If you are considering breast surgery with implants, you want to make sure your results last. We will discuss the results you can expect from silicone and saline implants and what to look out for if you are considering breast implant surgery.
Breast implants come in a variety of shapes, sizes, textures, and materials. Your surgeon will help guide you through the process of choosing which implant is right for you. One of the most important choices you will make is saline vs. silicone. All implants have a solid silicone shell. The shell can be filled with either saline (salt water) or silicone gel. There are advantages and disadvantages of both options.
Silicone implants feel softer and more natural and are a better option for thin patients or patients with very little breast tissue to cover the implants. They also ripple less than saline implants. However, silicone implants have to be checked regularly with imaging to ensure that the implant stays intact. Because the implants are filled with a semi-solid or “gummy bear”-like gel, you may not realize there’s a problem with the implant because everything looks and feels the same.
Saline implants feel a bit more like a water balloon and tend to ripple more. These implants are a better option for patients who have more breast tissue to cover the implants. The biggest advantage of saline implants is that they don’t require regular imaging. If the shell ruptures, you will know right away because the breast will suddenly appear deflated. While saline and silicone implants are both very safe, some patients feel more comfortable knowing that if the implant ruptures, their body will only be exposed to regular salt water.
Older generation liquid silicone implants lasted about 10 years. Advancements in breast implant design have created longer-lasting silicone implants due to the cohesive gel fill which has a more stable interaction with the shell. The reason breast implants fail is that folds and creases in the shell over time break down. With cohesive gel, there is less creasing of the shell. These implants can last for 15-20 years or more. The FDA recommends screening silicone implants for rupture with ultrasound or MRI 5-6 years after surgery then every 2-3 years thereafter.
Saline implants last an average of about 10 years. In some women, they may last much longer. Eventually, the shell with break and the salt water will be reabsorbed by your body. Because a potential rupture would be obvious, screening with ultrasound or MRI is not necessary.
Saline and silicone implants are both equally safe. Some people are afraid that if a silicone implant ruptures, the silicone will migrate to other places in their body or make them sick. A ruptured implant will not make you sick. While older liquid silicone implants could have some migration into nearby lymph nodes, this really isn’t a concern with the newer cohesive gel implants. It is still important, however, to screen regularly because a longstanding rupture of a silicone implant could lead to capsular contracture. This is not dangerous but can distort the shape of the breast and potentially cause discomfort. If you develop capsular contracture, it will require a revision procedure that is more complicated than a simple implant exchange.
A common misconception is that breast implants need to be replaced every 10 years. This is not recommended, especially with newer cohesive gel implants. There are many reasons why you might want to have your implants removed or replaced that have more to do with your aesthetic goals and the condition of the implants. Here are a few common reasons:
Many women choose to remove or replace their implants simply because they want larger or smaller-sized breasts.
Over time, your implants can shift or move downward as a result of aging, gravity, or weight fluctuations. Sometimes the implants can move and women complain that the implants move toward their armpits when lying down or during certain activities. Depending on the nature of the problem, your surgeon may recommend implant replacement, as well as possible tightening of the capsule, creation of a new pocket, or placement of a support mesh.
The risk of an implant rupture increases the longer your implants are in place. Ruptured saline implants will deflate quickly and you will start to notice your breasts looking smaller or deflated. Ruptured silicone implants may not cause any symptoms or may be detected by a shift in sensation in your breasts or the development of small lumps. In any case, if you have a ruptured implant, your surgeon will recommend removal or replacement of the implant.
Capsular contracture is the formation of hardened scar tissue around the breast implants. This hardening can distort the shape of the breasts and be painful or tight-feeling. During breast surgery revision, the thickened capsule will be removed and the implants replaced to improve the appearance of your breasts and alleviate your discomfort.
Over time, aging of the breast tissue can cause sagging, changes in nipple position, or changes in volume of the breast. Sometimes a breast lift or reduction will be recommended along with a change in implant size or profile or an implant exchange because of the age of the implants.
In recent years, we have become aware of a rare type of lymphoma called BIA-ALCL that is associated with textured breast implants. Some textured implants have been recalled and replacement with smooth implants is recommended. Most surgeons no longer use these types of implants.
Although there are risks that may require implant replacement or removal after breast augmentation, working with a skilled surgeon limits these risks so that you can enjoy beautifully perky breasts for many years. If you want to enhance the size of your breasts or need an implant replacement, schedule a consultation today with board-certified plastic surgeons Dr. MacLennan and Dr. Schmidt.