Silicone vs Saline Implants

Am I  the only plastic surgeon offering saline (salt water) as well as silicone breast implants to my patients? Each day prospective patients come into the office asking for silicone gel breast implants. Many patients feel they have been educated as a result of their own Internet research and consultations in other offices. This is no surprise, as many surgeons in my community have reverted back exclusively use these implants. In addition, many websites extol the virtues of silicone breast implants without mentioning possible risks.

I give information on both implants and let my patients decide on what is best for them.   Discussions with patients mainly focus on the differences between each type of  implant and issues of safety should a rupture occur.    Silicone implants can give patients the benefit to feel them less with their hand while doing breast self-exams.  People often say, “They feel more natural.”   This particular aspect is most important for some women.  However, in terms of appearance, when properly placed both types of implants have a natural appearance.  

All implants will break eventually.  When a saline implant breaks, the result is that one of a woman’s breasts    will “deflate”  to a smaller size.  The salt water is naturally absorbed and  passes out of her body.  Silicone implants do not have this advantage and the silicone gel does not pass out of the body, as it cannot be metabolized.  It makes diagnosis of a ruptured silicone implant more difficult.  Ruptures are “silent.”  For this reason, the FDA currently recommends  regular MRI examinations to determine the presence of implant rupture.

As I mentioned in an earlier blog, I am always amazed how quickly women “forget” they have had breast enlargement surgery.  They incorporate their new figure into their new body image quite rapidly.  Silicone gel implants run counter to this mindset and women are often reminded of their surgery by needing the MRI studies and the consideration of a possible implant rupture.

When my patients receive this information, most patients choose  saline implants for  their surgery.    They often mention that the main reason is  they will have peace of mind with their final decision, and it is almost entirely  based on safety.

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