Choosing Silicone or Saline
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Choosing Silicone or Saline Implants, Pros and Cons of each type of Implants
Cosmetic Breast Augmentation
Breast augmentation is a surgical enhancement of the size and/or shape
of the breast. The American Society for Aesthetic Plastic Surgery
reports, last year 383,886 breast augmentations were done in the U.S.
It’s the most common cosmetic surgery procedure performed on American
women.
There are many reasons given for breast augmentation. Some women want
to have larger or better-shaped breasts. Sometimes breast augmentation
is done to provide equal proportion to the breasts. The procedure may
also be chosen by women who have lost breast shape or volume (after
pregnancy, weight loss or natural aging).
One way to enhance the size/shape of the breast is with a breast
implant. There are two main types available: saline and silicone.
Saline implants are silicone shells filled with a saline (salt water) solution. They may be pre-filled with saline or filled at the time of surgery. Some saline implants can be size adjusted for a limited time after surgery by adding or removing some of the salt water. Currently, saline implants are approved for breast augmentation in women 18 and older.
Silicone implants are silicone shells that are pre-filled with silicone gel. Some silicone implants contain a second wall that allows doctors to add saline to change the size of the implant during or after surgery. Silicone breast implants were banned for cosmetic uses in 1992 due to concerns about their safety and possible association with autoimmune and connective tissue problems. After several years of study, the FDA re-approved the marketing of silicone implants last year. The implants are approved for cosmetic breast augmentation for women 22 and older.
A newer type of silicone breast implant is the Cohesive Breast Implant (also called the “Gummy Bear” Implant). The implant contains a firmer core (like the consistency of a gummy bear, hence the nickname). The cohesive gel helps the implant maintain shape, even if it is cut in half. Cohesive breast implants are not yet approved in the U.S. and are only available in certain locations for women taking part in a clinical study.
Making the Choice
With the re-introduction of silicone breast implants, women who want breast augmentation now have one more option from which to choose. Plastic Surgeon William Gorman, M.D. says most of his patients choose silicone because the implant feels softer and more natural than a saline implant. However, a small minority still prefer the saline implants.
There are advantages and disadvantages to saline and silicone implants. Women should thoroughly look into the pros and cons of each type and discuss any concerns with their plastic surgeon. In general, here are some things to think about:
Saline implants can sometimes be altered in size (not all saline implants have this option, so be sure to discuss this option with your physician). All implants carry a risk of rupturing. If a saline implant leaks, the salt water seeps into the surrounding tissue and is absorbed by the body. The saline is harmless to the tissues. However, it results in an immediate and very obvious deflation of the breast. The implants can’t be refilled. So a ruptured implant needs to be removed and replaced.
Silicone implants feel more like a natural breast and are less likely to cause skin rippling. If they rupture, the gel usually seeps into the surrounding breast tissue. So there is typically no visible difference in the breast. However, the leaking silicone gel can cause problems, like pain, swelling, numbness, burning or hardness in the breast. The long-term safety of silicone breast implants are still not entirely known. When the FDA approved the cosmetic use of silicone breast implants last November, officials stipulated that women must be advised to have a periodic breast MRI (starting at three years after implantation and then every two years). Medical insurance may not cover the cost of MRI screening. If an implant is found to have a rupture, the FDA recommends it be removed and replaced.
There are also some general risks that women need to be aware of. Breast implants don’t last a lifetime. However, no one knows how long they will last. So women should be prepared to have them replaced at some point in time. Scar tissue can form around the implant (called capsular contracture). As the scar tissue shrinks, it can cause pain and unnatural firmness or hardness in the affected breast. There is a chance the implant could move or push through the skin. Lastly, if a woman is unhappy with the results or breast implant surgery, or if complications develop, the implant will need to be surgically removed.
No matter which type of implant a woman chooses, Gorman reminds all patients 40 and older to have annual mammograms for breast cancer screening. Patients should also tell the X-ray technician about the implants to ensure better quality mammograms.
About the Author
The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons have a breast implant safety website at: http://www.breastimplantsafety.org
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