Breast Augmentation – Saline Breast Implants
Saline-filled breast implants were introduced by a French company (Laboratoires Arion) in 1964. Over the years different companies have changed the implant shell composition as well as the sizes and shapes of saline implants. In 1992 the US Food and Drug Administration (FDA) placed a moratorium on the use of silicone gel breast implants for cosmetic breast augmentation due to safety concerns. Saline implants were not included in that decision, allowing them to continue to be used for both breast augmentation as well as breast reconstruction after mastectomies. The popularity of breast augmentation soared during the 1990’s, during the time that silicone breast implants were not even available. Today there are two companies, Allergan (through their Natrelle brand) and Mentor, that make FDA-approved saline breast implants for use in the United States.
Shapes and sizes
Saline breast implants may either be round or shaped like a “tear drop”. Round saline implants are used more commonly for breast augmentation than shaped (“tear drop”) saline implants, but both types are available for use by women age 18 and older. There are different “profiles” of round saline breast implants. The two companies have slightly different names for their profiles, but basically the profile names are ‘moderate’, ‘moderate plus’ or ‘midrange’, and ‘high’. (There are additional profiles but they are used primarily for breast cancer reconstruction.) The profiles refer to a combination of width and projection (front-to-back dimension) of the implant. A moderate profile implant is wider and flatter than a high profile implant of the same volume, and the midrange implant is in between those two. To make this a little more understandable, imagine that you have three vases into which you want to place some flowers. Suppose that the volume of water each vase can hold is the same (a quart, for instance), but the vases are shaped differently. One vase is tall and thin (comparable to a high profile implant), one vase is short and wide (comparable to a moderate profile implant), and one vase is in between those two. Each vase holds the same amount of water, but they look different. That is what profiles of breast implants are like. Having so many profiles of implants available allows a more individually customized approach to breast augmentation and breast reconstruction surgery.
Shaped, or ‘teardrop’ saline implants are different. Instead of being round, these have more of an oblong shape and are thinner at the top and wider at the bottom. These ‘anatomical’ breast implants were developed in the 1990’s in an effort to create a more gentle shape to the breast. Some women and some surgeons think these implants are a bit firmer than round implants and there is debate as to whether or not they actually create breasts that are shaped differently than breasts with round breast implants.
There are more sizes of saline implants available than silicone implants. The largest saline breast implant available for use in the U.S. is 960 cc’s. That is an extremely large implant, used essentially only in breast reconstruction cases and not for breast augmentation. These types of issues may be more thoroughly discussed during a visit with Dr. Kunkel.
Technique of placement compared to silicone breast implants
Silicone breast implants are pre-filled. Saline implants are empty initially. Because of this, smaller incisions may be used when placing saline breast implants compared to silicone implants. After the incision is made and the pocket into which the saline implant will be inserted is created, the edges of the saline breast implant are rolled toward the center into a shape that looks something like a thin burrito. This allows an empty, narrow implant to be inserted into the pocket, then unrolled once inside. Sterile saline is then added to the implant, filling it to its final volume.
Benefits of saline breast implants compared to silicone implants
The incisions and resulting scars are usually smaller when saline implants are used than when similar-volume silicone breast implants are used. Saline breast implants allow more fine adjustment of size compared to silicone implants because saline may be added or removed during the surgery to optimize the result. This is particularly beneficial for a woman who has one breast that is larger than the other. Saline implants also cost less than silicone implants.
Who are the best candidates for saline breast implants?
Saline and silicone breast implants wrinkle around the edges. With saline-filled breast implants, it may be possible to feel those wrinkles under the skin more easily than with silicone implants. For that reason, saline implants tend to work best in women who have a little more existing breast volume than women who have almost no shape or volume before undergoing breast augmentation. Women who are of average weight or even higher BMI’s (body mass index) and have more existing tissue may be good candidates for saline breast implants. Also, in situations where one breast is substantially larger than the other, saline implants may be a good choice. Finally, saline implants cost less than silicone implants, and that is certainly a major consideration for many women interested in breast augmentation surgery.
How long do saline breast implants last?
As is the case with other types of medical devices (pacemakers, knee joints for instance), saline-filled breast implants will wear-out over time. Eventually a leak will develop. When that happens with saline breast implants there is an obvious change in the breast size and shape. The saline leaks out and the breast loses its volume. Some patients refer to this as having “a blowout”. The saline is absorbed by the body but now one breast has volume and shape and the other does not. This is not a dangerous situation; the saline breast implant shell is still sterile. However, it may be a bit of a social emergency when it happens. The average length of time that saline breast implants last is between 13 and 14 years. When a saline breast implant loses its volume and shape, additional surgery will be needed to either remove or replace it.