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Next Wave of Breast Implants

WebMD Health News

May 10, 2001 (New York) -"We must, we must, we must increase our bust!"

For decades, women have been chanting this mantra, doing special exercises, having enhancement surgery and many other things to make their breasts larger.

And information presented recently at the annual meeting of the American Society for Aesthetic and Plastic Surgery (ASAPS) held here suggests that today's surgeons and their female patients have some new and improved tools -- including cohesive gel implants and vacuum-bras -- at their disposal.

For one, silicone breast implants are back. But they are not the same as the implants that the FDA banned in 1992 because of their propensity to leak and possibly cause disease. The newest generation of silicone breast implants are made from cohesive gel. Therefore, there is a substantially lower risk of rupture problems, says Mark L. Jewell, MD, a plastic surgeon in Eugene, Ore.

"It's a viscous gel that doesn't run or migrate or even have the propensity for migration," he tells WebMD. "You can cut it, come back a year later and there is still no gel migration."

Jewell and several other U.S. plastic surgeons are currently enrolling women in a 10-year study that is designed to look at 450 women who receive the cohesive gel implants.

And so far, so good, he tells WebMD.

In Europe and Australia, thousands of women have had these implants. In the U.S., there have been about 100 done by about 25 plastic surgeons, including Jewell.

"The consensus is that they are safe and women really like how they look," he says. "They retain their original shape and give a very nice appearance."

Importantly, "they don't look fake and most women want a natural look."

Saline implants feel more liquid to the touch, which is why some women do not like them, he explains. "The cohesive gel implants feel very natural to the touch," Jewell says.

Mired in controversy for years, the older-generation of silicone-filled breast implants were banned by the FDA following reports of high rates of rupture as well as diseases where the immune system goes awry such as rheumatoid arthritis, lupus, scleroderma, and the "dry-eye" condition known as Sjögren's syndrome.

But, an independent panel convened by the prestigious Institute of Medicine concluded that silicone breast implants do not cause cancer or other illnesses such as those previously mentioned.

And a large review study in the New England Journal of Medicine found that women with silicone breast implants do not appear to have a higher risk of developing diseases of the immune system.

"Silicone-filled implants have been carefully studied and the concerns that were raised in regard to disease risk have been addressed," Jewell says.

Rupture rates, however, are still a concern, he says, which is one reason that the cohesive gel implants are better.

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