Reader Question~ Breast Implants

From Rebecca:

Dr. Bashioum,

I have been to other plastic surgery offices for breast augmentation consultations.   They have all told me that silicone was the only choice for me.  Do you have any insight on why these other physicians are only pointing me to silicone?

There is a strong belief among many plastic surgeons that silicone gel filled breast implants are the best choice for their patients, because they believe that silicone gel breast implants both look and feel better.   I cannot agree with these statements.   The visual appearance of a patient’s breast is independent of what implant is filled with.   Our Before/After photographs have shown the results of saline (salt water) filled implants.  It is a choice that I leave up to my patients.  In fact, Melissa discusses this topic in her patient blog.  Click here to read about her decision.

Regarding claims that women “feel” saline the implants; it is true that a woman might feel saline implants slightly more, depending on how much volume of breast tissue they have before surgery.   However, when saline breast implants fail, the implant deflates and the salt water is passed safely out of the body.   Nothing needs to be done medically.

On the other hand, the failure of silicone gel implants will lead to inflammation around the implant which makes them more difficult to remove or replace.   This inflammatory problem is the reasoning behind the FDA’s strong recommendation to have an MRI tests periodically after silicone gel implants.   When given the choice and all the information, most of my patients choose saline filled breast implants, mainly because of safety concerns.  I feel strongly that the decision should be up to the patient and based on having been given adequate information on their options.

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