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If you decide to pursue breast reconstruction with an implant, there are many factors to consider with your physician such as: fill type (saline or silicone), shell surface (smooth or textured), shape (round or shaped), profile (projection), and volume (size). Perhaps the most basic of these considerations is fill type - saline or silicone. Each fill material has its benefits and drawbacks; understanding these advantages and disadvantages will help you and your surgeon determine the right option for you. It is important to note that the FDA continues to strictly regulate and review the use of breast implants for use in breast reconstruction and augmentation which you should discuss with your surgeon prior to making your decision.
Saline breast implants are filled with a sterile saltwater solution. Although they are not filled with silicone, they do have an outer shell that is made of solid silicone. Saline implants are delivered unfilled, and are filled by your surgeon with saline in the operating room. If you and your surgeon choose saline for your breast implant reconstruction, any ruptures, tears or leaks will typically be noticed immediately because the implant will deflate.
Some of the potential advantages and disadvantages of saline breast implants are outlined here:
Potential Advantages | Potential Disadvantages
If saline implants rupture or leak, the filler material is safely absorbed by the body.¹
Saline implants can be adjustable, allowing for modifications in size during surgery.
A smaller incision is possible, because the implant is filled interoperatively.
Some people may find that saline implants do not provide a look or feel that is as natural as silicone implants.
Saline implants have a higher tendency to visibly wrinkle or ripple under the skin (versus silicone).²
Saline implants have a higher rate of leaking and deflations (which may lead to a higher replacement rate).³
Silicone breast implants have been scrutinized by the FDA over the last few decades. In 1992, silicone breast implants were available only as a "public health need" until 2006 when the FDA announced they were approving silicone breast implants made by two manufacturers. However, the approvals contained certain requirements for each of the two manufacturers and further details can be found on the FDA web site. There has been little evidence that silicone implants cause autoimmune disease, cancer, or other illnesses. Further, many women appreciate the more natural contour, look, and feel of silicone implants.4
Silicone implants are particularly attractive to some breast reconstruction patients because cancer treatment often leaves women with very thin tissue on their chest. For these women, the rippling and wrinkling that can occur with saline implants may be particularly noticeable. However, rippling and wrinkling generally occur with less frequency with silicone implants, even for women with thin tissue.5
Because they are filled with gel, not liquid, a ruptured silicone implant may not be noticeable immediately. For this reason, breast augmentation and breast reconstruction patients with silicone breast implants are advised to have periodic MRI's to check for a "silent rupture."
Some of the potential advantages and disadvantages of silicone breast implants are outlined here:
Potential Advantages | Potential Disadvantages
Most women find that silicone implants provide a more natural contour, look and feel.4
Visible rippling occurs less frequently.5
Thin women and those with less breast tissue may still achieve a natural-looking result.
Studies suggest that silicone implants have a longer life span than saline implants.6
If silicone implants rupture, it is possible that it may go unnoticed for some time.
A larger incision may be required for silicone implants.
As you can see, as with all breast reconstruction options saline and silicone implants each have their advantages and disadvantages. The best way to determine which implant type will best achieve your goals is to consult with a board certified breast reconstruction surgeon. Your surgeon will assess physical factors such as skin quality and breast size, as well as other considerations such as your personal preferences and unique concerns. Together, you will establish if breast implant reconstruction is the best option for you, and which implant may meet your needs.
IMPORTANT INFORMATION: Every patient is different and their reconstruction options and their results
may vary. All depictions on the site are for illustration purposes only. Whether or not you have breast
reconstruction is a decision you need to make in consultation with your physician. Only you and your
physician can determine the best option for you. Please ask your doctor to explain the benefits and
risk of various reconstruction options and whether they are right for you.