Implant type for family history of breast cancer - what is the safest option?

Hello, thank you for your excellent question. If there is a family history of breast CA(cancer) then there are several factors to consider. The first is if there is a family history of breast CA have you thought about genetic testing for the BRCA gene, secondly you will have to go for mammograms and early screening prior to the age of which your mom was diagnosed. The main difference between saline and silicone for the purpose of detecting breast CA is obtaining an MRI with silicone implants vs saline the ultrasound alone will be helpful in early detection. As time goes on and hoping medicine/science advances, maybe they will improve the ability to detect breast CA early on. You will want to consider the pros and cons of each option. Overall you will have to choose what is the best option for you. Consider speaking to your Plastic Surgeon and your family doctor.

Dear BaileySmith06,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello @BaileySmith06 thank you for your question. I understand your concern. However, without a proper assessment an expert opinion is not possible. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

There are pros and cons to both silicone and saline implants. It's important that you discuss each with your surgeon in order to make the best decision for you. Both are safe to use. Mammograms can detect cancer with either in place. It is suggested you go behind the muscle., which will also give you a more natural look. You may also want to look into BRCA testing. This simple blood test can help detect your risk for certain breast cancers.

Both saline and silicone are safe and both are placed behind your breast tissue. Going behind the breast does not obstruct in future X-rays or exams. Since saline implants' only foreign material is the bag, they may be somewhat safer. Also, saline implants do not block X-rays. Saline implants are more firm and may show ripples. If you have minimal breast tissue or want to go with a large size, you will probably be happier with silicone.

There's no evidence that saline implants are safer than silicone for either breast cancer detection or prevention.Both types of implant use a silicone shell so go with whichever you feel will give you the best result. Modern silicone implants are very well made indeed. Make sure you are shown the correct method for self-examination and ensure that any mammorgrams you may have are optimised for 'implant views', for example, using the displacement technique.Your doctor should be able to stratify your risk and advise you accordingly. Best of luck

Studies have shown that mammagrams are slightly poorer quality with implants in place. Below the muscle position is far better than above the muscle position for cancer detection. Your own breast self-exam, that I hope you do monthly, is actually better with implants in place. In my own patients, who themselves have had a breast cancer and are at a higher risk, who desire breast implant on the non-cancer side, I will gladly do that, because, with mammograms and self-exam, they can detect breast cancer as easy or easier than no implant.Your other concerns are capsular contracture, and rippling making it harder to find breast disease. Capsular contracture can be minimized by placing the new highly cohesive silicone implants, with a textured surface, below the muscle. Ripples are also far less with the new highly cohesive silicone implants. Other than these issues, silicone vs saline is insignificant. If you were my patient, I would recommend silicone textured subpectoral implants, and instruct you to do regular monthly self breast exams.You will also be due for your first mammogram in your early 30's.Good luck! and do those breast exams!!!

There is absolutely no evidence at all, that silicone implants lead to any increased risk of breast cancer. Silicone implants definitely feel more natural and are less likely to cause rippling. Your mom should get tested for the BRCA gene etc but you should do fine with regular screenings looking for breast cancer such as mammograms etc and your implants should not create any problems for this.

david berman md, frcsc

Hello and thanks for your question. Both implant types has no relation with the breast cancer. I personally prefer silicone implants for breast augmentation operation since the silicone implants has better long-term result.