Saline or Silicone…How Do I Choose?
Breast implants can serve one or more of a number of purposes; breast cancer victims can use breast implants for reconstructive purposes after mastectomy, or women with asymmetrical breasts may use a single breast implant to balance the difference in size.
Following pregnancy, many women opt for breast implant surgery to correct reductions in breast size, resulting from fluctuating hormones. And of course many breast implant candidates are simply interested in creating a more flattering contour.
Since 1992, silicone gel-filled implants have been available only to breast reconstruction patients and patients undergoing breast revision surgery. In order to receive silicone, women must be enrolled in clinical trials.
It is worth explaining the differences between a silicone gel-filled and a saline-filled breast implant, which is an alternative to the silicone gel implant. The outer shell of both silicone and saline implants is made of a solid silicone material. Solid silicone is widely used in implantable medical devices. In contrast, silicone gel implants are filled with silicone gel, which is a semi-solid. Saline-filled implants are filled with the same kind of salt water that is used in I.V. fluids.
Offering an alternative to silicone, manufacturers chose saline as an implant filler. Saline implants also have a silicone outer shell (the same shell used in silicone gel-filled implants) and contain salt water.
Saline implants have a silicone rubber shell that is inflated to the desired size with sterile saline. Most implants have a valve that is sealable by the surgeon.
There are two types of saline-filled implants. One type is a fixed volume implant, which is filled with the entire volume of saline at implantation. Another type is an adjustable volume implant, which is filled intraoperatively and has the potential for further postoperative adjustment.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan (Inamed) Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. Silicone implants come in smooth or textured shell surface and vary in shape, profile, volume, shell thickness, and number of shell lumens. Most silicone gel-filled implants are not adjustable which is one disadvantage compared to saline implants.
In the early 1990’s it was reported that silicone breast implants were possibly responsible for connective tissue diseases in some women. Since the controversy began over the potential risks of silicone breast implants, researchers have been conducting scientific studies to investigate the safety of silicone implants.
In 1999, a landmark report, undertaken by the Institute of Medicine (IOM) concluded that silicone implants do not cause major health problems such lupus or rheumatoid arthritis. In fact, there have been a number of major studies failing to find an association between implants and autoimmune diseases or cancer. And while no one can ignore the fact that silicone – and saline – breast implants may cause localized problems for some patients, numerous scientific studies over the years have shown that silicone gel-filled implants are both safe and effective for breast augmentation and reconstruction. However, silicone implants are still not available to the general public in the United States. They are still widely used in Europe and may be available again in the US.
Silicone gel-filled breast implants are available for select cases: women seeking breast reconstruction or revision of an existing breast implant, women who have had breast cancer surgery, a severe injury to the breast, a birth defect that affects the breast, or a medical condition causing a severe breast abnormality.