According to both the American Society of Plastic Surgeon (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS), the most popular surgical procedure is breast augmentation. In 2010, ASPS reported 203,000 breast augmentation cases performed and ASAPS recorded over 318,000 cases. There are many things to consider before undergoing a breast augmentation, one of which is the decision between the type of implant. The two popular choices, silicone and saline have different properties and depending on your body type and whether you've had children or not, could decide which is best for you.
Ann Arbor cosmetic surgeon Dr. Robert Burke, who has had extensive experience with both types of implants believes that the choice of implant is ultimately up to the patient. However, as a cosmetic surgeon who has performed many breast augmentation procedures, Dr. Burke also believes that certain body types are better suited for certain types of implants and the issue of previous childbirth plays a big part.
"One of the things that I like about silicone breast implants is that it feels like a natural breast. I've been on a few FDA pre-approval studies so I've been able to use them for the past 10 years," states Dr. Burke. Silicone breast implants which underwent a voluntary moratorium in 1992, was placed in effect by the FDA to test and research their safety and potential health risks. In 2006, the moratorium was lifted after the FDA issued new provisions regarding the use of silicone breast implants that would increase the safety of their usage in breast augmentation.
New silicone breast implants have been made available to mitigate previous fears of leaking silicone. Earlier iterations of silicone breast implants were filled with liquid silicone and when there was an implant rupture, the fear was the silicone could potentially cause health risks. The new silicone breast implants are made from a cohesive gel, natural feeling and not liquid. Dr. Burke comments, "When I examine patients post-op, after a breast augmentation with cohesive gel silicone implants, what I find is many times, I wouldn't even be able to tell there was an implant there: it feels like a normal breast."
While the majority of Dr. Burke's patients do request a cohesive gel silicone implant, the saline implant also has its merits and with the proper patient, is more ideal than its silicone counterpart. "If a patient comes in with almost no breast tissue, very small areola and have not had children, I would encourage them to have the saline implant," explains Dr. Burke, "The saline implant will act as a tissue expander so it will expand the breast cavity."
Saline implants, which experienced a surge in popularity during the moratorium on silicone implants, were heralded as safer since if the implant ruptured, only saline would be introduced into the body. However, with ruptured saline breast implants, the patient would still have to undergo another surgery to remove the old implant and replace it with a new implant.
According to Dr. Burke, "There is no implant designed to last a lifetime. All implants generally lose their wall of integrity somewhere around 10 years or so." Therefore, in patients that originally started with saline implants and has moved on to have children, Dr. Burke would recommend a cohesive silicone gel implant as the next set to be swapped in.