Breast Implant Technology

Breast implants have been around for over 40yrs and breast augmentation has been a top sought after plastic surgery procedure for years. This procedure is well established and safe - as well as the implants that have been extensively studied. There is no significant change in the current technology in the near future. Stem cells may some day play a role in breast augmentation, but that is likely decades away. For now feel comfortable that patients who undergo the procedure do very well and enjoy the results.

There may be some exciting options in the future but currently there are no anticipated immediate options other than the FDA approval of a form-stable (firmer) silicone implant also known as the Cohesive gel implant.

Other options which are being evaluated are fat injections or some version of a stem cell modification. Stem cell research which has been limited due to regulations with the past administration may become available over the next 10 years. However, there are no immediately anticipated changes.

FDA approval generally takes many years and may not be predictable. In fact, many of us were somewhat surprised when the current generation of silicone implants were approved late on a Friday November 17, 2006.

The current silicone implant which is awaiting approval has more of a tear drop (natural appearance) but it generally is firmer than exsiting implants.

Currently you have two acceptable options which come in different shapes (round or tear drop) and heights (low, medium, high profiles) and sizes (different volumes) and surfaces(smooth or textured:

1. Saline: silicone outer envelope (bag) with salt water filling that comes from the IV bags that otherwise are injected directly into your veins. Rupture usually occurs as a leak or rupture (slow or rapid deflation). This is usually obvious. In very thn individuals the saline implants tend to have a higher likelihood of  of visible or palpable ripples
2. Silicone: silicone outer envelope with silcone gel filling which is now more firmer than the silicone of the past. This makes the implant feel somewhat more real than saline but the disadvantage is that a leak can be "silent." This means that the leak does not result in an obvious loss of a shape as the saline implants. This has resulted in the FDA recommending MRIs at 3 years after the surgery and subsequently every 2 years after that.

I would like to leave you with one additional thought that is a simple analogy which may help to explain why an implant can look natural or not.

• If you consider taking a baseball and covering it with a silk sheet, all aspects of the baseball will be visible; you will see a round ball with the stitching apparent. However if you cover it with a thick comforter, it may appear to have a soft contour with a gentle fullness. Now if you change the baseball to a volleyball, all bets are off. Do you understand this simple analogy? The natural qualities of the result are depedent on and a balance between the implant and the tissues covering them. If you have abundant but deflated breast tissue, then an moderate sized implant (silicone or saline) may appear natural. If you have thin tissues (ribs on your chest are visible) and you skin pinch is less than an inch, you are more likely to have an obvious result and I would steer you more towards a modest sized silicone implant under the muscle to maximize the tissue covering or blanketing the implant.

There are many factors to consider and I hope I have not confused you! But to answer your question in brief, there are no anticipated technology changes of which I am aware.

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There is no benefit to waiting for a new implant technology at this time.  The implants that should be available to the market soon are not significantly different from the current implants.  There are different shapes and slightly more cohesive gel products.  The silicone and saline implants availble today are the best implants thus far.  Both Allergan and Mentor have improved the shell of the implants to be much less likely to leak or rupture.  The silicone gel is a cohesive product.  It is not really a liquid, so even if the implant ruptures, it will not leak or travel anywhere in your body.

I prefer the feel of the silicone implant over the saline.  I think most patients agree.  the feel is slightly more natural and has less chance of rippling or feeling the edge.  They do require a slightly larger incision,

Approximately 350,000 women will have augmentation surgery this year.  The risk of a rupture or leakage is less than 1% over 4-5 years.  The risk of a bad internal scar or capsular contracture is reduced by going submuscular and using a new implant.

Discuss these issues with your doctor.  They should be willing to answer all your questions about implants.  If they don't, go see another board certified Plastic Surgeon

Good Luck.

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