Friday, June 13, 2008

Saline-Filled vs. Silicone Gel Breast Implants


Breast augmentation is a surgery designed to enlarge and improve the shape of the breasts. Breast augmentation is usually sought by women who are not fully satisfied with the current size and shape of their breasts.

There are basically two different types of breast implants used today: the saline-filled implant and the silicone gel implant. The saline-filled implant has been the most popular choice for the past 15 years or so, but the silicone gel implant is now being recommended to many women. In 1992, silicone gel implant use was restricted by the Food and Drug Administration (FDA), but in November 2006, silicone gel breast implants were approved for all women age 22 and over.

Saline-Filled Implants

Saline-filled implants have been the more common implant used for many years. Saline-filled implants are constructed of a tough, semi-permeable silicone elastomer shell with a single valve on the front (anterior) surface of the implant. The saline-filled implants come in smooth and textured surface and round or contoured shapes. Contoured shapes are also referred to as anatomical, teardrop, and biodimensional shapes.

Two companies currently manufacture saline-filled implants: Inamed Aesthetics (formerly McGhan Medical) and Mentor Corporation. Most saline implants are single lumen and are filled at the time of surgery. There are no prefilled saline implants with FDA approval at this time. Should these implants rupture, the body will absorb the saline as it is a harmless solution (used in I.V.'s).

Ruptures in breast implants can happen, and although breast implants are made to be strong and stable, there are instances where they can break and the saline filer may leak and circulate throughout the body. If a rupture would occur, a saline breast would simply deflate, and the saline held within the implant would harmlessly absorb within the body.

This "safety feature" is just one of the many reasons why saline-filled implants have been the popular choice for so long. Saline breast implants are extremely versatile; they do vary in terms of shell surface, volume, shell thickness, profile shape, and ability to expand. Saline-filled implants are certainly a popular choice to a fix disproportion between breasts or to gain proportion within your body.

Silicone Gel Implants

Silicone gel implants' outer shell is similar to that of the saline-filled implant in that it is made of solid silicone material; however, silicone implants are filled with silicone gel, which is a semi-solid material. In silicone gel implants, the surface may be smooth or textured (multiple fine bumps on the surface of the implant). There is some evidence that textured implants have a lower incidence of scar formation around them, but since a textured implant adheres to the surrounding skin, there may be visible rippling (wrinkling) of the skin. A textured implant also requires a larger incision due to the increased difficulty of sliding the implants through the surgical opening.

Implants can be placed either over or under the pectoralis muscles of the chest wall. Each type of placement has advantages and disadvantages. Generally speaking, placement of the implant beneath the muscle gives an extra layer of muscle coverage and may give less interference with mammographies of the breasts. Placement beneath the muscle usually requires more anesthesia and higher costs for the surgery. Placement of the implant over the muscle generally results in less post-operative discomfort and a quicker return to normal activities for the patient. Over the muscle implants may be placed under local anesthesia.

The silicone gel implant is usually inserted through an incision in the crease under the breast or just above it. The incision may be 3-6cm in length. An incision at or above the fold is often hidden by the slight droop of the breast and not seen unless someone is looking up under the breast. Silicone implants can also be inserted through an incision in the armpit, but this is much more difficult and more difficult insertions may cause damage to the implants.

Silicone gel implants have been known to leak through the shell. Rupture of an implant may be related to the length of time it has been in the body. Rupture may also be caused by force or traumas, such as a blow to the chest or a jolt from a car accident. Additional surgery may be required to repair or removed a ruptured breast implant.

Deciding to have breast augmentation surgery is a serious matter and one that needs to be discussed thoroughly with your cosmetic surgeon. He/she will explain your options and discuss which one is best for you.

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