shape — similar to a gummy bear. They are particularly common in anatomically shaped (teardrop) implants. Key advantage: the gel retains its shape even if the shell ruptures. Key disadvantage: firmer feel compared to soft silicone gel; rotation of an anatomical implant may require revision surgery.

Shapes of Breast Implants

Round Implants

Round implants have a uniform, circular contour and fill the breast evenly at the top and bottom. They are the most widely chosen implant type worldwide. Key advantages: no rotation problems (as they are symmetrical), can create upper pole fullness, simpler handling during surgery, better cost-to-performance ratio.

Anatomical Implants (Teardrop Shape)

Anatomical implants mimic the natural shape of the female breast: flat at the top, fuller at the bottom. They are particularly suitable for patients with very little natural tissue, reconstructive procedures after mastectomy, and correction of tuberous breast deformity. Important: anatomical implants must be textured to prevent rotation in the implant pocket.

Implant Surfaces

Smooth implants move more freely in the implant pocket, allowing natural movement. Textured implants have a roughened, sponge-like surface to better anchor the implant. Note: certain strongly textured implants (particularly from specific manufacturers) have been associated with an increased risk of the very rare Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), leading to some products being withdrawn from the market. Polyurethane-coated implants (used by Polytech and Motiva) promote strong tissue integration and according to current studies significantly reduce the risk of capsular contracture.

Implant Volumes

Volume	Result
100–200 cc	Subtle augmentation, one to two cup sizes
200–300 cc	Natural augmentation, very popular
300–400 cc	Pronounced fullness, good balance between natural and full
400–500 cc	Prominent augmentation, harmonious with broader chest
500+ cc	Strongly augmenting, recommended only for appropriate build

Note: Volume in cc alone says little about the actual aesthetic result. The decisive factors are individual body measurements: breast base width, chest circumference, existing natural tissue and desired bra size.

Key Implant Brands

Mentor (Johnson & Johnson)

One of the oldest and most well-known breast implant manufacturers. The MemoryGel line is particularly known for its soft, natural gel feel. Mentor implants have an extensive long-term study database, CE and FDA approval, and a lifetime guarantee against rupture.

Motiva Implants (Establishment Labs)

One of the most innovative implant brands. Features an extremely thin, high-strength shell with ProgressiveGel Plus silicone and SmoothSilk/SilkSurface technology with extremely low particle deposition. Every Motiva implant has an embedded QR tag (Q Inside Safety Technology) for traceability. CE-certified.

Polytech Health & Aesthetics

A German company based in Dieburg — one of the few European implant manufacturers. Offers round and anatomical implants in smooth, textured and polyurethane-coated (Microthane) versions. Strict European quality standards, domestic manufacturing, and comprehensive warranty services. CE-certified.

Allergan / Natrelle (AbbVie)

Long the world's largest implant provider. The Natrelle line includes round and anatomical silicone gel implants. Important note: Allergan voluntarily recalled certain strongly textured products (BIOCELL) in 2019 due to elevated BIA-ALCL risk. Current Natrelle products with smooth and moderately textured surfaces are CE-certified and available.

B-Lite (Polytech)

A special product line from Polytech offering implants approximately 30% lighter than conventional silicone gel implants of the same volume. This can benefit women with an active lifestyle or those wishing to avoid back discomfort from heavy implants.

CE Certification and Safety Standards (EU MDR)

In the European Union, breast implants must carry the CE mark to be approved for the market. Since the European Medical Device Regulation (MDR, EU 2017/745) came into force in May 2021, significantly stricter requirements apply:

Clinical evaluation and post-market surveillance
Registration in the European database for medical devices (EUDAMED)
Strict quality management systems (ISO 13485)
Independent certification by notified bodies

Patients should insist that their surgeon uses only CE-certified implants from reputable manufacturers. So-called "no-name implants" from unknown sources have no place in a reputable operating room.

Longevity of Breast Implants

Breast implants are not lifetime devices — however, they can remain in the body for many years or even decades without problems. The commonly cited "10-year rule" is a myth: there is no blanket medical recommendation to routinely replace implants after 10 years.

Implants should be exchanged or removed when: rupture is diagnosed, capsular contracture develops, aesthetically disturbing positional change or asymmetry occurs, or the patient wishes a change.

Capsular Contracture — The Most Important Risk

Capsular contracture is the most frequent complication after breast implantation. The body forms a connective tissue capsule around every foreign body — this is physiologically normal. It becomes problematic when this capsule thickens and contracts (Baker Classification Grade III and IV), which can lead to hardening, pain and breast deformity.

Risk factors include: certain implant surfaces, subglandular placement, breast irradiation, haematoma or infection after surgery, and individual genetic predisposition. Severe contractures (Grade III/IV) are treated surgically (capsulotomy or capsulectomy), often combined with implant exchange.

Costs of Breast Implantation

Cost Component	Typical Range
Implant costs	€500–€2,000 per pair
Surgeon's fee	€2,000–€4,000
Anaesthesia costs	€400–€800
Clinic / operating room costs	€500–€1,500
Pre- and post-operative consultations	€200–€500
Total	€3,500–€8,000

Statutory health insurance covers breast implantation costs only in rare exceptional cases: reconstruction after mastectomy for breast cancer, congenital severe deformities (e.g. Poland syndrome), or pronounced transsexual gender alignment. For purely aesthetic procedures, patients bear the costs in full.

Frequently Asked Questions

Can women with breast implants breastfeed? Most women with breast implants can breastfeed without problems. The implant lies behind the breast tissue or muscle and generally does not directly affect the milk glands.

Do breast implants affect mammography? Breast implants can limit the informativeness of a mammogram as they may overlay parts of the breast tissue. Radiologists experienced in examining implanted breasts use special techniques (Eklund technique) to optimally visualise the natural tissue.

What is BIA-ALCL? Breast Implant-Associated Anaplastic Large Cell Lymphoma is a very rare form of lymphoma associated with textured breast implants. The absolute risk is very low (estimated 1 in 30,000–500,000 implanted women), but real. Warning signs include sudden breast swelling years after implantation.