Which are safer saline or silicone-filled breast implants?

Breast augmentation with breast implants, quickly became the most popular type of plastic surgery procedure for women, after being introduced to the aesthetic surgery market in the 1960s. However, within a few years, there were numerous reports of women with breast implants suffering from adverse health and debilitating symptoms that they did not experience before breast augmentation. The FDA restricted silicone breast implants in 1992, for use only in reconstruction surgery or for secondary breast augmentation. This was introduced further to numerous women, claiming the silicone inside the breast implants was making them ill and following several successful lawsuits.

Saline-filled breast implants replaced silicone implants in the USA and were marketed as a safe alternative. The general consensus was that if the silicone inside breast implants was causing health issues then this would be eliminated by saline-filled implants. Saline was considered safe as it can be absorbed by the body and then expelled in the urine. Silicone, especially in early breast implants was a liquid that could travel around the body and end up in the lymph nodes. When silicone gets into the lymph nodes it can cause lymphedema or lymphadenopathy and silicone lumps (granulomas). Symptoms such as chronic tiredness, muscle aches, and pains, difficulty concentrating, and chronic pain have also been associated with silicone in breast implants. In most cases when silicone-filled implants rupture, the silicone gel is contained within the capsule of scar tissue, which has formed around the implant. However, it is possible for the silicone gel to travel around the body and this can be very challenging to remove.

Can saline implants contain bacteria?

Despite the lawsuits in the USA none were ever won in Europe and there was never any conclusive evidence from medical research that proved a definite link between silicone and the adverse symptoms women who had silicone breast implants, were reporting. Silicone implants also continued to be available in Europe and other countries that did not feel there was any justification to restrict their use. Although saline implants were also available, silicone implants remained the most commonly requested and used in Europe. Silicone was and still is considered by many plastic surgeons, closer in consistency to breast tissue and more durable and aesthetically pleasing than saline, breast implants.

Women with saline, breast implants also continued to report the same adverse symptoms that had been reported with silicone, breast implants. This could be viewed in two ways, either the symptoms are not related to the silicone in the breast implants, or the silicone shell of the saline breast implants which shed minute particles was still causing the symptoms even when the implants were saline-filled.

In 2006 the FDA lifted the restrictions on silicone breast implants and it didn't take very long before silicone, filled breast implants became more popular than saline, filled breast implants. There is no conclusive evidence that saline-filled implants are safer than silicone-filled breast implants although they can prevent some of the complications that may occur when silicone implants leak. Deciding which type of breast implant to have is a very personal decision and one only you can make. Below I have listed the advantages and disadvantages of both silicone and saline-filled breast implants to help make your decision a little simpler.

Saline Breast Implants

Advantages

• Smaller incisions can be used as they can be inserted empty and filled once inside the breast pocket
• Less trauma on surrounding tissues when filled up after being inserted, reducing chances of seromas, hematomas
• Implant displacement may be less likely when filled up after being inserted, as the pocket created will be the exact dimensions of the implant
• The body can absorb and expel saline in urine if they leak
• When a saline implant ruptures it is immediately detectable
• Expandable saline breast implants can prevent the need for secondary breast augmentation if the initial volume of the implant is not satisfactory

Disadvantages

• Water is a different consistency to breast tissue and saline implants may feel firmer, especially if a larger implant is desired
• Some women say they can feel the saline 'sloshing' inside the implants
• Visible ripples on the surface of the skin are more likely with saline implants
• Saline implants are heavier than silicone implants and therefore may 'drop' quicker, requiring revision surgery at a later date
• Saline implants do not 'maintain' a shape that can result in your breast shape, changing more significantly over time
• Bacteria, yeast, and molds have been found in saline-filled breast implants

Silicone Breast Implants

Advantages

• Available in various consistencies including adhesive silicone gel which will not leak
• Closer consistency to breast tissue
• Tend to feel softer, especially when larger implants are desired
• Less likely to cause visible ripples on the surface of the skin
• Adhesive silicone gel will maintain a shape, which means a lower chance of a change to breast shape over time
• Weigh less which means they shouldn't drop as quickly making revision surgery less likely to be required
• Can be inserted via the transumbilical method (T.U.B.A) which means the only scar is completely concealed inside your belly button

Disadvantages

• Rupture can be (silent) and not easily detected
• Silicone gel can migrate around the body if the implants leak which can cause silicone lumps (granulomas) or block lymph nodes
• Large silicone implants require a bigger incision due to being prefilled
• Secondary breast augmentation may be desired if the initial volume of the implant is not satisfactory

Choosing the right size of breast implant

To be able to decide what size breast implants, you want, it helps to have an idea of how big you want your breasts to look, after your breast augmentation. One way to do this is to try on some bras in bigger cup sizes, fill them with socks in the shop to get some idea of what size you like and then purchase a couple of sizes to take home. Once at home you can use water balloons to fill them, which will give you a better idea of how your breasts will look with breast implants. It is important to remember this will only give you an idea of how your breast will look. Breast implants will look and behave differently to water balloons, however, they should help you to ascertain the approximate cup size you would like to be.

Large or extra-large breast augmentation

When a significant change in size is desired then this may not be possible to achieve with a single breast augmentation procedure, if you want to have silicone breast implants. Expandable saline, breast implants offer another solution, as saline can be gradually added and therefore this eliminates the need for a secondary procedure. The largest silicone breast implants are a maximum volume of 800cc and anything over this would need to be custom made and are considerably more expensive.

Natural 'looking' breast augmentation

When your priority is a natural-looking, breast shape, silicone implants may be a better option. Anatomical, silicone, breast implants are often recommended when there is very little breast tissue. This is because they are already a 'teardrop' shape which mimics a natural breast shape.

Natural feeling breasts

Silicone may also be recommended if you are concerned about how your breasts will feel after a breast augmentation due to the consistency of silicone being closer to breast tissue than saline.

Your final choice

Whichever breast implants you choose, the most important thing is to ensure you discuss all of the pros and cons with your surgeon. Ensure you know the name of the breast implant manufacturer and the details of the warranties that are provided with the breast implants prior to your breast augmentation. procedure.