Silicone Gel Breast Implants

Breast Augmentation with Silicone Gel Implants

Silicone breast implants (also known as silicone gel implants) offer several advantages over saline breast implants. They also have some disadvantages, so you and your surgeon should carefully weigh the pros and cons, if you are considering this option.

The Good News:Advantages of Silicone Breast Implants

Silicone breast implants are filled with silicone gel, which is softer and more natural (in the way it feels to the touch) than saline breast implants. They feel so soft and natural, that it is often impossible to discern them from natural breast tissue.Rippling is far less likely to occur in women with silicone implants than in women with saline implants. This is because silicone gel is far more viscous (thicker) than saline, so it does not move or slosh, as saline can. Because of this, silicone implants can be placed over the muscle in women with little body fat or little breast tissue without the aesthetic concerns (rippling) associated with placing saline implants over the muscle in these women.

Hence, the major benefits of silicone breast implants are in the realm of a more natural look and feel.

The Not-So-Good News: Disadvantages of Silicone Breast Implants

Silicone implants may rupture. If they do so, liquid silicone may leak out of the implant shell. It is important to note that silicone implant ruptures and leakage have never been shown to cause systemic problems (such as lupus-like diseases, see below). Yet, in response to silicone implant rupture (with or without leakage), your body may develop a thick scar around the implant, called capsular contracture. Ruptures, if they occur, tend to occur in implants which have been in place for years (as opposed to recently placed implants). Thus, so do capsular contractures. The overall rate of capsular contractures among women with silicone implants is higher than in women with saline implants. A new type of silicone breast implant has been developed to hopefully reduce the risk of rupture, leakage, and capsular contracture. It is the cohesive gel implant (see below). Studies regarding the rate of rupture, leakage, and capsular contracture for these implants are currently underway, so the rate of these problems is not yet known.Silicone implants are all pre-filled by the manufacturer. This means a longer incision (6-8 cm) is required to place the implant. This is in contrast to saline implants which are empty (hence smaller) prior to their insertion. As such, saline implants may be placed through a shorter incision (3-5 cm).

The cost of silicone breast implants is about $1000-$1500 higher than saline. This is due to higher production costs (compared to saline) by the manufacturer. Your surgeon may also charge a higher surgeon’s fee for placement of silicone implants because of greater follow-up time and paperwork for his/her office staff. Be sure to ask about this.

Additional potential issues with silicone implants exist and can be found here: Informed Consent for Silicone Breast Implants.

Putting it Together: Are Silicone Breast Implants Right for Me?

The advantage of having silicone breast implants with a softer and more natural feel is more important for women who have the least amount of natural breast tissue and women who have little body fat. In these women, saline implants can often be seen or felt through the skin. Although this does not bother many women, it does bother some. Women who are starting out with a more generous amount of natural breast tissue will have more “padding” between their skin and the implants. So, in these women, the difference between saline and silicone is less evident, and sometimes there is no difference. In other words, in women who have enough breast tissue, neither implant can be felt through the skin, so the advantages of silicone breast implants are less important, but the potential disadvantages remain the same.

If silicone implants came with no risks, no worries, no extra follow-up, and no extra expense, then everyone would want to have them. But, because they come with all of these things, they are probably best suited to women who have nominal breast tissue and are willing to accept the aforementioned disadvantages. They are also very appropriate for lean women and body builders, because they can be placed over the muscle with a low risk of rippling.

Options in Silicone Breast Implant placement:

When planning your operation with your plastic surgeon, you will need to decide important issues such as whether the implant will be placed under or over the pectoral muscle; whether the implant will be textured or smooth; whether the implant will be round or anatomic; and the size of the implant. Each of these issues is addressed through the breast augmentation decisions .