When deciding to go forward with breast augmentation surgery, we need to consider these two forms of implants: saline and silicone gel breast implants.
WHAT IS SILICONE?
Silicone is a chemical compound made from silicon, the earth’s second most common element, found in rocks, sand, and quartz, for instance, and used in lotions, soaps, processed foods, and many other everyday items. Silicone is used in both forms of breast implants, as it makes up the outside shell or pouch.
Silicone gel is used to fill the cavity in one kind of breast implant, whereas a saline (salt) solution is used to fill it in the other kind.
A MORSEL OF HISTORY
In the 1960s, silicone gel breast implants were most commonly used, and at the time were a big leap in safety and effectiveness. But by 1991, the FDA had received enough complaints about complications and leakage that it banned them pending further studies and improvements. In 1992 the FDA allowed them to be used, but only in approved research studies, open only to women who meet certain criteria. Your plastic surgeon can decide if you meet these criteria. About 10% of breast implant patients receive the silicone gel type.
Meanwhile, saline-filled breast implants increased in popularity and today are the most frequently used type.
WHAT ARE THE ADVANTAGES OF EACH TYPE?
SILICONE GEL
- The gel has a texture and look similar to breast tissue. So this type looks and feels more natural.
- Also because of its similarity to breast tissue, it’s more effective for women with very small natural breasts
- Recently, an improved form of gel was developed called cohesive silicone gel. It can retain its shape even if the shell ruptures, since it’s thicker in consistency. It’s still being tested and studied. In Europe it has become popular and the FDA has given conditional approval to some manufacturing companies in the U.S.
SALINE
- It’s safer, since if there’s any rupture and subsequent leakage, the saline solution will blend easily with the body’s other fluids, as much of the human body is composed of saline solutions.
- If the shell ruptures and fluid leaks out, this will be visible quickly, because the implant will shrink.
- Saline breast implants are more versatile. They vary in shape, volume, expandability, shell thickness and shell surface. That means they’re easy to customize.
- There are two types of saline breast implants. One is fixed in size (i.e. in amount of saline solution inside the shell). The other is filled at the time of implant but can be adjusted afterwards to have either less or more saline solution inside the shell.
- Incisions are smaller because the implant can be filled after insertion. This is often used with the TUBA Breast augmentation procedure.
WHAT ARE THE DISADVANTAGES OF EACH TYPE OF BREAST IMPLANT?
SILICONE GEL BREAST IMPLANTS
- Ruptures are not immediately noticeable because the breast will look and feel the same. Therefore the gel inside may start leaking in small amounts without being detected.
- It may leak into the bloodstream, where its effects are not yet well known (which is why the use of silicone breast implants is restricted in the U.S. to approved research projects, although it is readily available in Europe). The silicone gel may also migrate to other parts of the body, e.g. arm, abdomen or chest wall, and cause lumps.
- While there is no definitive evidence that links silicone to cancer or any neurological problems, there is also no definitive evidence that eliminates such a link. Let’s note, however, that silicone is used in many surgeries in all parts of the human body, e.g., in heart monitoring, dentistry, treatment of scars, ophthalmology, etc.
The silicone gel type is more often associated with capsular contracture. What’s that? It’s a hardening and tightening of the fibrous scar tissue that develops around the breast implant in its pocket, and it squeezes the implant. This may occur over a period of months or perhaps years, and may cause pain and / or hardening and changes in the shape of the breast, and may sometimes be severe enough to require corrective surgery.
To help prevent it, the shell of the implant can be texturized. This delays the development of fibrous tissue.
This type is more difficult to replace than saline breast implants.
SALINE BREAST IMPLANTS
- Ruptures happen rather more suddenly than in silicone gel implants. That means that the breast size may suddenly decrease. This could be a social disadvantage, but as mentioned above under Advantages, it is also to our benefit, in that we can notice the rupture quickly.
- Ruptures are a little more frequent with this type.
- Some women feel the movement of the saline solution as a discomfort.
- Saline breast implants usually must be replaced after about 10 years.
GENERAL REMARKS
Both types of breast implants require maintenance. Your plastic surgeon will inform you of what this involves. Also, when you have a mammogram, be sure to inform the technician that you have a breast implant. The implant can cover up some cancer evidence.
Breast implant data is continually being collected and analyzed world-wide, and by and large, when approached in an informed way, the breast implant experience is positive for most women. To keep informed when considering your surgery, contact an experienced cosmetic surgeon.
