QUITE a number of people have shown interest in getting breast implants. The most prominent question on their minds, apart from cost, is safety. Which breast implants are safest? Basically there are two general types of breast implants—saline and silicone.
Both consist of a silicone outer shell; the difference is what’s inside the implants. Saline implants are filled with saline or sterile saltwater. Silicone breast implants are filled with silicone gel.
The question of breast implant safety is not as straightforward as believed. Current research shows there aren’t significant differences in the safety of silicone and saline implants; however, each type has its pros and cons.
Ruptures are a risk with either kind of breast implant and might be caused by surgical error, a fall, or pressure exerted on the breast. Experts say implications of a rupture are a little different for the two types.
Saline implant ruptures are easy to spot. The breast rapidly changes shape over days as the fluid leaks out. If a saline implant breaks, all that leaks out is saltwater. The saltwater is harmlessly absorbed into the body.
Silicone implant ruptures are more difficult to notice. When the implant breaks, the leaking silicone stays in the body. It can sometimes spread outside the breast and into distant lymph nodes. As unnerving as that sounds, studies haven’t found that this results in any increased risk of disease. Nonetheless, if a silicone implant ruptures, your doctor will probably recommend removing it and any loose silicone.
Ruptures of silicone breast implants are often “silent,” meaning patients and doctors may not notice them. They can only be detected by a sophisticate method called Magnetic Resonance Imaging, MRI. So it is recommended that women with silicone implants get an MRI three years after implantation and once every two years after that. Over the course of a woman’s life, these MRIs may cost more than the original implant surgery.
Many women and plastic surgeons prefer the look and feel of silicone breast implants. Silicone breast implants are generally considered to be more like real breast tissue. Saline implants are more prone to causing rippling of the skin.
Silicone breast implants contain platinum; saline implants don’t. While some people feel that platinum could be harmful, the FDA says that studies have not found that it poses any risk in breast implants.
Saline implants are filled after they’re implanted, so saline implants require a smaller incision than pre-filled silicone breast implants. Also, many saline implants can be adjusted after surgery. Months later, a woman could decide to increase or decrease the size of her saline implants without surgery. The doctor can just use a syringe to put in more liquid or take it out. The size of standard prefilled silicone implants cannot be changed.
There are some differences in who can get the two types of implants. For reconstruction, women can get either type of breast implant at any age. But for augmentation, saline implants are approved for women 18 and older, while only women who are 22 and older can get silicone breast implants.
Keep in mind that your doctor may have a strong recommendation for one type of breast implant over another. Certain things, like your body type or the current size of your breasts, might make one type of implant better for you.
While studies have not found evidence that breast implants, either silicone or saline, are connected with serious disease, there are still risks. There are also long-term implications. Here are some of the breast implant safety issues that you need to consider.
Over time, breast implants wear out and need to be replaced. How long do breast implants last? There’s no definitive answer. In general, rupture becomes more likely as breast implants age. The FDA estimates that breast implants should last at least ten years. Studies have shown that some breast implants last much longer than that and others much less.
Rupture isn’t the only problem that requires surgery. Over time, breast implants can change shape. One breast might start to look very different from the other. Sometimes, the tissue around the implant hardens, a condition called capsular contracture. Surgery is the only way to fix capsular contracture.
If you get breast implants and want to maintain your breast size and shape for the rest of your life, you should be prepared to have a number of additional surgeries. The surgery to replace an implant is not as involved as the original procedure. However, the risk of complications is actually higher.
Breast implants may permanently alter breast tissue. If you decide to have the implants removed, your breasts may not return to the shape they had before the surgery. Your breasts may stay dimpled or wrinkled.
Breast implants can cause a loss of sensation in the breast and nipple, as well as pain. They can sometimes result in excessive scarring and wrinkling.
Some studies have found associations between breast implants and certain health conditions. Like any surgery, getting breast implants poses risks. Some women have surgical infections, bleeding, and swelling. Breast implants can make breastfeeding more difficult or impossible. They may prevent a woman from producing milk. Breast implants can also interfere with the accuracy of mammograms.
Deciding whether or not to get breast implants—either for reconstruction or augmentation —is not easy. There are a lot of things to weigh. Keep in mind that studies show that most women who get breast implants each year are satisfied with them. While many women are still concerned about long-term health risks, research has generally not found an association between breast implants and serious disease.
Perhaps the most important thing is to develop realistic expectations. Find a doctor you really trust and talk frankly and openly. Make sure that you understand the risks of breast implants. Make sure you understand the best and worst case scenarios. The more you know, the more confident you’ll feel in your decision.