Breast augmentation with Silicone implants
“Silicone breast implants” are made up of a “shell” or “bag” made with silicone-rubber and filled with medical grade silicone gel. This material is very different from the silicone oil used in the 80’s for breast implants. The new silicone material is also referred to as “cohesive gel” silicone, because it is really a gelatin-like substance, not a fluid. In fact, if the silicone implant shell is ruptured or leaks, the material stays in form and does not tend to leak out unless placed under pressure stress.
Silicone breast implants are gaining popularity again since they were de-regulated in 2009 for cosmetic augmentation in the USA after the FDA has cleared the record on safety and efficacy.
Silicone breast implants:
· Are softer than saline. Silicone implants are filled to a specific and appropriate size range for their size and feel softer and more pliable. Some people define them as more “natural” feeling or more “breast like”.
· Provide extensive size and shape options and may be a better choice for thin women with less fat or breast tissue.
· Feel and look less round than saline implants. Since silicone filled implants are pre- filled to a specific level of firmness, a silicone filled implant in general will look less round than a saline implant, particularly in the upper pole (the area above the nipple-areola that may show in clothes)
· Are more expensive than saline filled breast implants. In general, silicone filled implants cost approximately 40% more than saline filled implants.
· Are visible on mammogram. Silicone breast implants will hide areas of the breast in standard mammogram, so it is important to discuss the presence of implants with the technician or radiologist before the mammogram so that they may take the necessary precautions and special views of the breast.
· Are not lifetime devices. We cannot define the actual life expectancy of silicone breast implants, but a rule of thumb that can be used is that at least another surgery will be necessary in someone’s lifetime.
You should consider silicone breast implants if:
· You want a less round, softer look
· Are concerned about visible implants or wrinkling, or are particularly small or thin. If you are smaller you will see less wrinkling with silicone implants (also called “Rippling”) due to less breast tissue and fat covering the implant.
Silicone breast implants can be inserted via the:
· Armpit (“axillary” or “trans-axillary”). This incision is hidden in the armpit so no breast scars are visible. Once healed, it will look like a small wrinkle. Silicone breast implants placed via the armpit incision may be placed in front or behind the muscle but may only be relatively smaller due to the size of the incision and scar in the armpit.
· Areola-nipple (“periareolar”). This incision is placed in the lower aspect of the areola (the darker area around the nipple) and usually heals very well and it is barely visible. Silicone breast implants placed via the periareolar incision can be placed in front or behind the muscle.
· Breast fold (“inframammary”). The incision is in the lower breast, usually right at the fold between breast and chest skin. This scar is usually not visible in normal breast position unless the breast is lifted up. With this incision the silicone implant may be placed in front or behind the muscle.
Silicone breast implants can be placed:
· In front of the muscle. In this position the silicone implants will:
1. look rounder
2. will be more easily felt. The breast implant feels firmer and the edges are more easily felt.
3. Have a shorter recovery because the muscles are not affected.
· Behind the muscle. In this position the silicone implants will:
1. look less round, particularly in the upper pole (the area above the nipple).
2. be higher initially and the settle more over time.
3. Less palpable. The muscle will cover the silicone implant in the upper aspect and make it less easily felt. This is particularly important in thinner women with less breast tissue and fat.
4. Have less chance to form a firmer scar or “capsular contracture”. Silicone filled breast implants placed behind the muscle develop a capsular contracture with about half the rate of silicone implants placed in front of the muscle.
Silicone breast implants are available in many sizes and shapes. The most commonly used silicone filled implants at New Day Plastic Surgery Center are:
| Profile | Moderate | Proportionally wider and less projecting. Particularly useful in creating a tighter cleavage. |
| Moderate Plus | Balanced in width and height. The most commonly used implant. | |
| High | Taller implant with greater “projection”, which is the distance the implant extends from the chest. This implant creates a deeper cleavage. | |
| Texture | Smooth | The surface of the implant is thinner and softer. Best for thinner women with less breast tissue as these implants are less palpable. |
| Siltex (textured) | The implant shell is thicker and covered with a fine texture. The surface texture can decrease the chances of scar hardening (“capsular contracture”) after the procedure. | |
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