Why are women avoiding Silicone Breast Implants?

This morning we removed a pair of silicone breast implants that had been inserted 20 years ago.

The woman had no symptoms of Silicone Breast Illness although she did feel that her chest was a little tight and she was aware of her breasts looking unnatural –  “like a pair of tennis balls placed into my chest”.

Naturally, over the years her breasts had dropped a little and this had exaggerated her deformity.  

At operation we found that that both implants were leaking.  Although part of the implant shell was intact, part of the shell had dissolved and allowed silicone to spread both within the capsule and also into and around the capsule that was surrounding the implants.  

Following removal of the implants and the extravasated silicone, her breasts were reconstructed by a breast lift with Autologous Fat Transfer.

The question arises:-

“How can women with silicone breast implants avoid this problem?”

In the USA it is mandatory for all women with silicone implants to have an MRI every 2 years.  An MRI will certainly detect silicone leakage but cannot be used to predict leakage over the next 2 years.

Some surgeons say that breast implants last “up to 10 years”.  This is not true, as we often find implants still intact after 15 years.  Some implants, however, are leaking after only 2 years.  Why is this so?  It is possible that the implant has suffered some trauma during insertion.  This could be something as simple as a needle stick injury that was unnoticed by the surgeon.  Another aspect of implant insertion technique that has not been fully evaluated  is the use of a Keller funnel.  As its name suggests, this is a funnel type of device that allows large silicone implants to be inserted through small openings by using the funnel.  The implant is significantly compressed during its passage thorough the funnel and I often wonder whether this damages the implant such that its lifespan is reduced.  

Probably the least expensive and most comfortable way to check on your implants is to have an ultrasound examination.  Modern ultrasounds have high resolution and are capable of detecting even small implant leakages.  Having an ultrasound which shows the implants are intact should provide you with considerable reassurance.  It probably should be repeated every 2 years.  

In my opinion, a better way to avoid this problem completely is to use saline-filled implants When placed behind the muscle, it is usually almost impossible to tell the difference between silicone and saline implants.  Saline implants usually  last well over 20 years.  More importantly, in the rare event that they leak, it is only salt water that leaks and this is readily absorbed by the tissue.  Replacing a rupture saline implant is as simple as removing the shell, replacing it and inflating it with fresh saline solution.

Of course these days it is also possible to do breast augmentation using your own fat.  The procedure is known as Autologous Fat Transfer and involves harvesting excess fat from your abdomen, hips and thighs and, following preparation, grafting it carefully throughout your breasts.  At Avenue Aesthetic Surgery we have been performing this procedure since 2013.  With hundreds of satisfied patients and virtually 100% survival of the fat graft in most cases, Autologous Fat Transfer is now our go to method for breast augmentation.

You can learn more about removal and replacement of Breast Implants here.