Are silicone implants heavier than saline implants?

No. Both implants have a shell which is made of siloxane (a silicone compound). The density of the silicone gel is 0.968 grams per cc and saline 1.0046 grams per cc. This means that silicone implants are very slightly lighter than the same volume of saline. This can be easily shown by floating a silicone implant in water (see below!).

Are silicone implants prone to rupture?

No. Many patients have seen images of rupture “generation II” implants from the 1980s. These implants had thin shells and more fluid silicone gel. Modern implants (generation IV and V) have highly cohesive gels and very thick shells. These improvements are the result of advances in technology and engineering with time, just as cars and computers have improved. Most modern implants have a lifetime warranty against manufacturing defects resulting in rupture which shows the commitment from the manufacturers to their bioengineering processes. Just how strong are modern implants ? Could you drive a car over one ? Naturally, I had to find out … see the video !

What implant brands do you use?

I personally use and recommend Allergan Natrelle Implants, as they are FDA approved and locally well supported. As with most major implant manufacturers, Allergan offer a conditional lifetime warranty on their implants. More information is available from the Allergan Natrelle Website.

Will I be able to breast-feed after my breast augmentation surgery?

Breast milk is the best food for babies. Many women with breast implants have successfully breast fed their babies. With the infra-mammary approach, minimal damage to the duct system is done and the surgery is unlikely to have any effect ; with the peri-areolar approach, some ductal tissue is damaged and the chances of successful breastfeed is decreased. It is not known if there are increased risks in the breast milk of a woman with silicone breast implants. A study measuring elemental silicon in human breast milk did not indicate higher levels from women with silicone-filled gel implants when compared to women without implants. Interestingly, cow’s milk contains higher levels of elemental silicon as compared to human milk.

Will the breast implants obscure mammogram images?

Possibly. Breast implants may make mammography more difficult and may obscure the detection of breast cancer. Special views, known as Eklund views, may be necessary to improve visualization of the breast. Inform your mammography technologist that you have had a breast augmentation so that appropriate mammogram techniques may be used. Ultrasound and MRI studies may be of benefit to evaluate breast lumps and the condition of the implants where standard techniques are unclear. I recommend that all patients over the age of 35 undergo a preoperative mammogram and another one after implantation to establish baseline views of their breast tissue.

What about breast implants and connective tissue disease?

A small number of women with breast implants have reported symptoms similar to those of known diseases of the immune system, such as systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma, and other arthritis-like conditions. To date, after several large scientific studies of women with and without implants, there is no scientific evidence that women with either silicone gel-filled or saline-filled breast implants have an increased risk of these diseases. These diseases appear no more common in women with implants than those women without implants. Despite these extensive studies, there is the remote possibility of unidentified risks associated with silicone breast implants and tissue expanders. The effects of breast implants in individuals with pre-existing immune system and connective-tissue disorders is unknown.

What is capsular contracture?

The body naturally forms a layer of new tissue around any foreign, even the most biocompatible, and this is known as a capsule. This layer is distinct from scar tissue. Every implant has a capsule surrounding it. In most cases this capsule is thin and flimsy and is not perceptible. However it can thicken and tighten and make the breast round, firm, and possibly painful- this is known as a capsular contracture. The reason for this is not fully understood, but infection and silicone leakage are well established causes; other causes are obscure. This may occur soon after surgery or many years later. The occurrence of capsular contracture is not predictable, but the incidence can be expected to increase over time. Capsular contracture may occur on one side, both sides or not at all. It is more common with implant placement in front of the chest muscle layer, and there may be a slight increase in smooth implants. Treatment for capsular contracture may require surgery, implant replacement, or implant removal and capsular contracture may reoccur after surgery.

Will I lose any sensation in my nipples or breasts?

Some change in nipple or breast sensation is not unusual immediately after surgery. This generally occurs with large implants or tight breasts (most younger patients). This incidence of this is somewhat increased with the use of the peri-areolar incision. It is also not uncommon to have increased sensation after the procedure, which may be uncomfortable. After several weeks to months, most patients have normal sensation. Permanent loss of nipple and skin sensation is very rare.

How long is the recovery period?

I perform breast augmentation under general anesthesia in hospital. Most patients stay overnight to optimized pain and nausea control with IV medications and are discharged the following morning. The first 5 days are generally uncomfortable and good pain medication I required. Most patients are able to return to their normal activities of daily living, including driving after 2 weeks. I recommend that strenuous activities and exercise be delayed until 6 weeks and highly strenuous or unusual activities, such as rock-climbing, be delayed until 8 to 12 weeks after the operation.