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Silicone or Saline? Which to choose for Breast Augmentation surgery?

There are many important decisions that you have to make with your plastic surgeon before you undergo breast augmentation surgery.  Your desired size, nipple position, and the surgical approach which will be used must all be discussed at length in order to create a plan that will result in your desired aesthetic result.

One of the most important decisions in this process is what kind of implant you will use for your breast augmentation surgery – silicone or saline? Once again, each has advantages and disadvantages, and choosing which one is right for you must be done within the context of your overall aesthetic goals.

Silicone can be an excellent choice for many patients because silicone is a product that can mimic the feel of a natural breast very closely. However, the options that you have forsurgical placement of the silicone implant can be limited.

For instance, a trans-umbilical (through the belly button) approach to breast augmentation, or what is otherwise known as a TUBA procedure, requires that you use saline implants because the saline implants are inflated only after they are placed into position within the breast pocket.

Likewise, transaxillary (armpit) approaches to breast augmentation can be performed with silicone implants, but it’s much more technically difficult, and the results can sometimes be more erratic.

If one of the critical aspects of your desired aesthetic result from breast augmentation is a natural feeling breast, not simply a more fully contoured breast, then silicone implant is an excellent choice. However, if you have concerns about the size and placement of the incision, then saline might be a better choice for you.

Saline implants also offer specific advantages for patients, even though they do not feel like natural breast tissue. Saline implants can be placed through a variety of very small incisions, which include the trans-umbilical, the transaxillary, the inframammary, and the circum-areolar.

Likewise, saline breast implants and for the specific advantage of being easily replaced when they rupture. Since they’re filled with saline, if they rupture, the saline simply gets reabsorbed into your body, and a new implant can be easily replaced.

In the case of silicone though, the rupture will leak silicone into the breast pocket, which sometimes takes a bit more of an extensive surgical procedure to remove the silicone and replace the breast implant.

Breast implants, whether silicone or saline, are not lifetime devices as such, and surgical literature and patient experience seems to suggest that the average life of these implants is about 12 to 14 years.

Some patients, though, can have implants present for 20 to 30 years without any problems. Likewise, there some patients who develop scar tissue, or what is known as capsular contracture, around the breast implant which causes the breast implant to deform as a result of the scar tissue. This is usually corrected surgically by excising the scar tissue and replacing the implant.

Recently, a new type of silicone gel has been formulated, which is known as a cohesive gel. This cohesive gel formulation of silicone is not as liquid in nature as the traditional silicone, and it confers a theoretical advantage of perhaps lasting longer.

These implants, which are now available through the Allergan Corporation, are called the Natrelle 410 implants, but usually go by the nickname of ‘gummy bear implants’. This is because the cohesive silicone gel formula is reminiscent of the classic gummy bear candies.

In addition, for patients who would like to undergo breast augmentation but don’t want to choose either silicone or saline, a third option of using your own fat tissue is rapidly becoming a popular technique for many patients.

In this procedure, patients undergo usually liposuction of the abdomen and thighs. The fat that is removed is then prepared and injected into the breast tissue. Patients can have exceptional results with this procedure, but the downsides are that sometimes the fat does not completely survive, and the initial fullness after the procedure will be lost. In addition, small hard bumps can form in the breast from the transplanted fat, which if the patient has personal or family history of breast cancer, can be of concern because these spots can mimic breast cancer symptoms and may require biopsy.

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