Off label silicone implants?

Thanks for your question.  Properly approved and tested implants will cost more but in the interest of safety I would strongly recommend using them.

It sounds like you have done your research the best thing to do now is have a consultation with a board certified plastic surgeon who can direct you in the best size for your body as well as helping you achieve the look you want. If you are not of legal age there are options available to you in other places or countries that will still allow you to get you implants in a safe environment with a qualified professional. Best of Luck.

Silicone implants are available off-label for women under 22 and over 65. Any surgeon can use the impalnts off label if he/she chooses.I'm not sure what the largest implant size available is, but I would caution against just deciding to put the largest implant into your body. Discuss your breast size desires with a board certified plastic surgeon and let them advise you on the appropriate size to fit your frame. Very few women need any where near the largest size to reach their desired goals, and the larger implant may not even fit inside your frame if you have tight tissue.

Though the FDA has stated that women under 22 years of age cannot get silicone gel implants for cosmetic surgeries, this is a grey guideline an has no sound medical evidence to support the age restriction at all.  They are allowed to be used in reconstructive purposes for any age, so what is really the difference?  Using them in a patient younger than 22 is just an off label use, and does not void the warranty at all.  Most plastic surgeons will utilize them in all age ranges for a cosmetic breast case if that is the implant that will work best for the patient.  I hope this helps.

The decision by the FDA to recommend that age 22 be the age for silicone gel implants but not saline implants has confounded plastic surgeons. Plastic surgeons do not know of any studies that are contrary. Many plastic surgeons believe the decision was at least partly political in nature. The decision seemed to be based on that some women under age 22 may still have further breast development, and since they have previously banned silicone gel implants in the United States, to validate the prior decisions that women should wait until age 22 for silicone gel implants.On the other hand the data for the cohesive gel implants as reported is superior to saline, with a lower long term re-operation rate. In addition many younger patients are thinner which cohesive gel implants seem to have less long term problems such as rippling or wrinkling which is more common in this group. Reports indicate them holding the shape of the breast better over time. The rupture rate of the cohesive gel is reported as 0.5% per year much less than the saline deflation rate.In my opinion the results and data are markedly superior for gel than saline, and it hard for me to recommend an inferior treatment that has higher rate of problems. Therefore, I discuss, all the options with my patients both those over 22 and those 18-21 and help them decide the best option for them.I use Mentor, Sientra and Allergan. The biggest size is irrelevant, the size depends on the width of the chest, the laxity or stretch of the skin, or what can fit. Generally, younger patients that have not had children will not fit the largest sizes, which goes up to 800 cc. We measure our patients, and give them the largest, most ideal, and smaller sizes that will actually fit.

Off label use is not just off label. It is illegal. Wait till you are 22.  You can find size information on internet. Biggest implant is not always the best implant. 

Old silicone implants were filled with a liquid silicone and the shell of the implant was thin.  These implants leaked silicone and ruptured frequently, leading to additional surgeries to replace them.  The FDA (Food and Drug Administration) removed these implants in 1992.  From 1992 until 2006 the only FDA approved implants in the United States for use were the saline implants.  These implants are adequate, except they do wrinkle and ripple much more than silicone implants and the rupture rate is high.  They also feel like water balloons.After over a decade of vigorous testing and meeting strict FDA guidelines, implant manufacturers released NEW silicone breast implants to the marketplace in 2006.  The new implants had a more solid silicone, often referred to as gummy bear implants, with a much thicker shell and a more natural feel.  They have now been in use for 9 years and we have found the rupture rate and capsule formation rate to be very low.  They are now the preferred choice of over 90% of women who choose breast enhancement.One of the FDA guidelines for release of the implants in 2006, was the clause that a person had to be age 22 or older, they also recommended MRI breast exam 3 years after the procedure and then every 2 years to detect implant rupture.  Well, like many things that the government mandates, sometimes they are just silly or have no medical evidence to back their decisions.  After 9 years, I have yet to see even one implant rupture detected by MRI exam and since the exams cost about $3,000 (I know because I just had one), and insurance doesn't cover the exam, no one recommends these needless exams any more.The same can be said for the age 22 restriction.  It was a silly recommendation without any scientific evidence, apparently placed to appease a Pediatrician who was on the government panel when the FDA released the implants in 2006.  Since when is a 22 year old a child any way?  Like many medications we use in medicine, such as Botox, we give as "off label use".  What this means is the use of an approved product, but not exactly like the FDA has recommended, so it is now "off label".  A good example is Botox, the FDA has approved it for the glabella area (the frown area on the forehead between the eyes which makes you look angry), but not the rest of the forehead, silly right?  We use it on the forehead all the time, so the patient signs a waiver, a one sentence explanation that states they are receiving Botox for an off label use.  If you are informed that it is off label and agree to have it used, that is acceptable.Breast implants for women under age 22 is now the same.  We inform our patients it is an off label, non FDA approved procedure.  If you are willing to sign a waiver, then we will perform the procedure.  The new silicone breast implants are wonderful, they come with a life time warranty, it is a quick recovery outpatient procedure that takes under an hour to perform.Good Luck!

Thank you for the question.
In my opinion, there is no good reason why there is an FDA mandated age of 22 for patients to receive silicone breast implants. There are many patients under the age of 22 who would ( based on their body type and the advantages of silicone breast implants) benefit from the use of silicone gel breast implants. Therefore, I find that I do use silicone gel breast implants for patients under the age of 22 frequently. I suspect, that other plastic surgeons who have busy "breast practices" do the same.Also, I do not know of any “language” in the warranty (from the company that I use most) that references patient's age and the coverage provided. I hope this, and the attached link, helps.