Worried about BII and silicone "sweat"

The medical literature is clear: modern, highly cohesive silicone gel implants don't sweat and capsular material taken out for examination in modern studies show no silicone embedded in the tissue. But most importantly, silicone materials of all sorts are everywhere in our ecosystem, for almost 100 years, from medical instruments to cooking supplies; silicone has been used in industry and food products as far back as the 1930's (anti-foaming agents in food, for instance). With regards to systemic symptoms of breast implants (SSBI), the proper name for an entity that has failed to meet the criteria for a disease or illness, we know that women enrolled in the studies with saline filled implants represented a majority of the patients, not silicone gel filled devices. Another bit of information you should know is that breast implants were not the first implants made of silicone in humans. The very first were testicular implants, beginning in the 1940's. Since then, millions of men have gotten them, and despite this, there has never been such a widespread issue with them as we have seen with breast implants; there is no such thing as 'testicular implant illness'. Additionally, there are a myriad of other implantable silicone devices in millions of people over many decades without problem. With the addition of information gleaned from these ongoing studies, it's becoming clear what SSBI really is: a phenomenon not related to any pathophysiology from the material implants are made of. Specifically, breast implants are not toxic.

While silicone has become increasingly popular as option for breast augmentation, saline remains a safe and reasonable option.

There are differences between the two options. The most often reported weakness of saline implants stems from the potential for visible rippling. This is easily mitigated by overfilling the implant at the time of augmentation. Additionally, patients report that silicone feels softer and more natural.

On a separate note, silicone implants are not unsafe. Numerous peer-reviewed scientific studies have demonstrated silicone implants to be safe and effective (without any association to autoimmune disease, as was previously erroneously reported).

With regards to your specific questions, "silicone sweat" is not necessarily an actual phenomenon. The shell can be compromised over time as it ages but the gel does not simply leak out over time without a failure of the shell. Typically any gel bleed will be for the most part contained to the implant pocket/capsule.

As always, discuss your concerns with your board certified plastic surgeon as you develop a treatment plan.

You are describing "gel bleed" which shouldn't occur with newer implants. Implants are not permanent and need to be replaced to prevent problems with aging implants such as gel bleed. You can eliminate the risk of gel bleed by choosing a saline implant.

If concerned, why not consider saline. I do. The implants look and feel similar according to the first scientific study done 6/2020 in PRS by Dr. Eric Swanson. Click the link below to read more. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

The term is actually silicone bleed and no one really knows to what degree it occurs or if it causes problems. Newer implants are low bleed. Saline implants work just fine and you won’t have the issue of silicone bleed

Both silicone and saline implants have pros and cons. Learning about each can help you decide which is best for you. You have mentioned concerns about silicone so you may want to consider saline implants instead. This may allow you to undergo the augmentation you want without the worry. I've included a video I hope you find helpful.

I think most plastic surgeons support the use of silicone implants as being safe, and a good way to accomplish aesthetic goals.
If you’re not comfortable having silicone implants, then you should not get them.
Best,
Mats Hagstrom, MD