The Silicone Solution

Serving Chattanooga, Tennessee

With the release of silicone breast implants for general cosmetic use, an increasing number of patients have developed an interest in their risks and benefits.

I believe that the most significant point which needs to be made concerning these medical devices, is that we simply cannot compare the silicone breast implants of 2007 to those of the 1970’s and 80’s. Great advancements have been made in our understanding of silicone chemistry. Also, I believe that the current population of breast enhancement patients are much more savvy consumers than have been past generations. That’s not to say that the breast augmentation patients of the last century weren’t smart about their choices, but the volume of educational material concerning this subject has exploded. The internet is packed with websites dedicated to cosmetic breast surgery. Some of that information is reliable, yet some can verge on fantasy. I also contend that today’s patient may be more realistic with regards to long term results. Many women who had breast augmentation decades ago were under the impression that they would never need anything else done to preserve the look of their breasts or service the implanted device. I would venture to say that the poorly understood concept of maintenance helped fuel the fire of dissatisfaction which resulted in a moratorium on the use of silicone breast implants in the 1990’s.

We have gleaned a great deal of experience with silicone breast implants by a studied application to the breast reconstruction population. In my personal practice, I have been very pleased with the results. The current implants are reliable and yield reproducible results.

So how does one make a choice between silicone or saline implants? There are several basic points to consider. You must be 22 years old to be offered a silicone breast implant. Silicone implants are about two and a half times as expensive as saline implants. You will be asked to commit to post implant study of your implants for rupture with a breast MRI at three years after surgery and every two years thereafter. Your health care insurance will not pay for these exams.

With these immediate points in mind, most plastic surgeons will only place a silicone implant through a breast crease incision. Occasionally a peri-areolar incision could be used. Silicone breast implant patients are typically followed in a scientific reporting database so that continuing evaluation of the product’s efficacy can be determined.

That being said, saline implants have enjoyed a 95% efficacy rate in breast augmentation patients. The issues of deflation, contracture, and rippling represent the principal risk of the device itself. Of course, silicone implants do not deflate, but they can rupture. We are still learning about how subclinical (physically unidentifiable) rupture will affect the aesthetics of the breast and the use of the device. The most significant advance with silicone implants is in their lifelike nature. They blend both visually and palpably better with one’s native breast tissue than a similarly sized saline breast implant.

It appears that silicone breast implants are here to stay. If you are considering a breast enhancement, consult your board certified plastic surgeon for more information to determine if silicone is the right choice for you.