Brian S. Glatt MD, a board certified plastic surgeon, performs a great deal of breast implant surgery using both saline as well as silicone gel implants. While there were a number of years in which saline filled breast implants were the only option for those who desired cosmetic breast augmentation surgery, women now have the choice of receiving silicone gel filled implants as well. There are advantages and disadvantages of each kind of implant and these will be fully discussed with you during your consultation with Dr. Glatt. He views an important part of his job as educating you as much as possible in order to help you make the right decision for you. Dr. Glatt will never pick an implant type (saline versus silicone) for you – this important choice is always made by his patients. Regardless of your choice, excellent results can be obtained with either type of implant.
Saline filled implants contain a sterile salt water (saline) solution which comes straight out of an IV bag. These implants are placed into the breast implant pocket empty and are able to be rolled up for easy, non-traumatic insertion and then get filled in the operating room, so the incision length can be slightly smaller than that required for silicone gel implants. Saline implants feel and look slightly less natural than silicone gel implants. There is also a higher chance of developing “rippling” with saline implants, especially in very thin women, which can make the implants look more obvious. No implant will last forever, and all of them have a chance of rupturing some time in the future. One of the features of saline implants is that if they rupture, it is usually quite obvious as your breast will “deflate”. This requires a small operation to replace the ruptured implant with a new one.
Silicone gel filled breast implants were reapproved by the FDA in 2006 for use in all cosmetic and reconstructive breast surgery. This decision came after plastic surgeons collected data based on a nationwide study which tracked women who received these implants for approximately 15 years. It may be interesting to know that the silicone gel breast implant is the most studied device in the history of our country! These breast implants feel much more natural and softer than saline filled implants and most seem to think that they feel more like a natural breast does.
Silicone gel breast implants have never been made better – the gel inside is extremely cohesive and maintains its structure upon compression. One point to keep in mind though is that these breast implants are made so well that if a silicone gel breast implant were to rupture, it may not be noticeable and you might not be aware that the implant has ruptured! Breast implant rupture may be detected on physical examination by your doctor or you may notice a difference in your breast feel or shape. The gold standard and most definitive way to know if they have ruptured or not is to undergo radiographic studies, such as an ultrasound or an MRI. Thankfully, if they are found to be ruptured there is no harm that will come to you. Although people seem to believe that the gel will “leak” or ”spread” in their body or make them sick, none of these things happen. In reality, medical studies have proven that breast implant rupture is not associated with autoimmune disease or other syndromes. Also, your body forms a wall of protective tissue, called a capsule, which keeps implant material from coming in contact with any other part of your body or tissues.