There are two general types of breast implants available in the U.S. -- saline and silicone. Both consist of a silicone outer shell; the difference is what's inside the implants.
- Saline implants are filled with saline or sterile saltwater.
- Silicone breast implants are filled with silicone gel.
Silicone Breast Implants
Silicone breast implants were first introduced in 1962. During the 1980s, the popularity of silicone breast implants surged, but so did accounts of their supposed risks. Many people claimed there was a link between ruptured silicone gel implants and a greater risk of immunological disorders (such as lupus, rheumatoid arthritis, fibromyalgia, and other conditions). Some women reported that their symptoms went away after the implants were removed. Some filed lawsuits against implant manufacturers.
While no studies established a firm connection, the FDA looked into the issue and, in 1992, restricted the use of silicone breast implants to women having reconstruction after surgery for breast cancer. For the next 14 years, women who wanted breast augmentation had to use saline breast implants.
In 2006, after reviewing research and finding no connection between silicone implants and disease, the FDA approved the sale of silicone breast implants..
Three companies -- Allergan, Mentor, and Sientra -- have FDA approval to make silicone implants. All three companies are required to track long-term safety of the implants.
Which Breast Implants Are Safer?
According to the current research, there aren't significant differences in the safety of silicone and saline implants. But each type of breast implant has its pros and cons.
- Ruptures. Ruptures are a risk with either kind of breast implant. Ruptures might be caused by surgical error, a fall, or -- very rarely -- the pressure exerted on the breast during a mammogram. But the implications of a rupture are a little different for the two types.
Saline implant ruptures are easy to spot. The breast rapidly changes shape over days as the fluid leaks out. If a saline implant breaks, all that leaks out is saltwater. The saltwater is harmlessly absorbed into the body.
Silicone implant ruptures are more difficult to notice. When the implant breaks, the leaking silicone stays in the body. It can sometimes spread outside the breast and into distant lymph nodes. As unnerving as that sounds, studies haven't found that this results in any increased risk of disease. Nonetheless, if a silicone implant ruptures, your doctor will probably recommend removing it and any loose silicone.
Ruptures of silicone breast implants are often "silent," meaning patients and doctors may not notice them. They can only be detected by MRI. For this reason, the FDA recommends that women with silicone implants get an MRI three years after implantation and once every two years after that. MRIs may not be covered by your insurance. Over the course of a woman's life, these MRIs may cost more than the original implant surgery.
- Aesthetic results. Many women and plastic surgeons prefer the look and feel of silicone breast implants. Silicone breast implants are generally considered to be more like real breast tissue. Saline implants are more prone to causing rippling of the skin.
- Platinum. Silicone breast implants contain platinum; saline implants don't. While some people feel that platinum could be harmful, the FDA says that studies have not found that it poses any risk in breast implants.
- Surgical differences. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than pre-filled silicone breast implants. Also, many saline implants can be adjusted after surgery. Months later, a woman could decide to increase or decrease the size of her saline implants without surgery. The doctor can just use a syringe to put in more liquid or take it out. The size of standard prefilled silicone implants cannot be changed.
- Eligibility. There are some differences in who can get the two types of implants. For reconstruction, women can get either type of breast implant at any age. But for augmentation, saline implants are approved for women 18 and older, while only women who are 22 and older can get silicone breast implants. The FDA explains that the risks are different for the two products, specifically citing the issues surrounding the removal of ruptured silicone breast implants.
Keep in mind that your doctor may have a strong recommendation for one type of breast implant over another. Certain things, like your body type or the current size of your breasts, might make one type of implant better for you.