DC and Maryland Breast Augmentation with Saline or Silcone
In my practice currently, I perform mainly Silicone Cohesive Gel implants, with the remaining 10% being saline filled implants. There are advantages and disadvantages to each, and I will discuss what I think is best for you and your goals during the consultation.
Saline implants are filled to size during the procedure. As the name implies, they are filled with sterile saline fluid, which is just salt water. Note that the outershell of the saline implant is made with silicone, but this is similar to many medical devices. The difference is the filling, not the shell (which is solid and does not “leak”)
Because they are filled during the procedure, they can be roll them like a cigar and inserted them into either a submuscular or subglandular pocket via a very small incision. In general, the saline implant will have a slightly smaller scar than the silicone implant. This becomes more of a difference with implants greater than 300 cc.
They do not require monitoring. If an implant leaks, and it is filled with saline, you will know it because the fluid will seep out over the next few days. This is not true of silicone. If a silicone implant shell ruptures, you may not know it until you get the breast examined with a study.
They are less expensive than silicone, although that has diminished over the past five years. In general, they will be around $500 cheaper than the silicone implants due to the different costs charged by the manufacturer.
While I personally think that both saline and silicone implants are safe, if one of my patient is a “worrier”, or is not convinced of the absolute safety of the silicone gel, than I would recommend saline implants. There are enough stresses in today’s life and I would rather not implant a product that cause my patients to worry more! I want my patients to be stress free and beautiful.
Disadvantages of Saline
The feel is the greatest relative disadvantage. I say relative because it is not that I think that saline feels bad, its just that I think (and most of my patients too) that silicone just feels better. This becomes more of an issue the less native breast tissue you have and the bigger the size of the implant. It is also more of an issue with the subglandular (over the muscle) placement of the implant.
Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. The earlier models (it has been over 50 years since the first models were invented!!) were pulled from the market due to health worries. After comprehensive evaluation of the evidence for the Association of Silicone Breast Implants with human health conditions, the Institute of Medicine concluded in “no definitive evidence linking breast implants to cancer, neurological diseases, neurological problems or other systemic diseases.”
They were therefore reintroduced for use in 2006. Please note that today’s breast implants are, due to the refinement of the manufacturers, more advanced and safer than the early silicone filled implants.
Feel, feel, feel. I think saline implants feel fine. But silicones feel better. this is more of an issue with larger implants, and implants being used over the muscle.
slightly larger incision required because they come prefilled. Only an issue if you are planning to go big, ie 300 cc or more. overall this is a minor issue. The scar is still small, and only slightly bigger than the saline.
Monitoring. The FDA recommends you get every three year monitoring via MRI if you get a silicone implant. this is because you would not necessarily be able to tell if the implant ruptures.
Slightly more expensive than saline implants.
Size comes typically come in 25 cc intervals.
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