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Breast implants: A choice between saline and silicone
How can you tell if a breast implant has ruptured?
If your breast implants are saline-filled, a rupture will likely be obvious. Your breast implant will become deflated, changing in size and shape as the saline solution leaks outside the shell of the implant. Though it's an obvious problem, the good news is that leaked saline solution is easily and safely absorbed by the body.
Silicone breast implant ruptures can be intracapsular — contained within the scar tissue surrounding the implant — or extracapsular, when the silicone leaks outside the scar tissue. Silicone gel implant ruptures are difficult to detect with a mammogram alone, and it's likely you won't have any signs that the implant has ruptured. This is called a "silent rupture." While some women experience subtle changes in the size, shape or contour of their breasts, magnetic resonance imaging (MRI) is usually necessary to identify the rupture and to help determine if it's intracapsular or extracapsular. Because intracapsular ruptures can become extracapsular if they're not addressed, doctors will usually recommend that ruptured implants be removed and replaced.
Because silicone gel-filled implant rupture is difficult to detect with a physical examination, women who get silicone gel-filled breast implants are encouraged to have MRI exams every two years, starting three years after implant surgery. The cost of MRI screening may not be covered by insurance.
What happens if an implant ruptures?
If your implant ruptures, you'll need surgery to remove it. This procedure typically can be done through the same small incisions used in your initial surgery. Most of the time, you can have a new implant inserted at the same time. The procedure usually is straightforward, but leaking silicone gel can be difficult to remove, and may require more extensive surgery. Additionally, your health insurance may not cover implant removal or replacement due to rupture.
How will safety of silicone gel-filled breast implants be monitored?
The FDA is requiring the two companies that manufacture the approved breast implants to conduct extensive follow-up studies. Over a 10-year period, each company will conduct a large-scale post-approval study comparing the silicone gel-filled implants with saline implants. Investigators will look for evidence of continued safety and effectiveness of these products.
What about the platinum in silicone gel-filled breast implants? Is it dangerous?
Platinum is used in the silicone shell and the gel filling for silicone gel-filled breast implants. Based on the available evidence, the FDA considers the platinum in these breast implants safe. The agency will continue to monitor these products for safety.
Will there be other types of breast implants available in the future?
Another type of silicone gel-filled breast implant — called a "gummy bear" implant — is in development. The gummy bear implant consists of a more cohesive silicone gel, which is believed to help the implant better keep its shape over time. Currently, these breast implants are available only to women enrolled in clinical studies to test the product's safety and effectiveness. If these implants make it through the clinical trial phase, they could one day be available to other women considering breast implants.
What else should women think about before getting breast implants?
If you're thinking about getting breast implants, be sure to consult a board-certified plastic surgeon. Get both verbal and printed information on saline-filled and silicone gel-filled breast implants. Based on your body type, your surgeon may recommend one type of implant over another for optimal cosmetic results. Either type of breast implant is safe, but ultimately the decision is up to you.
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