Looking at the online forums, it seems that the prevailing attitude is that if you are having problems with your saline implants, a switch to silicone gel is the universal cure.
Although I am not in total agreement of the FDA position on the matter, I believe that silicone gel implants pose a long term risk to the patient. In my experience, they tend to harden much more readily than their saline-filled counterparts. The newer cohesive gel types are just that: “new.” There is no long term data showing us how patients implanted with them will do. They are probably better than the older gel implants, but they will leak to some extent and the outcomes of this are not as of yet known.
Hardening in the case of silicone gel frequently involves calcification. Your body deposits calcium inside a scar tissue shell around the implant. It looks like egg shells:
This patient had had silicone gel implants for twenty years before I removed them. The white layer in the picture is calcium.
Saline-filled implants do not tend to do this in the same way or to the same extent.
Best Regards,
John Di Saia MD
BP-
Why wouldn’t so many doctors take them out? Seriously, I’m curious.
It’s cool….just had to comment though…
the 3 posts were an accident, sorry, I have never posted on this forum before & thought it didn’t go thru.
Geez Val…
three posts…
Saline implant capsules calcify much less commonly than silicone gel implant capsules. When they do calcify it is to a much lesser extent. I have not seen them do it to the extent that it is demonstrable on a photograph.
The scar capsule with saline implants tends to be soft and pliable…like latex. They get firm most commonly in the presence of infection, blood and if they are irradiated.
Silicone implants may feel more natural initially, but when they start getting the “calcium coating” that changes. The degree of this coating varies as well of course. In my opinion, when you choose silicone gel you are gambling, so I use these implants only rarely (when that risk seems justified).
do you have a photo of an explanted saline implant? don’t they form a scar capsule as well? does the caclification ever occur with saline impants?
You guys are making me blush….
Thanks for the kind words though.
-JPD
yeah…I agree…this doc is honest and would be hopeless as a used car salesman (that’s a great thing!
)…he’s exactly what I would want for a surgeon 
love,
elisa
I have been reading this blog for some time now and Dr. Di Saia strikes me as exactly the kind of doctor I’d want treating me.
My mother is a nurse practitioner and I have a few chronic health problems, so I’ve seen my share of callous, cold-hearted, nasty docs. It’s refreshing to see one who cares about his/her patients. I salute you, Dr. Di Saia, for following the ideals of the Hippocratic Oath.
uhm, because i talk a lot?
your best. thanks.
bp-
I am flattered. Why would I delete this?
-JPD
veggieboo,
i got my implants after i broke my back.
I went from running four miles three or four times a week, dancing and being so limber and graceful some of my friends called me ‘cat’ to weighing ninety pounds (thank you pain meds and stress) walking like a lumbering elephant (severe nerve damage to the right side, leaving me with a pronounced limp) with such an androgynous body that looking in the mirror made me cry.
i looked like a boy and moved like a buffoon.
My best friend was getting implants and graciously loaned me the money so i could get them. She really was a friend and couldn’t stand to see me so depressed.
We both thought that the ‘curves’ would make me feel more like a woman again.
What neither of us could know was that our particular doctor had a one size mentality. He implanted us both with the same size, saline implants, she was a good five inches taller then i and they looked great.
I hated mine from day one. They were like rocks on my chest and to me they looked ridiculous, i had this broomstick body and these huge lumps.
I went back to him immediately to have them removed but he told me i’d have to wait six months, after six months he talked me out of it by telling me i would look like i had tube socks on my chest.
Getting the implants was horrible for me. Not for everyone, but for me.
About two years ago i decided to get them out, period.
I went to four doctors, all of which declined to remove them for me.
FINALLY i found a doctor who listened to me (I talked for over an hour). He listened to all my woes and horror stories and concerns about having implants in general.
He then outlined everything BAD that could result from my getting them out.
Mostly the ‘bad’ was the same reason i got them in, i.e., the way they would looks. May i just say, he didn’t mince with the descriptive phrases, all of which were terribly depressing.
However, he heard me and let me, the consumer, make the call and he pulled them and i am thrilled.
I recognize this body as mine and I am SO glad to have it back! I can’t believe that it took me two years to find a doctor that would just let me do what i wanted w/my body in regards to those implants!!
Dr. Di Saia was that doctor.
I know this is really long, but Dr. Di Saia was the only doctor i found who actually has the balls to be honest about his profession and walk his talk. He is flat out wonderful and i’ve decided that he was worth the time it took for me to tick off and irritate all those other doctors until i found one that actually wanted to help me achieve what i (the CONSUMER) wanted!
dr. d….if this is to long or out of line, you can delete it. i’ll bitch, you know, but you can delete it…
I was thinking of getting implants in the future. I was told by a friend who has then that I should wait until after I have children because the skin of my breasts will already be stretched and therefore recovery will not be so bad. What do you think.
Oh.My.God. Why? I just can’t fathom why someone would put something like that in their body.
This is a body’s reaction to silicone gel. This is just the capsule around the implant. I do not like silicone and do show this to patients when they indicate they would like to see it. I do not use many silicone gel implants. This is only one reaction however and individual reactions will vary. We also do not know how the newer cohesive gels will come out on this.
-JPD
so, what’s the story on the calcium? the silicone leached calcium from her system or what?
yummy. not.
ok, so at some point I still want implants. And wow, after seeing THAT, they will definitely be saline.
Is that the implant, or the tissue around the implant, or both? All I have to say is, “Gross!” Do you show this to your patients who want silicone implants? What a great piece of patient ed.