Silicone and Saline Breast Implants

Many women look at themselves in the mirror and wish for a more feminine figure. Despite several years of controversy, breast implants are now more popular than ever before.

Claims that implants cause a particular disease have to be tempered with the fact that, with over two million women with breast implants, there are going to be women with virtually every disease imaginable that have implants! Many studies have been done regarding the relationship of implants to cancer and auto-immune diseases such as arthritis. The preponderance of data shows no increase in the incidence of these diseases in women with implants. This does not, however, mean that there are no problems or risks to having implants.

The most common problem with implants is known as capsular contracture. This is an over formation of scar tissue in the normal fibrous capsule that the body forms around the implant. It can lead to rippling of the skin or a tight, round – looking implant. Correction of this problem involves removing the implant and the scar tissue and replacing the implant. This usually works. In some cases, however, the capsule stubbornly returns and the implant must be removed. While this problem is not truly an illness, it can lead to the need for additional surgery.

Most women now have saline implants. These are filled with salt-water. The bag, however, is still made of a solid silicone. While this material is still classified as investigational by the FDA, it has been used in many types of medical devices for decades.

Alternative fillers such as soybean oil and peanut oil are not approved or, at the time of this writing, even in active patient trials in the United States. Soy implants were recently abandoned in European studies because they caused several problems. Early complications with these appear to have sent researchers back to their drawing boards and we do not expect to see anything new approved in the near future.

Muscle coverage is an important issue. Early implants, and some placed today, have been placed under the skin but outside the pectoral muscles. It is my experience that if only a layer of skin and thin fat covers the implant, when the swelling goes down the breast is more likely to look and feel like an implant!

Near complete muscle coverage causes the implant to be squeezed against the chest and gives the patient an unnatural look for the first month or so, but as these implants settle, the muscle acts as an internal bra and hides the implant much more effectively. The problem here is that not all patients and not all surgeons are willing to tolerate “funny looking breasts” until they settle. I strongly feel that if the normal urge for ‘instant gratification” can be overcome, the ultimate result will be a breast that looks and feels more natural.

Many patients feel self-conscious about their desire for bigger breasts. People will only realize that your breast size has changed if you want them to! In a tight top that hugs the midriff, even moderate sized breasts will draw attention. On the other hand, if one wears a button-down sport shirt and a conservative bra, no one will know whether you are an A cup or a C cup.

Proportion really makes a difference when it comes to breast size. With a small chest a person looks like they have big hips! When breast size increases, the hips and waist look much smaller.

This surgery is done with local plus sedation and takes less than an hour. Most people are back to near normal activity in 4-6 days. Upper body exercise is usually deferred for 2-3 weeks.