Introduction to Silicone Breast Implants
While breast implants are done therapeutically, there are so many women out there who get it done for cosmetic reasons. The society we live in pays too much attention on the shape and outlook of a female and expects too much whereas some women do it for themselves not giving a heed on what others say. According to statistics by American Society of Plastic Surgeons, published in the FDA website, approximately 3 million breast implant surgeries were done in America in the year 2010 out of which 50% were Silicone Breast Implants. The million dollar question is, is the hassle of breast implant surgery worth it? This article will explain in depth all the information you need to know about Silicone Breast Implants.
How does it work and is it safe?
Silicone Breast Implants are merely a device which increases the size of the breasts or in therapeutic cases, work as an artificial breast after mastectomy. Be it reconstruction of new breast or augmentation of the ones already present, silicone breast implants carry an external membrane made of silicone carrying fluid which is also made of silicone. The type of surgeries that uses Silicone implants are as follows (FDA, 2011):
- Primary Augmentation: To make breasts look fuller and bigger.
- Primary Reconstruction: To replace breast tissue that was lost in any condition such as a pathology, inborn deformity or trauma.
- Revision Augmentation: For correction or improvement of previously performed primary augmentation surgery.
- Revision Reconstruction For correction or improvement of previously performed reconstruction surgery.
Silicone Implants were first introduced in the year 1962 but they were approved by the FDA in the year 2006. (FDA, 2011) In between, a lot happened and emphasis was put on exploring the safety of these implants. While research is under way regarding the long term performance, cause of failure and the potential side effects that it can pose, FDA claims that the outcome mainly depends on the type of breast implant surgery that is carried out and also on the duration the implant has stayed and on the number of follow-ups.
Why Silicone over other types?
Most women choose Silicone Breast Implants over Saline Breast Implants because it appears so natural to the eyes and also feels very similar to natural breast tissue since it mimics the texture of human adipose tissue itself, sticky as well as thick. Silicone implants don’t have the tendency to ripple from the sides or the lower edge as compared to saline implants.
How do you decide if Silicon Breast Implant is for you?
This is a decision which is challenging and most critical for you to make. It is mostly your surgeon who will decide for you according to your overall anatomy. It is quite true that you want people to compliment you on your figure rather than them asking where you got your boob job done. So your aim is to get a natural looking implant that doesn’t give others a clue about it being artificial. Each individual has variable amount of breast tissue. Those who have less amount of breast tissue or have low body fat, this type of breast implant gives way better and natural results than saline implants do. Your surgeon will inquire about the expectations that you have with the augmentation surgery and will help you decide if Silicone Breast Implant is for you.
What is the ideal age for getting a Silicone Breast Implant?
While breast development in women continues till early twenties, the FDA approves the woman to be at least 22 years or older to get silicone breast augmentation. (ASPS, 2017)
What are the types of Silicone Breast Implants? Who are the manufacturers?
After multiple clinical studies that were carried out, in November 2006, FDA gave a green signal to the following two manufacturers and demanded six studies after approval:
- Allergan’s Silicone Gel-Filled Breast Implants
- Mentor’s Memory Gel Silicone Gel-Filled Breast Implants. (FDA, 2011)
While there is one type of silicone implant that is approved by FDA, it can however be high profile which is shaped like a baseball or pancake shaped low profile implant.
The profile of an implant is the ratio between its heights (projection) in regard to the diameter. This helps the plastic surgeon, keeping in view the chest circumference, shape and size as well as the breast dimension, to choose the right implant for an individual. Implant may be smooth in texture or rough.
How much does silicone implants cost?
The cost of silicone breast implant depends on different variables and these are
- Surgeon’s fees
- Implant’s cost
- Anesthesia team charges
- Facility fees
These account to make the total cost of silicone breast implant. The price varies from city to city and also depends on the surgeon you choose to get the surgery from. It also depends on the method chosen by the surgeon that if it is sub-muscular placement or sub-facial placement, the latter being faster than the former. But the average rate is between 4000$ to as high as 8000$.
Queries that you must clarify with yourself and your surgeon:
People who are considering a Silicone Breast Implant should clarify their queries with themselves by asking the following questions:
- Am I ready to alter my physical appearance?
- Can I afford the cost of surgery and if, God forbid, any complication arises, will I be able to pay for those expenses?
- Who am I doing this for?
- Am I ready to change my activities during recovery period?
- Do I know everything about Breast Implants including risks and benefits?
- Is my plastic surgeon reputed?
- How many times will I have to get myself checked after implant?
After doing your homework of finding names of experienced, reputed and well-trained plastic surgeons, schedule a cost-free consultation with each to satisfy yourself that you are choosing the right doctor for this job. You should clarify your queries from your surgeon by asking them the following questions:
- After asking about their qualification, ask about their experience.
