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Deciding between saline breast implants and silicone breast implants is a matter of personal preference for the patient. Patients who are considering breast augmentation surgery often have the option of choosing between saline breast implants and silicone breast implants. Since 1992, there was a restrictive ban on the use of silicone breast implants by the Food and Drug Administration (FDA), however, this ban was partially revoked by the FDA in 2006 making the use of silicone breast implants permissible in all breast reconstruction procedures and in breast augmentation procedures involving women over the age of 22.
Saline breast implants consist of a silicone shell which is filled with a salt solution which closely mimics other fluids in the body. Many patients favor this type of implant because it is believed to be relatively safe and ruptures are typically easy to detect because the majority of the fluid leaks from the implant. When this happens the size of the breast is usually noticeably different within minutes, but the fluid which escapes into the body is harmlessly absorbed and excreted. The implant will still need to be removed and replaced, if desired, but patients enjoy the security of knowing ruptures will be detected quickly and escaped fluids will not cause complications.
Silicone gel implants consist of a silicone shell which is filled with a thick, synthetic substance. Many patients favor this type of implant because they believe the results are the most physically appealing. Additionally, silicone breast implants are less likely to produce contour irregularities, such as wrinkling. However, one disadvantage to silicone gel implants is ruptures can be difficult to detect. When a rupture occurs, the majority of the gel usually remains in the implant so there may not be a noticeable change in breast size. A surgeon may not even be able to detect a rupture during a routine examination. It is recommended that patients undergo an MRI every three years to determine whether or not the implant is intact. These MRIs can be expensive and will not likely be covered by insurance. Additionally, gel that escapes from the implant may result in granulomas, which can migrate to remote organs and be difficult to remove.