Should i get saline or silicone implants

Plast Reconstr Surg ; 7 SS. Soft Touch is a registered trademark of Allergan, Inc. Style cohesive silicone breast implants: safety and effectiveness at 5 to 9 years after implantation.

Plast Reconstr Surg ; Although silicone gel breast implants have been controversial at times, the advantages of their natural weight and feel, as well as their ability to be molded and shaped, have outweighed concerns over past problems and kept them at the top of the implant market.

Round silicone gel implants have always had a more breast-like consistency than saline and have better resisted visible or palpable rippling in patients with a thin tissue envelope. With form-stable implants, surgeons will have a much more powerful tool to help patients with small breasts and thinner skin envelopes achieve a natural result.

Note the rounded look of both the round saline and silicone gel implants compared to the more natural look of the contoured saline and the form-stable silicone gel implants.

For patients who desire a less round look, the form-stable implant is an option. A, C A year-old woman who presented for breast augmentation. B, D Three months after augmentation with smooth, round saline implants Allergan 68MP filled to cc and placed subpectorally from a transaxillary approach.

B, D Five months after augmentation with contoured saline implants Allergan LF filled to cc and placed subpectorally. B, D One month after augmentation with round cc silicone implants Allergan style and placed subpectorally. B, D Six months after augmentation with form-stable gel implants Allergan style MM, g placed subpectorally.

B, D Two years after augmentation with smooth, round saline implants Allergan 68MP filled to cc and placed subpectorally from a transaxillary approach. B, D Two months after augmentation with contoured saline implants Allergan LF filled to cc and placed subpectorally. B, D Three months after augmentation with form-stable gel implants Allergan style MM, g placed subpectorally. Form-stable implants require a larger incision for placement current recommendations are for an incision between 5 and 5.

Gel fracture has been found to occur with excessive deformation of an implant resulting from an attempt to place it through a small incision, but it is a rare occurrence, and the effect of a fracture in the gel is largely unknown and likely of little consequence.

The increased stability and cohesivity of silicone gel as compared to saline has led to the belief that silicone exerts a more minimal stretching and deforming force on overlying tissue. As a patient moves, local forces governed by gravity and inertia are exerted on the implant.

The more the implant deforms, the more these forces are transmitted to surrounding tissue. Although data indicate that the incidence of malposition is indeed increased with saline implants over silicone implants Table 3 , studies have not been sophisticated enough to detect whether this implant property is the reason.

Although silicone gel implants are undoubtedly technologically more advanced and saline has a firmer, less natural feel, saline implants do have some distinct advantages. First, they require almost no long-term surveillance. Once patients are informed of the consequences of rupture namely, visible deflation, accompanied by nearly instantaneous resorption of the saline contents , they can be trusted to be aware of this occurrence.

Device malfunction is clinically much more obvious than with a silicone gel implant, which may require physical exam, sonography, mammography, MRI, and even surgery to determine its integrity. Saline implants also have the advantage of being inserted in the collapsed state. This allows them to be easily inserted through small and sometimes remote incision sites as in the case with a periareolar incision in a patient with a small areola or via a transaxillary or transumbilical incision.

Saline implants have some degree of adjustability, giving the surgeon slightly more flexibility by allowing fine-tuning of volume within a narrow range. Visible rippling and risk of failure can increase with underfilling, thus further limiting the versatility of saline implants. The low viscosity of saline also makes the shape of the implant less resistant to local tissue pressure.

A patient with a constricted skin envelope in the lower pole may therefore achieve less lower pole projection with a saline implant than with a form-stable silicone gel implant. This difficulty in controlling the distribution of the fill in a saline breast implant gives the surgeon less control over the breast shape. Even for plastic surgeons not participating in manufacturer-sponsored surveillance studies, it is common practice for surgeons to evaluate silicone gel implant patients on a yearly or biyearly basis to examine the implant and check for problems such as capsular contracture or rupture.

If a surgeon places silicone implants at the rate of pairs of implants a year and normally sees patients in the office approximately days per year 2 days per week, 50 weeks per year , he or she will need to see roughly one patient per office day in follow-up, per year of implants he or she has placed. That would not be a problem for the first two or three years, but after five years, the number of follow-up patients needing to be seen becomes more substantial.

Now consider a practice at 15 years. The surgeon has now placed silicone implants in roughly patients and, to keep up with yearly follow-up, he or she will now need to see 15 long-term follow-up patients during every clinic day. Even if the surgeon switches to two-year follow-up, seven or eight women will need to be seen every clinic day. By the time a surgeon has been in practice for 22 years and has placed silicone gel implants in close to patients, 22 patients would need to be seen every clinic day to keep up with routine surveillance.

This represents a significant manpower burden. It also raises the question of who is going to pay for these visits. Should patients or surgeons pay for surveillance of the implants? Over the course of several years of implant operations, charging for the time spent on surveillance may ultimately become the only feasible way for a surgeon to manage the situation. Future innovations may ease this situation, and some patients may not be compliant with long-term surveillance, but as it stands, routine yearly screening for rupture or contracture of a silicone gel implant will have important implications.

