Silicone Vs. Saline Implants
Saline and silicone gel are very different filler materials with different properties. Saline is called a non-coherent filler. A non-coherent filler does not resist a change in shape, whereas a coherent filler like silicone gel does resist a change in shape. In other words, if saline is placed into a round container and suddenly that container changes shape to square, the saline will quickly flow and assume the square shape. Not so with silicone. It will stay round, at least for a while, until it slowly moves to take the new shape of the square container.
A silicone implant feels much closer to human breast tissue, whereas a saline implant is firmer than breast tissue. Due to the cohesive nature of silicone gel, such an implant has far less rippling and wrinkling than does a saline implant. This is especially important for women with thin tissue, as irregularities in the implant contour will be painfully obvious with respect to the look and feel of the augmented breast. Remember this important concept for later: the more tissue you can put in front of an implant, the less visible and palpable the implant will be.
A Word About Silicone and Safety
In 1991, due to unfounded concerns that silicone breast implants were responsible for certain autoimmune diseases such as rheumatoid arthritis, lupus and scleroderma, the FDA director, David Kessler, MD (a pediatrician), created a moratorium on silicone breast implants pending further study. What this meant was that silicone gel filled breast implants would not be available in the United States for general use in women except under special organized multicenter investigational studies. The use of these implants did continue, however, in other parts of the world. In November, 2006, the FDA gave clearance to the use of silicone gel filled implants. Silicone breast implants became the most studied medical devices in history. The results of these studies concluded that silicone breast implants are safe and are not related to breast cancer or connective tissue disorders.
The best information regarding the safety of breast implants is obtained from epidemiological studies between two groups of women who have and do not have implants. With this type of study, one can then draw an accurate conclusion as to whether certain disease processes occur more frequently in those women with (or without) implants. These studies are much more scientifically meaningful in terms of drawing an accurate conclusion than case reports of individual or small groups of women.
The best summary of these studies that I am aware of can be found in Appendix 2 and Appendix 3 of The Best Breast 2, where the key epidemiological studies are individually summarized by Dr. Tebbetts. These studies conclude the following:
- There is no connection between breast implants and breast cancer.
- Women with breast implants who do get breast cancer are not delayed in their diagnosis of breast cancer and are not diagnosed at a further stage of breast cancer than women without implants.
- There is no connection between breast implants and connective tissue disorders such as lupus and scleroderma.
For more information regarding the safety of breast implants I recommend that you visit www.breastimplantsafety.org.
