Silicone Vs Saline Breast Implants- Sydney Plastic Surgeon: Dr Graham Sellars

The controversy surrounding Silicone Gel Implants of the 1990s has led to anecdotal misinformation. This, along with a diversity of Implantable devices, has caused some confusion in the minds of both Surgeons and Patients.

Most patients choose Silicone Breast Implants rather than Saline Breast Implants due to their natural look and feel. Over 90% of breast implants used in Australia are silicone gel filled.

About Saline Breast Implants
The main reason why many patients opt for Saline Breast Implants is that if the Implant were to rupture the breast “deflates” and the saline is simply absorbed by the body. However, Saline Breast Implants tend to demonstrate wrinkles, which can be felt and are sometimes visible. To avoid this, Saline Breast Implants can be slightly overfilled, but this leads to a more spherical appearance with increased fullness in the upper part of the breast and a firmer feel to the Breast Implants. Saline Breast Implants have a rupture rate of 1-3% per year, which requires another operation to correct.

About Silicone Breast Implants
Today modern Silicone Breast Implants are substantially different from the old type used in the 1970s and 80s. The casing of the Silicone Breast Implant is much thicker and often has a textured surface, which reduces the chance of capsular contracture (hardening) of the Implant. Modern cohesive Silicone Gel Breast Implants contain a gel that is similar in consistency to a set jelly, which retains its shape and does not run like a liquid, as the old silicone gel did.

Another advantage of the Silicone Gel Breast Implants is that they are made in a variety of round and tear-drop shapes, which means it is easier to choose a Breast Implant to achieve the breast shape that you desire.

Like all foreign materials, Silicone is walled off by the body with a thin, inelastic lining or "capsule". In both cases the capsule can undergo capsular contracture where the capsule surrounding the Breast Implant tightens, becomes hard and occasionally tender.

All Silicone Gel Breast Implants will develop a very fine layer of Silicone, which osmoses through the elastomer shell over many years. This is known as gel bleed and has been reduced in some of the newer Breast Implants with advanced layering of the elastomer shell. If Silicone Breast Implants do rupture, the capsule will initially confine the gel. Free gel may precipitate capsular contracture. If unchecked, Silicone gel can extravasate or leak outside the capsule, known as an extra capsular rupture and results in localised granuloma (benign lumps) around the edge of the capsule.

The granulomas may be tender. If ignored the older, less cohesive gels can spread towards the axilla (armpit). This certainly has been the down side of Gel Implants in the past and is unusual with the newer, cohesive Gel Breast Implants.

Overall
Misinformation emerged about silicone in the late 80's and early 90's. The effects of Silicone Breast Implants have since been studied extensively these claims were made, looking at 100,000s of women with Silicone Breast Implants. In June 1999, The Institute of Medicine at the National Academy of Sciences in the U.S.A. released a report which confirmed that there is no increased risk of the development of cancer, immunologic or neurological problems associated with the use of Silicone Breast Implants, which had been claimed in the late 80's. Patients with Silicone Breast Implants can breast-feed normally, as there is no effect on breast milk.

Both Silicone Gel and Saline filled Breast Implants are widely available for use in Australia. The vast majority of Breast Implants used in Australia are Silicone Gel. They both have a Silicone Elastomer shell. This shell may be textured or smooth.