Posts Tagged saline breast implants
I read online a woman telling about how her saline breast implants got mold and she had terrible problems. Does this happen very often?
A few years ago I put up a YouTube video of my experience with silicone gel breast implants. Now every year or so somebody posts a comment about how saline implants are just as dangerous. A frequent feature of these responses is a statement about a moldy saline implant. My response is and always has been, if saline implants are so often affected by mold, then why have I never seen it?
I have been implanting (and at times removing) breast implants for over 15 years. You would think if something was a dangerous and common phenomenon that I would be seeing it. I haven’t. Not even once. I have seen occasional implant infections but they have always been bacterial, not fungal.
Breast Implant Infections
Breast implant infections can be a big deal. That is the main reason that doing what we can to minimize them is important. When an implant within a person’s body becomes infected by bacteria or fungus, simple pharmacological treatment is usually not enough to stop it. The implant must usually be removed. An infection affecting a breast implant will therefore plague the patient until that implant is removed and the body can clear the remaining infection. A moldy breast implant is fortunately a rare problem and we would like to keep it that way.
Breast implants have risks, but these risks can be minimized by making good choices….choose good surgical talent and facilities, don’t go too large, put your implants under good soft tissue coverage and stay with saline over silicone implants in most cases.
John Di Saia MD
Originally posted 2011-06-29 07:30:11.
It is interesting in this economy how some patients are thinking about breast implants. The more limited funds available in a down economy might be good for one thing: people are thinking implant surgery through much better on average than in years gone by.
A forum at which I occasionally answer questions reflected this in a question. The poster indicated that the decision of whether or not to place breast implants with her planned breast lift may revolve around the risk of revisions.
I can’t afford to have revisions. If I have to replace implants I should not go for it then.
As we have discussed previously plastic surgery can be performed with the main goal of limiting the need for further surgery. In the case of breast implant surgery, limiting long term risk can be best accomplished by:
(1) Limiting implant size.
(2) Sticking with saline-filled implants which tend to simply rupture as opposed to encouraging scarring and significant capsule formation that requires more involved surgery to treat. Saline implants break and need simple replacement far more often than anything else at least when they are not huge.
(3) The other issue with saline implants is that rupture can be covered to an extent by buying an extended warranty at the time of their original implantation. This specifically covers breast implant rupture. The main problem that occurs with the smaller saline implants is rupture.
It is true that the extended warranty only covers the implants for ten years, but that is more coverage than you can get with silicone breast implants for the problem that is the most common with saline.
John Di Saia MD
After 14 years, women who want to surgically add more curves to their figures again have a choice: saline or silicone. However, those who opt for the newly approved silicone breast implants may find their choice is padded in confusion, frustration and added costs.
I have never been a real fan of silicone gel implants. The FDA approved them gain in 2007, but placed the burden of their risk upon the patients. It has become a disclosure issue.
Frequent MRIs to ascertain whether or not a rupture has occurred can get expensive when they are paid in cash. Patients don’t tend to do these in many cases.
John Di Saia MD
Originally posted 2007-01-29 09:34:00.
I am thinking of getting breast implants. Do silicone implants leak? If they do, does the silicone go all over my body and cause problems? Are the newer gummie bear ones any better than the older silicones? How do you decide to use saline or silicone implants?
Silicone gel implants can leak and they can also leech gel residue. The newer generation cohesive gels (also called “gummie bear implants”) have a “jello” consistency, so they really shouldn’t “leak” as the gel isn’t a liquid.
Leeching refers to the tendency for all gel implants to kinda weep smaller amounts of silicone into the tissues around them even through intact implant casings. This may spread the gel somewhat over the years, but the real question is how much for the newer “gummie bear” implants. The answer is that we won’t know for years. It takes 10-20 years to study something like this. I tell my breast implant patients that newer generation silicone gel implants are probably safer than the older ones, but the bottom line is that they likely represent at least a little more risk than the saline-filled version. We just don’t know how much yet. The question of which implant to use is the patient’s choice after a discussion of risk versus benefit. Some patients do not mind the risk and others stick with saline implants.
With age, older generation silicone implants were associated with hardening of the breasts (capsular contracture.) The hope is that the newer ones will do this to a lesser extent.
John Di Saia MD
Originally posted 2009-11-12 07:30:09.
I am asked pretty regularly about what a woman should do with old breast implants. The answer depends upon how things look and feel and what kind of implants are in place. Silicone gel implants in my opinion should be changed more frequently.
Silicone gel implants degrade over time and our bodies react with the gel creating scar and calcium. This hardens the breasts and requires removal of the implants and capsules to repair. This is amongst my reasons for preferring saline filled implants as they cause much less of this reaction than the silicone gel implant types. Newer generation gummy bear silicone gel implants will hopefully cause less reaction than their predecessors, but we won’t know how much for about another 10 years.
The images on the next page are those from a recent case in which I removed 25 year old silicone breast implants and the scar capsules that surrounded them. In this case the patient didn’t realize that her right implant was ruptured until an imaging study was obtained. In addition, since her breasts had hardened slowly over years, she didn’t connect it with her implants.
John Di Saia MD
Originally posted 2010-04-28 07:30:32.
I understand that with silicone breast implants it is recommended to get an MRI every 3 years to check on them. Do I need to do this if I get saline implants instead?
Silicone gel breast implants can leak without signs that anything is going wrong from the surface of the breast. That is the reason interval MRIs are recommended to follow the condition of the implants. This can be a big deal as insurance will usually not cover this expense and MRIs can be expensive. In reality, most women do not have these MRI studies. The health implications here will not be known for years.
Saline-filled implants do not have this problem as there is no silicone gel inside them to leak into the patient. When a saline-filled breast implant leaks, it is only salt water that leaks out. The breast flattens and most women have simple surgery to replace the broken implant.
John Di Saia MD
OC Register’s Cosmetic blog opens the hot discussion of breast implants and toxicity.
Despite their critics, breast implants are like cell phones — embraced by enthusiastic consumers who are willing to overlook the problems they cause.
Apparently Dr Michael Zenn, a plastic surgeon at Duke, entered the fray on the NY Times blog recently:
Today’s breast implant options are saline or silicone. Saline implants are a silicone shell filled with salt water, silicone implants are a silicone shell filled with cohesive gel. Both implants are equally safe, both have the same safety profile.
The Institute of Medicine found that much of the concerns were hoopla — except for the problems that they both have: rupture, scarring, and infection. Most plastic surgeons and patients will tell you silicone just feels better. Implants are replaced when one of the above problems occurs — about 35 percent will have something fixed after 5 years.
While most of his other comments on the blog seem OK to me, it is on silicone gel that we disagree. It is a matter of focus:
What does “Safe” mean?
I do not believe that silicone gel is dangerous per se, but local tissue reactions to silicone gel implants are not the same as with their saline counterparts. I have produced a few short videos to show what happens inside some patients with silicone gel implants over time. We just do not know to what extent this may happen with newer generation silicone gel implants. It has not in my experience happened to the same extent with saline-filled implants. Patients need to make a choice when they choose breast implants. The choice is really deciding on a level of comfort with silicone gel. It is the reason that in my practice many patients still choose saline.
John Di Saia MD