Dr. Mendoza in the Media

For Immediate Release
March 2007

Making an Informed Choice - Silicone Versus Saline Breast Implants
by Rigo Mendoza, MD, Board Certified Plastic Surgeon

I understand that the FDA recently approved silicone implants for breast augmentations. For many years, I heard so much negative press about silicone implants. What are the pros and cons of the different types of implants available on the market today? - J. M. of Hinsdale

I get this question several times a week from women who are weighing the options of silicone versus saline implants.

According to the American Society of Plastic Surgery statistics, nearly 300,000 women chose breast augmentation in 2005, making it the most frequently chosen plastic surgery procedure. While some women seek implants out of vanity, there are many reasons why a woman might consider augmentation, including:

• Women who feel their bodies or breast are disproportionate or asymmetric
• Loss of breast tissue and firmness after childbirth
• Women whose weight loss has changed the size and shape of their breasts
• Women whose breast has been removed or disfigured by breast cancer surgery
• Women who want to improve appearance of a breast that is missing or disfigured due to trauma, heredity, or congenital abnormalities.

For safety reasons, use of silicone implants was restricted fourteen years ago and saline implants became a popular alternative. In November 2006, the FDA approved the return of silicone breast implants to the U.S. market. As a result, there are bound to be numerous questions, which we will address in this article.

A BRIEF BACKGROUND ON BREAST IMPLANTS

In 1992, the FDA issued a moratorium on silicone gel breast implants and restricted the use of silicone implants to breast reconstruction and clinical trials. This moratorium was instituted because it was suspected that the silicone leaked from these implants might have caused autoimmune diseases such as lupus and rheumatoid arthritis.

After silicone was withdrawn from the market, sterile saline implants were developed to answer the demand for a safer alternative and received formal FDA market approval in 2000. While still using a silicone outer shell, saline implants are filled with sterile salt water that is safely absorbed by the human body should the implant rupture.

It should be noted that researchers from the University of North Carolina who reviewed 20 studies involving 10,000 women with gel implants from the United States, Sweden, the Netherlands, Canada, the United Kingdom and Australia could find no link between gel implants and autoimmune diseases.

PROS AND CONS OF SILICONE IMPLANTS

The shells of both silicone and saline implants are made of the same solid silicone material. The difference is what is inside the implant. The silicone implant is filled with a semi-solid silicone gel. Perhaps the greatest advantage silicone types of breast implants have over saline implants is that they look and feel more natural. Silicone gel has a consistency that closely resembles that of natural breast tissue, so silicone breast implants are often virtually undetectable after they have been placed. The viscosity of the silicone gel reduces the occurrence of rippling that is more common with saline breast implants. Because of this, women who are very thin or who need reconstructive breast surgery achieve much better results with silicone implants.

The disadvantages of silicone implants compared to saline types include the risk that a rupture will go undetected. When a silicone breast implant ruptures, the silicone can leak from the implant but remain in the cavity that holds the implant, making detection of the rupture difficult. A MRI can detect any suspected ruptures. Historically, capsular contracture rates were higher with silicone gel implants. These rates have decreased in recent years due to a new generation of silicone gel implants that changed the outer shell.

PROS AND CONS OF SALINE IMPLANTS

Saline implants offer a variety of advantages over silicone ones. The primary advantage is that saline implants are adjustable; doctors can differentially fill implants to the appropriate level to obtain near perfect symmetry in both breasts.

Another big advantage of saline breast implants over silicone is their safety. Should a saline implant rupture or leak, the human body can easily absorb saline solution, which is essentially saltwater. A rupture is almost immediately evident with a saline breast implant because deflation is rapid.

Another distinct advantage of saline breast implants is that they are less expensive than silicone implants, which can be a significant consideration when calculating cost and affordability. One more advantage is that the incision to place saline implants is smaller than silicone implants. Saline implants are inserted rolled up and empty into the pocket of the breast whereas the silicone implants come pre-filled from the manufacturer.

A disadvantage of saline breast implants is that they tend to show rippling more than silicone-gel breast implants because they are filled with water. Saline breast implants also present the risk of capsular contracture. Capsular contracture is a potential complication from breast implants in which scar tissue forms around and squeezes the implants, causing the breasts to harden.

A PERSONAL CHOICE

The biggest reason to celebrate the recent FDA approval of silicone implants is not that they are necessarily a better option for women - it is the fact that women are given a new aesthetic choice for plastic surgery that may better suit their expectations. Whether to use silicone or saline? The decision should be made after consultation with your doctor.

Any medical procedures should be taken seriously, whether they are performed in a surgery center or in the doctor's office. Anyone considering these procedures is strongly encouraged to check your doctor's credentials and training. To confirm that your doctor is board certified in the field that they are practicing medicine, please visit the web site for the American Board of Medical Specialties at www.abms.org.

Rigo J. Mendoza, M.D.
Board Certified Plastic Surgeon

Chicagoland Plastic Surgery
Naperville - Chicago - Oak Lawn

630.305.0331 Main Office

www.ChicagolandPlasticSurgery.com

Dr. Mendoza is a Board Certified Plastic Surgeon with offices in Naperville, Chicago (Michigan Avenue) and Oak Lawn. Specializing in cosmetic surgery of the face and of the body, he also offers a wide range of cosmetic surgery options. Prior to November 2006, silicone implants were only available to women under certain strict criteria and they were required by the FDA to participate in adjunct studies. Dr. Mendoza has participated in the FDA silicone adjunct studies as an approved investigator since 2001.

Board Certified in Plastic Surgery, Dr. Mendoza has undergone extensive training in plastic, cosmetic, reconstructive and hand surgery. He also trained at Manhatten Eye, Ear and Throat Hospital in New York City, one of the busiest cosmetic surgery hospitals in the world.

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