Breast Augmentation Without ANY Silicone?

Question

I am a highly sensitive individual... I have wanted larger breasts for my entire life... I am considering using saline implants however I found out that the saline is encased in a silicone shell.... are there ANY other options for me as i will not use silicone... Also do you know of any breast fat transfers that will led to an increase of 2 cup sizes? Or herbs? I want to increase from 22.5 inches to 25.5... right now I am a 30 b or small c

Richard H. Tholen, MD, FACS · Answer

First of all, though fat grafting has been embraced by a number of unscrupulous, self-proclaimed "cosmetic surgeons," as well as a few reputable ABPS-certified "real" plastic surgeons who feel they are performing a legitimate procedure with few risks, MOST ABPS-certified plastic surgeons with years of experience (with implants of all kinds AND fat grafting procedures in other parts of the body) do not recommend fat grafting for breast augmentation.

	This is because no matter how good the surgeon's technique is and how carefully the fat is harvested and transplanted, SOME of the fat cells die and cause scarring (and sometimes calcifications) within the breast. This can interfere with the detection of breast cancer! Those of us ABPS-certified plastic surgeons who are also fully trained in General Surgery have done plenty of breast operations for cancer, and later (as plastic surgeons) for breast reconstruction, so this is not a "minor issue." 11% of women develop breast cancer at some point in their lifetime.

	Herbs, exercises, creams, and any kind of pseudo-pharmaceutical remedies only benefit the seller. Do not waste your time or money.

	Two cup sizes is a fair amount of breast volume increase, even for those who DO espouse fat grafting for breast enlargement. Silicone (latest generation of cohesive gel implants that cannot leak) is truly the way to go. Click and read the web reference link below for more information about implants.

	BTW, if you had cancer and needed chemotherapy, did you know the tubing that is inserted into your body for delivery of the medication is silicone? If your heart needed a pacemaker, did you know the leads inside your heart and blood vessels are insulated with silicone? If you were diabetic would you refuse insulin because the needles are lubricated with liquid silicone? Breast implants are made of the same polydimethylsiloxane polymer as these and a myriad of products, so the "scare" information you are concerned about really does not apply, even if you have sensitivities to many things. Silicone is extraordinarily unlikely to be one of them. Yet it is hard to convince someone of the science rather than the "junk science." Do not proceed with anything unless you are sure of your facts! Best wishes! Dr. Tholen

Gary M. Horndeski, MD · Answer

The goal of breast surgery is to create beautiful breasts.  Beauty is determined by several factors including position of the breast on the chest wall, symmetry, skin tone, areola position and least of all volume.  Unfortunately, your have not provided any photographs.  However, it is possible to lift your breasts higher, more medial and reshape them using only a circumareola incision.  While this does not increase the volume of your breasts it can increase the projection of your breasts by lifting your breasts higher on the chest wall over the bony prominence of your rib cage.  This is done without silicone or fat transfer.  The Mini Ultimate Breast Lift is a new technique that you may want to consider.

	Best Wishes,

	Gary Horndeski, M.D.

Rian A. Maercks, MD · Answer

The silicone shell should not cause you any harm.  Silicone is present in most skin creams, deodarant and hair products.  These products cause a much higher silicone blood level than breast implants.  That being said,  there is no better breast augmentation then fat grafting.  In my hands I have had fabulous results with absolutely no risk of implant related complications.  The one caeat is that you must have enough fat to achieve your volume goals.  If you do, this is the right choice for you.  If you do decide to go with implants, I would avoid saline and stick to the Sientra anatomically shaped "gummy bear" implants in a subfascial plane.  I am using these with my Cold-Subfascial Augmentation to achieve more natural results.  I hope this helps!

	 

	 

	All the best,

	 

	Rian A. Maercks M.D.

Shahriar Mabourakh, MD, FACS · Answer

All breast implants, saline or silicone, have a silicone rubber shell. I have never seen any patients react to the silicone rubber, which is an inert material. If you are concerned you can have a skin test performed to check for possible sensitivity. Work is being done on fat transfer to the breast, but there are still many concerns about breast cancer followup with calcification or fat necrosis after injection into the breast. It is not a approved procedure yet.

David J. Levens, MD · Answer

The weight of evidence over the last 20 years since silicone gel-filled implants were first removed from the market (for cosmetic breast surgery only....still have always been available for reconstruction) has not proven conclusively that systemic disease processes such as collagen vascular diseases are linked directly to implants.

	The use of silicone gel filled implants world wide has persisted and since the ban was lifted in the US in 2006 the numbers of women with these implants have risen without any significant incidence of systemic problems although of course locally in the breast, any implant can lead to scarring and infection as with any surgical procedure. 

	Some women opt for saline filled implants as you mentioned.

	Regarding fat transfer to the breast, that is a relatively new but growing area of interest. Nationwide, there are a handful of plastic surgeon advocates and ardent enthusiasts although the vast majority of augmentation procedures are still performed with implants.  It will likely be some time before the option of fat transfer becomes much more common and widespread.

Norman Bakshandeh Day, MD, FACS · Answer

There are surgeons who are performing this procedure, some with limited success and some not successfully at all. The volume that you need seems rather high for breast enlargement with fat. I have never seen a silicone allergy from breast enlargement with implants. I recommend you stick with what we know works well.

William B. Rosenblatt, MD · Answer

Sorry, but the only implants out there have a silicone shell, even if it is filled with saline. In my 35 years of practice, I have NEVER seen a silicone allergy. Good luck.

Jourdan Gottlieb, MD · Answer

If you want breast augmentation without any silicone, your only option is fat grafting. To increase more than one cup size would require several sessions of fat grafting, and you would have to have an ample supply of excess fat. 

	For a two cup size increase, implants would be a much better choice. Silicone allergies do exist, but they are very rare. 

	Thanks for your question, and best wishes.

Paul H. Rhee, MD, FACS - Account Suspended · Answer

I would agree with the other comments in that I would not recommend fat transfer for the purposes of breast augmentation.  It has the potential to create headaches in the future if you have any fat necrosis or calcifications as a result.

	 

	I have seen one case of documented silicone sensitivity, but it is EXTREMELY rare.

Robert E. Zaworski, MD (retired) · Answer

I would not recommend fat transfer to the breast. It is not worth the risk. In the 30 years I have been a Board Certified Plastic Surgeon, I have never seen a patient with a silicone allergy. You could be a rare case.

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