A frequently asked question to me is the safety of silicone breast
implants. In early 1992, the FDA placed a moratorium on the use of silicone
breast implants, under further investigation was performed to verify the
safety of these devices.
Over the next 15 years large clinical trials were performed to address
these concerns. Many of the more serious concerns you might have heard
about with silicone implants, like causing collagen-vascular diseases, such
as lupus and rheumatoid arthritis, have been disproven. Other claims
however had strong merit.
Among these claims was that these early liquid-filled silicone devices
ruptured easily, and could cause hardening of the breasts, and leaking into
the tissues of the breast. These observations led to a conscious
development, and the use of our current cohesive gel implants. These breast
implants are filled with a silicone gel which is more like a solid, rather
than a liquid form to reduce migration and extrusion of that gel.
Finally in November 2006, the Food and Drug Administration approved wider
use of these silicone gel breast implants. Specific inclusions and
exclusion criteria were mandated by the FDA, and these include that a
prospective patient will read an informed consent pamphlet, and review it
with us at the time of their consultation prior to surgery.
It's important for patients to realize that silicone gel implants come in
different sizes, projections, and texture. They are currently used for both
cosmetic reasons in breast augmentation with and without lifts, and by
myself and others in the reconstruction of breast cancer.
When compared to saline implants there are several advantages and
disadvantages of silicone implants. The advantages of silicone gel breast
implants include a more natural feel and potentially less rippling in
The disadvantages of silicone gel implants include that they often require
a longer incision to place, are pre-filled, and thus are not adjustable for
subtle volume differences, and tend to have less projection for any given
chest width, and finally are more expensive than their saline counterparts.
I prefer placing either saline or silicone implants under the muscle. In
this sub-muscular position there is less visibility, less palpability, and
there is no change in the detection of breast cancer with mammography. A
specific view called an implant displacement view is encouraged, and will
be done at the time of mammography when you tell the technician that you
I currently will use both silicone and saline implants to achieve the look
you desire. During your consultation, I will perform a thorough history and
discuss your breast goals and desires. We will then carefully analyze your
individual breast shape and dimensions to devise a surgical plan that best
enhances your look.