- Ask about how many surgeries they do monthly.
- How many cases come back for revision?
- Ask about before and after photos to see results of their work.
- Ask about risks and possible complications and how they plan to deal with it.
- Ask about preference of implant and what advantages and disadvantages there are for silicone breast implant.
- Ask about pre and post operation strategy and lifestyle changes.
- Ask about which size and profile would they choose for you according to your anatomy.
- Ask about follow up visits and what will they do in these visits.
- Ask about when you will have to change or remove the implant and about the recovery period after surgery.
- Whatever queries that you have in mind, make sure the surgeon answers to them in detail so that you are fully comfortable and satisfied.
How is it performed?
Prior to the procedure of breast augmentation, the surgeon will perform thorough medical evaluation and run some basic tests and might also ask the patient to stop taking certain medications that they were taking for a few days. The procedure is performed in an operation theatre with general anesthesia so that whole experience is pain-free. It takes one to two hours to complete. After the anesthesia team has anesthetized the patient, the surgeon will place an incision using a scalpel under the breast and cut through the chest muscle to create a sub muscular pocket. The muscle is elevated to make room for the implant to sit and the implant is then inserted. To make sure that the prosthesis/implant is safe; all sharp instrumentations are completed before its insertion. With optimization of symmetry and shape of both breasts, the wounds are closed with sutures and dressing is done at the site of wound.
Downtime after Breast Implant:
After silicone breast implantation surgery, post-operative care is needed. Antibiotics would be prescribed to avoid infection whereas it is important that the wound is kept dry and no strenuous activities performed up to 2 weeks. Special bra provided by the surgeon must be work till prescribed and sleep on your back for 2 weeks. It is said that sexual activity must be avoided for 2 weeks for it elevated the blood pressure which may be harmful post operatively.
Possible complications and side effects of Silicone Breast Implant:
According to post approval studies, about 20-40% of augmentation patients had to go through reoperation in the initial 8-10 years. (FDA, 2011). This is a long period but the value of follow up MRIs cannot be emphasized enough. This is because since the rupture is asymptomatic these would help in detection of the leak early.
According to the available data, the incidence of complications depends on the following: (FDA, 2011)
- Type of surgery (revision surgery has more risk of complications than primary)
- The longer the implant stays, the more risk
- Minor surgical procedures after breast implants increase the risk of complications.
Local complications of silicone breast implant include the following:
- Capsular contracture
- Implant rupture
- Breast pain
Since of silicone implant is a silent rupture therefore, routine MRI is indicated to catch any suspicious leak. This is why follow ups are necessary. (FDA, 2011)
What should you do if you notice something unusual?
One should keep in mind that any unusual sign noticed should be reported to the surgeon immediately. Implants are not lifetime prosthesis and they have to be removed or replaced to avoid long term complications. In women with implants, there is an increased risk of developing anaplastic large cell lymphoma. Make sure you are screened for breast cancer according to the schedule provided to you by your physician. (FDA, 2011)
Pros and cons of Silicone Breast Implants:
Following are the advantages of Silicone Breast Implants:
- Resembles in appearance and on touch with natural breast tissue
- It is not felt under the skin as saline implant
- Less incidence of leaking because of prefilled silicone rubber elastomer coating
- It doesn’t deflate or change in volume even when it leaks.
- It is best for those with less breast tissue.
- Does not tend to ripple or fold alongside or lower edge of the breast.
- Lasts longer than saline implant
Following are disadvantages of Silicone Breast Implants:
- Higher in cost as compared to saline breast implants
- Larger incision under lower edge of the breast
- Requires MRI every 3 years as recommended by FDA to detect any leaks because the leak doesn’t cause any change in volume of the implant but it may cause tenderness and become firm.
- Capsule contracture seems to be more common in silicone implants.
- The gel inside silicone implant may harden over time unless it leaks.
- Once the leak occurs, implant is difficult to replace and it has to be removed along with the capsule.
You may be overwhelmed with the many options available for you to decide from but it is important to not be confused with the choices. With good homework and guidance from your surgeon, you can benefit from the best. An educated decision is important and all your expectations and concerns should be addressed during your consultation and pre-op appointment. It is very significant to know that once the implantation has been done monitoring the breasts for local complications for their entire life is needed. Taking care of your physique and your health most importantly will guarantee your great future ahead. Your boob job should give you the satisfaction and attention you seek so let us make sure you get what you want by making a fair decision for yourself.
Breast augmentation article references, these include FDA website, American Society of Plastic Surgeon website, and answers from real cosmetic surgeons etc.