Are there any non-silicone breast implants available?

Question

Hello, are there any non-silicone breast implants available? there is some convincing evidence from experts linking BII to silicone implants and I don't think fat transfer will give me enough volume. Thank you in advance for your help.

Randal Haworth, MD, FACS · Answer

Yes, there are non-silicone breast implants available, such as saline and structured breast implants. Saline implants are filled with sterile saltwater solution, while structured implants contain an internal structure that supports the implant's shape.

Some patients choose saline or structured implants because they are concerned about the risk of breast implant illness (BII), which is a controversial condition that some people believe may be caused by silicone breast implants. While the evidence linking BII to silicone implants is not yet conclusive, some patients prefer to avoid silicone implants altogether.

It's important to note that each type of breast implant has its own advantages and disadvantages, and the best option for you will depend on your individual anatomy, goals, and preferences. You should discuss your concerns and goals with a board-certified plastic surgeon who can evaluate your case and provide you with personalized recommendations.

During your consultation, the plastic surgeon can explain the pros and cons of each type of implant, and discuss the potential risks and benefits of breast augmentation surgery in general. They can also show you before-and-after photos of previous patients who have undergone breast augmentation with different types of implants, which can help you visualize the potential results of each option.

Best of luck !

Moises Salama, MD · Answer

Thanks for your question. Breast implants can be either silicone or saline filled. Saline is a saltwater solution that can be harmlessly absorbed by the body in the unlikely event of a rupture. Saline Implants can provide excellent contour. However, they may not be as natural-looking or feeling as silicone implants, particularly for slender patients with thin skin. Saline Implants are round in shape, and they can come in many projections to achieve your desired fullness. Hope this helps. Always consult with a board certified plastic surgeon. Take care, Moises Salama MD, Board Certified Plastic Surgeon.

Daniel Barrett, MD · Answer

Dear L Atkin,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

The biggest and most scientifically validated study to date is a prospective study comparing women with breast implants who felt they had BII to women with breast implants who didn't. A control group of women getting a breast lift was also included. 50 women were enrolled into each group; they were operated on and are being followed. During enrollment, there were more women in the BII group with SALINE implants. The only 'experts' who link breast implants of any kind to an elusive, undefinable disease are surgeons looking to explant women for profit. Experts who are conducting actual studies cannot find a link between breast implants and actual definable disease. In this study I mentioned, there was no difference in the any of the groups with presence of heavy metals, toxins, silicone, bacteria, or bacterial byproducts known as exotoxins. Further, women in the BII group got better in a similar fashion regardless if they received a total intact capsulectomy ('en bloc'), a total capsulectomy, or a partial capsulectomy. The only difference between the groups that stood out was that the vast majority of the BII  women self reported having anxiety disorder or health anxiety disorder, and relied on the internet to get medical information over going to doctors. Silicone gel and saline filled implants, both with out silicone elastomer shells are the most studied medical devices in the world, and data has gone back 5 decades. To this day, there is no evidence that breast implants cause either autoimmune disease or this slippery, undefinable BII.

Ilker Yazici, MD · Answer

The available options for breast augmentation are such as: 1-saline filled silicone implants 2-silicone gel filled silicone implants 3-polyurethane covered silicone gel implants 4- fat injection. 
Fat transfer techniques for aesthetic breast augmentation is debatable and an unsolved topic between plastic surgeons. Smaller volumes of augmentation is available with this technique but there is a risk of microcalcifications which can mistakenly look like breast cancer in mammographies. So safety of fat inlection is still debatable to a point. I generally use and recommend silicone implants.
Mainstray usage is silicone gel-filled silicone implants. We know more of it and we have more experience on safety and long-term results. So we generally recommend it. Saline-filled implants may also be used and popular for some surgeons but they are a minority. 
Polyurethane-covered silicone implants have extra softness but stay put and sticky to the tissue. Has some advantages in some patients with very mild ptosis. Still, this implant is not widely used and is reserved for special cases in my practice.

Connie Hiers, MD, FACS · Answer

All implants have silicone bags, but saline implants, silicone bags filled with salt water, are available.

Camille Cash, MD · Answer

You can consider saline implants.  They come empty and are filled with sterile saline solution by your surgeon during surgery.  However the implant shell itself is typically silicone. There are risks and benefits to every type of implant.  Your surgeon can assist you in selecting the correct one for you.

Brian Widenhouse, MD · Answer

Thanks for your question. Saline implants are also an option. Ask your plastic surgeon if he/she still offers saline implants.
Best of luck!

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