I wrote the other day about silicone implants.  Following this, I received an email from a woman in Clear Lake asking if saline implants were a good choice.  Implant selection is a very important decision to make, and as such I feel that I should also spend some time addressing saline implants.   

Again, let me begin by saying that both types of implants have benefits and trade-offs associated with them.  Since the recent FDA approval for their use, it has become fashionable to use silicone implants.  Certainly in some patients there are benefits to using a silicone implant, but let’s not forget that saline implants have a large amount of long term data collected on them that support that they are not only effective devices, but that they are safe devices.  The current generation of silicone implants does not have long term data collected on them at this point.  Definitive conclusions about their safety and efficacy can’t be made yet.  In fact, the post approval study to address these very issues is being conducted as we speak. 

In the plus column for saline implants:  Saline implants are approximately half as expensive as silicone implants at the time of surgery.  They are also less costly in the long run.  To monitor for silicone implant rupture, the FDA has recommended that patients undergo a breast MRI at year 3 following their surgery, and every 2 years thereafter.  This is a very expensive study, and is not necessary for saline implants.  When saline rupture occurs, the patient or her surgeon are usually able to make the diagnosis.  Saline implants can be placed through a much smaller incision since they are not prefilled and can be rolled to a small size during insertion.  Revision surgeries are often necessary after breast augmentation and these procedures may be easier if saline implants were used during the initial procedure.  The rupture rate for saline implants is probably lower than silicone implants.  This is being evaluated currently in the post approval study.  Between 93 and 98% of saline implants remain intact at 10 years, contrasted to 60-85% seen in the historical data for silicone implants.  The capsular contracture rate for saline implants is also probably lower than silicone implants.  This question is also being evaluated currently.  The capsular contracture rate after saline implants is 16.6% at 10 years in comparison to 38.5-90% seen in the historical data for silicone implants.  Lastly, patient satisfaction with saline implants is also very high and is on the order of 87-95%. 

In the negative column for saline implants:  Feel.  Some patients prefer the texture of a silicone implant and believe it to feel more like breast tissue.  Wrinkling and rippling is also a greater problem for saline implants as saline is not a cohesive substance.  Silicone implants have less problem with wrinkling and rippling, and may be a very good choice for a woman who is thin and who has little soft tissue coverage for this reason.

So to answer the question ”Are saline implants a good choice?”  The answer is yes.  We have a large amount of data in the literature that supports their use.  Are they better than silicone?  It depends.   The individual needs of the patient will make this determination.  Again, I truly believe that a patient that is fully informed about her options will make the best decision for herself, be it saline or silicone.

Here is an example of a patient that underwent a saline breast augmentation in my practice.  She is a 25 y/o that presented desiring saline implants.  She was concerned about needing repeated MRI’s to monitor for implant rupture.  She was uncomfortable with the fact that she might not know that her implant had ruptured and could be leaking silicone gel.  On examination she has some mild asymmetries, and fair soft tissue coverage.  Here is the preoperative photograph:

The operation achieved her goal of a proportional, natural appearing breast augmentation using implants that have demonstrated both safety and efficacy in many patients without the need for an expensive followup study. 

Our websites, www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation.   I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or saline implants.  Please feel free to contact our office at (713) 661-5255 if you have any questions. 

-Brice W. McKane, M.D.

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