As a Board Certified Plastic Surgeon with fellowships in Aesthetic, Breast, & Laser Surgery, I have been on the cutting edge of breast augmentation surgery for more than three decades. In a typical week, I meet with dozens of patients seeking breast augmentation. Several questions and topics are discussed, with the most popular being “saline or silicone?” I take pride in empowering my patients at Persons Plastic Surgery in Lafayette to make informed choices. Implants have come a long way since being developed over fifty years ago. Advances in technology and surgical techniques make it easier and safer than ever to enhance the shape and size of your breasts.
Silicone vs. Saline?
Silicone gel implants were first created in the late 1960s and continue to improve with ongoing technological advancement. Silicone gel is a polymer with no known human allergies, sensitivities, or reactions. Similar to gummy bear candy, the molecules are stuck to one another in a cohesive matrix. This creates a natural look and feel to the breasts.
Silicone implants come in many shapes, sizes, and projections, allowing patients to customize and achieve their desired results. Saline-filled implants were designed as an alternative to silicone and became popular in the 1990s and early 2000s. Saline has the same consistency of water, which often leads to a rippled appearance under the breast tissue if the implant is under-filled. A major selling point for saline implants, however, is that some styles include ports that allow for the amount of saline to be adjusted after surgery. Saline implants are less optimal for women seeking larger implants such as a D cup. In general, the more popular choice among all age groups today is silicone.
New Generation of Silicone Breast Implants
Over the last 20 years, significant advances have been made to silicone gel Implants. We are now implanting the 7th and 8th generation of silicone breast implants. The newest silicone implants have a slightly higher fill (96% fill versus the previous generation’s 85% fill) and more cross-linking of the silicone molecules. The higher fill and more cross-linking allow for an increase in the cohesiveness of breast implants, as compared to past generations of implants, in which the folds of the silicone implant could be visible through the skin. Rippling was the only potential trade-off of placing silicone implants on top of the muscle in thin patients or after mastectomy – until now! Excitingly, with the 96% full implant there much less rippling even in very thin or athletic patients. These implants create a natural result for women desiring small, moderate, or also ample breast size.
The breast augmentation procedure requires a small incision, often in the crease below the breast, resulting in a tiny scar that is typically well hidden. Immediately following the procedure, an elastic sports bra is placed to minimize swelling and support the breast as they heal. Acute pain usually subsides after one to five days, but you may experience soreness and swelling for up to two weeks. Patients can resume exercise and regular activity based on my instruction within a few weeks. Overall, my patients find that recovery is quick and reasonably straightforward following the breast augmentation procedure.
The smooth shell of the new generation of silicone implants have the added benefit of eliminating the rippling effect and preserving a soft, mobile result without an increased risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) which is a rare and highly treatable type of lymphoma that can develop around breast implants. You may have heard about the recent reports of a potential association between breast implants and BIA-ALCL. It occurs most frequently in patients who have breast implants with textured surfaces. We have known about this disease for quite some time, and the Food and Drug Administration has been providing updates since 2011. In any case, as a precaution, I would not recommend textured implants. If you do have a textured implant, you are safe as long as you are happy with your cosmetic results and you do not develop late swelling with fluid collection around the breast. In those instances, visit your Plastic Surgeon for an evaluation.
Whether you are considering a breast augmentation for the first time or are a patient with existing implants looking for a change, I look forward to sharing my experience and expertise in determining the most suitable augmentation option for you.