Silicone Implants

A frequently asked question to me is the safety of silicone breast implants. In early 1992, the FDA placed a moratorium on the use of silicone breast implants, under further investigation was performed to verify the safety of these devices. Over the next 15 years large clinical trials were performed to address these concerns. Many of the more serious concerns you might have heard about with silicone implants, like causing collagen-vascular diseases, such as lupus and rheumatoid arthritis, have been disproven. Other claims however had strong merit. Among these claims was that these early liquid-filled silicone devices ruptured easily, and could cause hardening of the breasts, and leaking into the tissues of the breast. These observations led to a conscious development, and the use of our current cohesive gel implants. These breast implants are filled with a silicone gel which is more like a solid, rather than a liquid form to reduce migration and extrusion of that gel. Finally in November 2006, the Food and Drug Administration approved wider use of these silicone gel breast implants. Specific inclusions and exclusion criteria were mandated by the FDA, and these include that a prospective patient will read an informed consent pamphlet, and review it with us at the time of their consultation prior to surgery. It's important for patients to realize that silicone gel implants come in different sizes, projections, and texture. They are currently used for both cosmetic reasons in breast augmentation with and without lifts, and by myself and others in the reconstruction of breast cancer. When compared to saline implants there are several advantages and disadvantages of silicone implants. The advantages of silicone gel breast implants include a more natural feel and potentially less rippling in visibility. The disadvantages of silicone gel implants include that they often require a longer incision to place, are pre-filled, and thus are not adjustable for subtle volume differences, and tend to have less projection for any given chest width, and finally are more expensive than their saline counterparts. I prefer placing either saline or silicone implants under the muscle. In this sub-muscular position there is less visibility, less palpability, and there is no change in the detection of breast cancer with mammography. A specific view called an implant displacement view is encouraged, and will be done at the time of mammography when you tell the technician that you have implants. I currently will use both silicone and saline implants to achieve the look you desire. During your consultation, I will perform a thorough history and discuss your breast goals and desires. We will then carefully analyze your individual breast shape and dimensions to devise a surgical plan that best enhances your look.