Plastic surgeons in the US are practicing in an exciting time, when silicone gel has returned to the marketplace and new implant innovations are on the horizon. Although silicone gel is undoubtedly the leader in performance and innovation, saline still has a useful place as an alternative for breast augmentation.

With the availability of high-performance, form-stable silicone gel implants, the ability of surgeons to create a more natural-appearing result should be enhanced. However, as silicone gel implant usage continues to grow, surgeons will have to accommodate more follow-up and surveillance into their practice. As implant choices have evolved, certain concepts have proven useful.

When the main determinant for patient satisfaction is the shape and feel of the implant and in cases where the implant might be especially visible , a silicone gel implant is the better choice. In cases where the primary concerns are safety real or perceived , minimal access incisions, and ease of monitoring, saline may prove to be a better choice.

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Google Preview. Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama. Am J Roentgenol ; : 1 - 8. History of breast implants and the Food and Drug Administration.

Clin Plastic Surg ; 36 : 15 - Brody GS. Safety and efficacy of breast implants. In: Spear SL , editor. Surgery of the Breast: Principles and Art. Breast augmentation today: saline versus silicone—what are the facts? Plast Reconstr Surg ; : - The saline versus silicone breast implant debate: separating fact from opinion. Saline-filled breast implant safety and efficacy, a multicenter retrospective review. On the safety of breast implants. Breast implant rupture and connective tissue disease: a review of the literature.

Plast Reconstr Surg ; 7 : 62s - 69s. A review of epidemiologic studies analyzing the relationship between breast implants and connective tissue diseases. Deapen D. Breast implants and breast cancer: a review of incidence, detection, mortality, and survival.

Plast Reconstr Surg ; 1 : 70s - 80s. Handel N. The effect of silicone implants on the diagnosis, prognosis, and treatment of breast cancer. Plast Reconstr Surg ; 1 : 81s - 93s. Brinton LA. The relationship of silicone breast implants and cancer at other sites. Plast Reconstr Surg ; 1 : 94s - s. My Account. Why breast augmentation? Silicone vs saline implants All breast implants have a shell made out of an inert polymer called silicone.

Difference between silicone and saline implants Silicone gel Silicone gel is an inert polymer with no known human allergies, sensitivities or reactions. Saline sterile salt water Saline-filled implants are available to all women for breast augmentation over the age of How have breast implants improved or changed over the years?

What variants of saline and silicone implants are available? Variable cohesiveness of silicone implants Different degrees of stiffness or "cohesiveness" cross-linking of the silicone molecules are now available in silicone gel breast implants. How do we know breast implants are safe? More Like This. Updates, advice and lifestyle tips from the ASPS delivered directly to your email inbox. Join Connect. Related Posts. Will your breast implants last a lifetime?

Fat grafting for breast augmentation What you need to know about breast augmentation revision Dr. Find Your Surgeon. Why Choose a Board-Certified Plastic Surgeon Choose a board-certified plastic surgeon and be confident you are in the care of a highly trained surgeon you can trust.

Patient Resources. View All Surgeons Near You. Video Gallery View Video Gallery. Patient Safety View Patient Safety. What happens if an implant ruptures? Get answers to these questions and more. If you're considering breast implants, you might wonder how to choose between saline-filled and silicone gel-filled implants.

Here's help evaluating the options. Saline and silicone breast implants both have an outer silicone shell. The implants differ in the filler material and consistency, however. Saline implants are filled with sterile salt water. They're inserted empty, and then filled once they're in place. Saline breast implants are available to women age 18 and older for breast augmentation and to women of any age for breast reconstruction. Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat.

Most women believe that silicone breast implants look and feel more like natural breast tissue. Silicone breast implants are available to women age 22 and older for breast augmentation and to women of any age for breast reconstruction. Correcting any of these complications might require additional surgery, either to remove or replace the implants.

In addition, with certain breast implants there is a low risk of developing a type of cancer known as breast implant-associated anaplastic large cell lymphoma BIA-ALCL. Implants with textured silicone and polyurethane outer shells seem to have the highest risk. Although this type of cancer occurs in the breast tissue, it isn't breast cancer. It might require treatment with surgery, radiation and chemotherapy. If an implant ruptures, the approach might vary depending on whether the implant is saline or silicone.

If a saline breast implant ruptures, the implant will deflate — causing the affected breast to change in size and shape. Your body will absorb the leaking saline solution without health risks, but you'll probably need surgery to remove the silicone shell.

If you want, a new implant can likely be inserted at the same time. If a silicone breast implant ruptures, you might not notice right away — or ever — because any free silicone tends to remain trapped in the fibrous tissue capsule that forms around the implant. This is known as a silent rupture. Leaking silicone gel isn't thought to cause health problems, such as breast cancer, reproductive problems or rheumatoid arthritis. Still, a ruptured silicone breast implant might eventually cause breast pain, breast thickening, or changes in the contour or shape of the breast.