Breast augmentation with implants was approved in the United States in 1962. In 1992 silicone implants were removed from the United states market by the FDA for health concerns. From then until 2006 only saline breast implants were available. Silicone implants were reformulated by the implant manufacturers and approved for use in the United States by the FDA. Currently, women 22 years of age or older may select either silicone or saline breast implants for cosmetic breast augmentation. In Virginia Beach, we at Galumbeck Plastic Surgery offers both types of implants. This post will focus on differences between the two types of implants.
Both saline and silicone implants are manufactured with a silicone elastomer shell. Saline implants are filled with sterile salt water. Silicone implants are pre-filled with a cohesive silicone gel when they are produced. Below, I will discuss the differences between the two types of implants.
The silicone gel feels more like human fat tissue and has a more natural feel when used in women with little or no breast tissue. Rippling or wrinkling of breast implants can occur. This is more likely to occur with saline implants because there is little tissue between the implant and the skin.
All implants when introduced into the body are surrounded by scar tissue. The scar tissue may thicken and tighten around the implant. This tightening is called a capsular contracture. Capsular contractures can cause breast distortion and pain. In studies released by the FDA, capsular contractures in silicone implants are approximately 20%. Capsular contractures in saline implants occur less often, about 9%.
Over the life of the implant, the outer shell can lose integrity and the fill of the implant can leak. Ruptures of silicone implants occur in about 13% of women, while saline implants rupture in approximately 3% of women. In saline implants, when a leak occurs the salt water is absorbed by the body. The implant deflates and is immediately noticeable. Silicone implants use a cohesive gel that is not absorbed by the body. In many instances breast pain or breast deformity may occur; however, silent ruptures can occur. A silent rupture is when the implant ruptures but no signs or symptoms are noticeable. 35% of silicone implant ruptures are silent ruptures. Because of the risk of silent ruptures with silicone implants, the FDA recommends women with silicone implants get a screening MRI 3 years after breast implant surgery and every 2 years after that.
Mammograms can be safely performed in women with both saline and silicone breast implants. Because silicone implants are filled with a denser material than saline implants, mammograms can be more difficult to interpret.
These are some of the differences between saline and silicone implants used in breast augmentation surgery. I guess the ideal implant would have the advantages of both of the types of implants. Until then, women need to weight the advantages and disadvantages of each to determine which breast implant is better for them.