Dr. C. Bob Basu: The two types of implants that are available are saline implants and silicone gel implants. Both are very safe medical devices; both are FDA approved, and we have very good safety data about the implants. They're very safe - both saline and silicone gel implants will not increase your risk for any health problems; will not increase your risk for breast cancer or any cancer. And it is A-okay to continue with breast cancer screening, whether it be with self-exams, mammograms or other imaging modalities.

There's a big difference between saline and silicone gel implants. I will tell you that in my practice, over 99% of my patients opt for the silicone gel implants. Now, not that saline implants are bad; they're right for some patients. But my patients are looking for the most natural look and feel. And silicone implants are simply softer, and they feel lighter. Patients are happier with the result and there's a lot less rippling with silicone implants than saline implants.

Now, with the introduction of the newer Allergan 410 Ultra-cohesive implants, that offers yet another opportunity for patients to get a more natural result. So in my practice, the overwhelming majority of my patients are opting for a silicone gel implant.

Both implants are very safe medical devices, but just like any medical device that's out there, whether we're talking about a knee replacement, a cardiac pace maker, implants are medical devices and no medical device lasts forever. And implants will not last forever. What are some of the risks or concerns about implants? Well, implants can rupture. With saline implants, they'll deflate fairly quickly. With silicone gel implants, these are the cohesive gel implants. Some people use the term "gummy bear" implant. If they do rupture, they don't bleed out; they're designed to retain their shape.

Implants can also facilitate some scar tissue formation. This is a condition called "Capsular Contracture," where a scar tissue forms around your implant, and it can get hardened. So when would you need to have revision surgery? Well, some surgeons like... there's an old teaching out there where you need to have your implants removed and replaced every 10 years. That may or may not be the case for you. At 10 years time, what I tell my patients, is if cosmetically you're happy with the way your breasts look and feel, there's no reason to have revision surgery; that would be unnecessary surgery.

That's also true if you're having mammograms and everything's okay. However, if 10, 15, 20 years down the road, cosmetically you don't like the way your breasts look or feel. Perhaps one breast is starting to become a little hardened because of scar tissue formation. Or let's say down the road you get a screen mammogram or some form of imaging study for your breasts, and the imaging study suggests maybe your implant maybe ruptured, these are not medical emergencies. But when you have time at your leisure, get it addressed with about a 1 to 2-hour in-and-out surgery, to have your implants removed or replaced.

So bottom line, implants are very safe medical devices, but no medical device lasts forever. You will likely need revision surgery in the future.

What is the Difference Between Saline and Silicone Implants?

Dr. Bob Basu compares saline and silicone implants and discusses what option might be right for you.