Saline Versus Silicone Breast Implants
Reviewed by Michael Olding, MD, FACS
Lawsuits against the manufacturers of silicone breast implants in the early 1990s caused a closer inspection of the safety of silicone implants. The Food and Drug Administration (FDA) removed silicone-filled breast implants from the market in 1992. This left only saline-filled implants available to the public.
From 1992 to 2005 investigators involved in clinical studies — who were evaluating the use of silicone implants for reconstructive and revision surgery — were the only ones allowed to use silicone breast implants.
According to the American Society for Aesthetic Plastic Surgery, surveys in 2005 showed that 83.4 percent of respondents used saline and 16.6 percent used the silicone implant. In November 2006 the FDA lifted restrictions, and approved the use of silicone breast implants for women who are at least 22 years old.
Advantages and Disadvantages
An advantage of saline breast implants is that, if ruptured, the saline (salt solution) is dissolved by the body.
A disadvantage is that saline implants are more likely to show ripples in the implant, or the implant itself may appear less natural in small-breasted or reconstructive patients. This is especially important for very thin women who have little breast tissue to cover the implant, or for women who have a breast injury or need breast reconstruction. The small ripples in the implant may be more likely to show through the skin in these women.
The Silicone Option
Silicone implants provide another choice for breast implant patients. New silicone gel-filled implants may provide a more natural feel in the various implant placement positions:
The final analysis of studies attempting to link silicone to connective tissue diseases and certain autoimmune diseases, is that they have failed to show any connection. There have been other studies to show that silicone implants are safe, and the FDA has approved them for breast augmentation.
Discuss the Benefits and Risks with a Surgeon
When deciding which type of implant is best for you, discuss your options with a board-certified plastic surgeon. Because of the former FDA restrictions on silicone implants, which were in effect for 14 years, there are many surgeons with little or no silicone-implant experience. You should be careful to consult a plastic surgeon who has extensive and specific silicone breast implant experience.
Experienced breast augmentation surgeons can explain the benefits and risks for certain implant types depending on your personal anatomy, implant placement, and the type of implant incision.
Related Topics
[page updated June 2008]
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