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.
"I think the cohesive gel looks promising but they are new and need further study," says
New York plastic surgeon Darrick Antell, MD. Until that time, Antell will continue using saline implants for all of his breast augmentation surgeries. Both saline and silicone-filled implants have a silicone shell. But if the saline implants leak, deflate, or rupture, which they often do, they would release only salt water and not silicone into the body.
No surgery is without risks and for some women, an external vacuum bra called the BRAVA Breast Enhancement and Shaping System may suffice to help breasts increase in size, Jewell says. "This must be worn 16 hours a day for 10 weeks," Jewell says.
"It's like wearing a breast pump for that length of time," Jewell says. "The long term results are unknown."
This bra may be an answer for some women, but it is certainly not the answer, Antell says.
"Most women do not wear the bra for the time periods that they have to in order to see results and the average increase is very small - not even a cup size," he says. That's not the case with implants, where surgeons are able to increase a woman's bust line by one or more bra cup sizes.
"[The vacuum bra] is a step in the right direction, but it doesn't allow for controlling the shape of the breast, " Antell says. "People will not be satisfied and will want the real thing."