Dr. Wojo. Healthy Living. Simplified.

Have you noticed that on these new makeover television programs just about every woman wants breast implants? Well, put your coffee cup down, because we are going to talk about the crème de le crème of plastic surgery: breast augmentation.

During the peak of breast implant popularity, complications came from what some blamed on the use of silicone implants, which meant that since 1992, only saline implants have been available for patients. Recently, an advisory panel completed an evaluation on the use of silicone implants and a vote of 9-6 occurred in favor in reinstating their use. This reverses an 11-year ban in the United States, meaning this recommendation will now go to the Food and Drug Administration (FDA) for final approval.

What are implants? In the early 1960s, two plastic surgeons developed the concept of silicone breast implants. The implant was initially manufactured by Dow Corning in New York. The intent was for plastic surgical correction of female breast deformity after breast cancer surgery. In addition, the implants were used for augmentation for cosmetic enhancement. For nearly 30 years, silicone implants were used successfully and without difficulty. Last year, there were more than 225,000 women that underwent breast augmentation surgery using saline implants.

What are the complications? Over the years, female patients began to develop some complications after the use of the silicone implants. The biggest problem was that the implant would eventually leak or rupture. The failure rate of the implant after about 15 years was nearly 25 percent. This is true of all breast implants, saline or silicone.

It was thought that the leaking silicone contributed to systemic medical conditions such as increased risks of cancer. It was also thought that there was an increased risk of connective tissue disorders such as rheumatoid arthritis and fibromyalgia. Silicone implants were also thought to interfere with reproduction and the ability to breast-feed. It was also thought that women with silicone implants had a higher risk of suicide.

What happened? After a variety of these concerns and complications were raised, public out-cry resulted in the FDA banning the production and use of silicone implants in 1992. The replacement implant developed was made of saline. Silicone is a manufactured substance that is in gel form.
Several medical devices such as heart valve coatings and intravenous catheters are made of silicone. The body does not usually react to its presence. Saline is saltwater and was thought to be safer. Cosmetically, it is thought that the silicone implants provided a much more natural appearance than the saline implants. Therefore, several research organizations studied the claims regarding silicone implants.

What research occurred? In the past 11 years, the Mayo Clinic, Harvard Medical School and the Academy of Sciences have studied this issue. Plastic Surgeons felt that patients needed a choice in implants and this provided the impetus for the studies.

Research has concluded that silicone implants leak and rupture at the same rate as saline implants. Due to the presence of the silicone gel, the leak is slower than saline implants. There was no increased risk for cancer amongst women with silicone implants. Mammography is not less sensitive in women with silicone implants. The incidence of connective tissue disorders is not any higher in women with these implants. Breast-feeding is not affected in these women either. Also, suicide rates and death rates are not higher in these individuals, compared to peers in similar situations.

What are the risks of implants? Whether silicone or saline implants are used, the severe risks are the same. Infection in the breast that results in the removal of the implant leads to cosmetic deformity. Additionally, an aggressive infection can severely damage the appearance and shape of the breast. The risk of leakage and rupture increases with time and additional surgery and replacement may be necessary. Overall, the chances of life-threatening illnesses are not greater with silicone vs. saline implants according to medical research.

What should you do? In the event that you need cosmetic breast surgery after cancer or simple cosmetic augmentation, seek out a board-certified plastic surgeon with vast experience. The FDA has not currently approved the reinstitution of the silicone implant, but that may occur in the near future. Be sure to complete appropriate research and be an informed consumer prior to surgical intervention.