Dr. Amy T. Bandy Breast Implants
For a number of years, saline implants were previously the only implants available for cosmetic breast surgery because of the moratorium that the FDA placed on silicone gel implants. The moratorium was placed due to the lack of controlled studies on these implants. Without these studies, it was not definitively known what the risk factors to the individual were for the silicone gel implants should they bleed, rupture or possibly migrate.
The moratorium was lifted in October 2007 and silicone gel was re-released onto the market for cosmetic breast surgery. This decision was due to the large amount of studies both retrospective and prospective that determined that there is very minimal difference in the safety margin of saline and silicone breast implants. The FDA now recommends that the silicone implants be available for cosmetic breast surgery for women 22 years old and older. The FDA also recommends that the patient undergo an MRI to study the integrity of the silicone implant 3 years after their initial placement, and every 2 years thereafter. The MRI is the most sensitive non-invasive study of implants for predicting the likelihood that there is a rupture present. Of course, the most sensitive “test” would be surgery, which is 100% accurate to determine whether an implant is intact. Currently, the FDA recommends that women change their silicone gel implants 10 years after their original placement.
Saline implants on the other hand are very easy to determine if there is a leak or rupture. The typical patient with leaking implants will present with a history of noticing that their breast appeared smaller and softer, and continued to get smaller over a few days. Eventually, the implant will leak out all or most of the saline, and the breast will be the original size that it was before surgery. This can be quite disconcerting for the woman, as she will now have 2 very different breasts. Re-operation in a timely fashion will allow the woman to regain the breasts that she had prior to the leak. Sometimes, a capsulectomy or removal of the scar tissue around the implant may be necessary if the breasts are firm or painful. Some women choose to replace their implants with the same size, some choose to go larger, and some choose to go smaller. Additionally, some women choose to exchange their saline implants for silicone gel after experiencing a saline leak.