1. What is an implant made of?

The shell of all breast implants is made of silicone. The filling of the implant is either saline or a different type of silicone, a silicone gel.


2. Is having silicone in the body safe?

Yes, according to extensive research presented to the FDA. Silicone implants were brought back onto the market because it was not found that silicone caused any health issues. Silicone is used in almost every other device placed in the body, such as artificial knees, heart valves, etc. Having said this, I am more comfortable that the new implants are like gummi bears, wherein after a rupture the silicone stays in place and does not travel as a liquid throughout the body.


3. If silicone does not make people ill, why do the suits continue?

The class action lawsuits against the original manufacturer of silicone implants will continue indefinitely, but no new lawsuits have been brought successfully against manufacturers of silicone implants because of the extensive testing that has been undertaken and because of the FDA approval. The current lawsuits are left over from the original class action ones.


4. What are the pros and cons of silicone filled versus saline filled?

I think the difference comes down to only a few things:

a) Silicone implants usually cost about $1,000 more than saline implants.

b) The incision used to place silicone implants is slightly larger than the one used to place saline implants. If somebody is having a breast lift, then this does not matter because the implants are generally put through the breast lift incisions.

c) Silicone implants feel a little more natural than saline implants: Because I place my implants under the pectoralis muscle, this is somewhat less apparent than you would think. In a thin woman with large implants, there is a noticeable difference, but in a woman with some subcutaneous fat and breast tissue who is not choosing a large implant, I think the difference in feel between silicone and saline is small. Also, silicone implants weigh less than saline implants -- this is usually not a significant difference, however.


5. Can salt water implants harden like silicone ones?

Yes, this hardening is caused by a condition caused capsular contracture, which can occur with any type of implant. For some reason, the normally soft and pliable shell that the body forms around an implant can scar and harden. Most of these contractures do not require treatment, but in about 25% of women who do develop a contracture, another surgery for removal of the encapsulation is required. This can occur with both saline and silicone implants.


6. How long do implants last?

The manufacturers warranty them for a life time, so they can last that long. I have seen many patients with implants in them for at least 30 years. Having said that, it is advisable to think that the implants will need to be replaced at some point, simply because there is no guarantee that they will not rupture or change position or that you will want that size forever. There is a myth that implants need to be replaced after 10 years: this came from data from an older generation of implants that showed a 50% rupture rate at 10 years. This is not true of the current generation of implantsthe rupture rate is much lower. Many patients with old implants come to me at 10 years and ask for them to be replaced: if they like the shape and if they have no issues with the implants, then I say to leave them in.