Breast Augmentation - Round Silicone Breast Implants
The first breast augmentation with silicone implants took place in 1962. These original breast implants were teardrop-shaped and the silicone gel inside the implant was a little thick. Over the years several modifications were made to the breast implants, with thinner silicone gel and thinner shells surrounding the silicone being some of the earliest changes. In 1992 the US Food and Drug Administration (FDA) placed a moratorium on the use of silicone gel breast implants until studies could be completed to show that the devices are safe. Between 1992 and 2006, silicone implants could only be used by women enrolled in specific studies, or in cases of breast reconstruction after mastectomy for cancer. In 2006 the FDA convened a special panel to review studies that had been completed between 1992 and 2006, and to hear testimony both in favor of and against round silicone gel breast implants. The panel recommended approval of round silicone implants for cosmetic breast augmentation as well as reconstruction, and the FDA lifted the restrictions it had placed in 1992. The round silicone implants used in breast augmentation and breast reconstruction today are considered to be the fifth generation of implants, having a semi-solid gel surrounded by a silicone rubber shell.
Benefits of Silicone Breast Implants Compared to Saline
Perhaps the greatest benefit of round silicone implants compared to saline breast implants is that silicone implants tend to feel a little more natural. All implants develop some wrinkles in their shell surfaces. Imagine you have two Ziploc bags. In one of those bags you place 8 ounces of water, and in the other you place 8 ounces of jello. Now imagine those two bags sitting on a counter-top. The bag filled with water would be flatter against the counter-top, with less height, than the bag filled with jello. Both bags would have some wrinkling. That's kind of what it's like with saline (the water bag) and silicone (the jello bag). This is not an exact analogy, but it helps people understand the differences a little better. The wrinkles in silicone implants do not feel quite as crinkly as the wrinkles in saline breast implants. Another potential benefit of silicone implants is that perhaps silicone implants provide a little more fullness higher in the breast than comparable-volume saline implants. This has not been proven in studies but makes some sense, particularly if you imagine the Ziploc bags on the counter-top. The bag filled with thicker material (jello; silicone) has more height to it than the bag filled with thinner material (water; saline). For a woman who notes a gap at the top of her bra when she leans forward, this may be of benefit. An additional 'benefit' of silicone breast implants compared to saline-filled implants is that, when the day comes that a leak develops in an implant, it is not as much of a 'social emergency' as when it happens with a saline implant. The silicone in the implants is very thick. If a small hole develops in the implant, the silicone does not all leak out and go away. For many women there is very little (if any) change noted in the breast. When a small hole develops in a saline breast implant, however, all the saline leaks out and is absorbed. Women have referred to this as "a blow-out", with the affected breast losing its shape and volume. A woman in this situation has to get creative in what she wears until the problem is corrected. With silicone implants, this type of problem rarely occurs because almost all of the silicone remains within the shell of the implant and the breast does not usually change its appearance.
Best Candidates for Silicone Breast Implants
While the overall look achieved in breast augmentation with round saline and round silicone implants may be similar, the feel of the implants to a hand touching the breast is very different. For a woman who wants the feel of her breasts to be the most natural, silicone implants are probably better implants for her. Women who are very thin and have very little breast volume may have a better result with silicone breast implants than saline. When there is very little tissue covering the implants, the implants are closer to the surface. That could make wrinkles more noticeable. Silicone breast implants may also be better for a woman whose breasts sit a bit low on her chest but are not actually droopy. Because of the thickness of the gel, silicone implants may help provide a bit more fullness higher on the chest than similar volume saline implants. FDA regulations require that a woman be at least 22 years-old to be eligible for silicone gel breast implants.
How Long do Silicone Implants Last?
Like other types of medical devices (pacemakers, knee joints, hip joints) that may be implanted in people, silicone gel breast implants will wear out or leak over time. In studies that were evaluated by the FDA, it was found that between 3 to 9% of women who underwent cosmetic breast augmentation for the first time developed a leak of one of their implants by 6 or 7 years (data from Mentor and Allergan, two companies that make implants approved for use in the U.S.). Taken another way, 91 to 97% of women who undergo breast augmentation with silicone implants have implants that are intact after 7 years. The exact length of time that implants last is not known, but from studies completed to date, it appears that on average silicone implants may last longer than saline breast implants.
Risks of Silicone Breast Implants
The vast majority of women who undergo breast augmentation with round silicone implants have great outcomes and are very happy with their results. However, as with all surgical procedures, there are some risks. Although rare, infection may happen. If it happens a breast implant may need to be removed. Hardening of the scar that develops internally around a breast implant may occur. This is known as capsular contracture. There has long been concern that silicone gel breast implants may cause connective tissue disorders like lupus, scleroderma, fibromyalgia, and rheumatoid arthritis. This has been evaluated by many doctors in numerous studies. The results of these studies indicate that breast implants are not significantly associated with a risk of developing a typical or defined connective tissue disease. There are additional risks and these are discussed with women when they visit Dr. Kunkel's office. Information may also be easily found at the breast implant company websites by using search terms like Mentor, Allergan, Sientra, silicone gel breast implant risks.
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