When a woman decides to undergo a breast augmentation or an augmentation-mastopexy, she is given a variety of implant characteristics to choose from. Each option has its pros and cons, and I believe every type can be beneficial for the right person. By understanding the details of silicone versus saline implants, the potential of the various shapes and the effect of implant sizes, my patients are able to select which implants can achieve their aesthetic goals.
Silicone and Saline Breast Implants
Silicone gel implants were FDA approved for use in 2007. This followed many years of study after unsubstantiated and highly publicized objections in the early 90s led to a government mandated moratorium. Their record so far shows no difference in outcome (complications, capsular contracture, failures, etc.) from saline implants. Since the re-introduction of silicone gel implants, I have found that a growing number of women prefer gel implants. “Feel” and contour of gel implants are superior to saline implants. Folds in gel implants are less likely to show through the skin. For these reasons, gel implants are preferable if the implant is to be placed over the muscle. It should be noted, however, that the FDA has restricted the use of gel implants to patient 22 years of age or older.
The gel in current implants is more “cohesive” than the gel used in implants used in the 1980s. This means that the gel is less likely to find its way to other parts of the body if the elastic shell encasing it develops a hole. The shells should remain intact 10 to 15 years on average. Many may last longer. Nevertheless, the FDA recommends an MRI scan for all patients with gel implants three years after their initial surgery and biannually thereafter. Saline implants do not have this same recommendation. If the shell of a saline implant fails, a specific endpoint is noted: the breast mound deflates in a matter of hours. The implant then must be removed from the pocket and replaced. The endpoint for gel implants is less specific and often not usually evident. If an MRI reveals a failure of the shell, then removal of the implant is recommended by both the FDA and implant manufacturers.
Gel implants cost almost twice what saline implants cost; the cost of the procedure with us is the same no matter which you choose. If placed under the muscle, one would probably be hard pressed to see a difference unless you are unusually thin. About 75% of my patients choose silicone. Good results, however, can be obtained with either implant.
There are now a variety of advances among implant shapes and types, and each has its own advantages and disadvantages. Recently, the U.S. Food and Drug Administration approved the Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants – Natrelle® 410 for short. These implants are specifically designed to complement a woman’s natural curves, and remain form-stable for a very long period of time. Form-stable implants often provide a more consistent shape, especially in the upper pole area of the breasts. Natrelle® 410 breast implants have also shown to have reduced rates of implant rippling or rupture. Patients are very happy with the results. I now offer these breast implants in addition to smooth and round implants, as not all patients are good candidates for shaped implants. At your initial consultation, we’ll talk a great deal about specific implant shapes and come up with an option that may be best for your needs.
Selecting an Implant Size
The choice of implant size is primarily at the discretion of the patient because only she can decide what size gives her the proportions she wants. I ask each patient to put on a spandex top that we provide and then try on different sizers that we stock. When a patient sees what she likes, that is the size chosen. At the time of surgery I inflate a sizer to fill the pocket I have made. If the desired size is too large to comfortably fit into the pocket, I put in the largest size that does fit. It is rare for me to find that the size a patient wants is too large when reasonable choices are made prior to surgery.
“I never felt pressured and I chose the size I was comfortable with even though I asked numerous times for advice, I was still told it was my decision to make. The best decision I made was choosing Dr. Silberblatt and getting so much more in return. You have given me back my self-esteem!” DA – Roanoke, VA*
Breast Implant Placement
Patients that have little or no breast tissue have better results with the implants under the muscle. However, women large enough to fill the average B cup or more, particularly when there is extra skin will probably get better results with the implants over the muscle. If there is too much skin, however a lift may be necessary as well. Every person’s anatomy is different and the decision of where to place the implants will vary. Many are able to go above or below the muscle. When I put implants over the muscle I will usually recommend using gel implants, as they are less likely to show rippling. I will be happy to address these and any other questions you may have about this and other plastic surgery procedures.
Breast Implant Warranty
Ever wonder about how long breast implants should last? The implants used at our practice come with an extensive warranty program designed to protect the patient. Visit our breast augmentation warranty page to learn more.
Natrelle® Gel implants join Brilliant Distinctions®
*Individual Results May Vary