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BREAST AUGMENTATION
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Types of Implants Denver

For many years, surgeons and patients in the U.S. were limited in their choices regarding breast implants. Advances in implant technology available elsewhere in the world were unavailable here. Over the past 10 years, however, the FDA has re-approved standard silicone implants, and approved a number of newer silicone devices, as well. While having more options is a good thing, it can make the decision seem quite daunting for patients. A thorough understanding of the various implant types is an important part of the decision-making process, however, and it is worthwhile to take the time to understand the differences with regards to shape, fill material, and texture.

Saline

Saline implants have been available for many years and have remained essentially unchanged during that time. They are made of a silicone plastic shell that comes empty from the factory. Once inserted into the breast, they are filled with a sterile saline solution. These implants are very easy to deal with long-term, as the failure of an implant usually results in an obvious loss of volume as the saline is harmlessly absorbed by the body over a day or two. They are also less expensive than other implants. Saline does not replicate the feel or look of breast tissue, however, and these implants tend to be more noticeable in both look and feel compared to silicone implants. Ideal patients for saline tend to have more subcutaneous fat or breast tissue to camouflage the implants. Pre-childbearing breasts tend to be firmer, and may hide saline implants more effectively.

Advantages Disadvantages
Cost Less natural feel
Ease of detection and relative safety of implant rupture Greater likelihood of rippling

Standard Silicone

Standard silicone implants have also been around for a long time. They were briefly off the market in the 90‘s as a result of concerns regarding their safety, and then were available in a limited fashion while further research was done. In 2005 and 2006, however, their safety was confirmed and they became widely available.

These implants have a silicone plastic shell like saline implants, but come pre-filled from the factory with a thick, cohesive medical silicone gel. Also like saline, they come in a variety of shapes and sizes, and can be used to achieve a variety of breast shapes, from a very natural look up to a very augmented look. They feel much more like breast tissue than saline does and have a lower chance of rippling. They are more expensive, however, and can be more challenging if they rupture. Although there is no health risk from ruptured silicone implants, they can result in a thickening of the scar tissue around the implant known as a “capsular contracture”. This is surgically correctable, but entails a more significant operation than that required to swap out a ruptured saline implant.

Advantages Disadvantages
Soft, natural feel More expensive than saline
Less chance of rippling Rupture more difficult to detect than saline
Correction of rupture may be more challenging

Form-Stable “Gummy” Silicone

Form stable implants have been available elsewhere in the world for many years, and the FDA finally approved them for use in the United States in early 2013. These implants also have a silicone plastic shell, but are filled with a silicone gel more tightly cross-linked than standard silicone implants. As a result, the gel behaves more like a solid than a liquid, and the implants can be molded into different anatomic shapes. They have a number of advantages and some disadvantages relative to standard silicone implants. First and foremost is the shape. The tear-drop shape of the implants gives a more tapered upper pole to the breast, with more projection down low. Patients with less breast tissue will notice a greater difference than those with more tissue, and patients may prefer round to shaped implants based on their aesthetic goals and tastes. Another advantage of form-stable implants is their superior resistance to rupture. Failure rates for these implants are approximately half those for standard silicone implants, which should lead to significantly longer intervals between surgery. Gummy implants have lower rates of capsular contracture, as well. Finally, as a solid implant, if the shell tears then the implants should leak to a lesser degree than standard silicone implants. These implants are a bit more expensive than standard silicone implants and require a slightly larger incision for insertion. Because they are shaped, there is the potential for rotation which could necessitate additional surgery for correction.

Advantages Disadvantages
Natural shape Cost
Lower failure rate Potential for rotation
Lower capsular contracture rate Larger incision
Firmer gel