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It's anticipated that silicone breast implants will be approved for use as a breast-enhancement option for women ages 22 and older some time in 2006. But while we wait, many women have questions about silicone breast implants.

Q: Are the implants pending approval "gummy" implants?

A: The silicone-gel implants that received pre-market approval from the FDA in 2005 are considered the third generation of silicone: The implant filler is cohesive, meaning elastic and binding unto itself, yet has a soft and fluid feel. Gummy implants, which may be reviewed by the FDA in 2006, are the fourth generation of implants: Gummy implants have a high degree of cohesion and are considered form stable, meaning the implant shape does not change or flow.

Q: Isn't silicone linked to breast cancer?

A: According to an October 2000 report by the National Institutes of Health, "researchers found no association between breast implants and the subsequent risk of breast cancer."

Q: I've heard that silicone causes autoimmune diseases like lupus, rheumatoid arthritis and scleroderma, or can cause poisoning.

A: To date, there has been no independently reviewed and validated research that demonstrates a clear link between breast implants and autoimmune diseases in women. It is estimated that some 300 studies have been conducted in attempts to demonstrate this link.

Q: Is it safe to breast-feed if I have silicone implants?

A: There is no indication that mothers with silicone breast implants should not breast-feed. In 1999, the Institutes of Medicine specifically stated, "There is no evidence that mothers with implants pass silicone on to infants when breast-feeding."

Q: When do silicone implants need to be replaced?

A: The current standard is such: If an MRI screening determines no silicone is located outside the breast implant outer shell and the capsule (naturally occurring scar tissue that surrounds the implant), it may not need to be replaced. Whether silicone or saline, the most common reason women choose to replace their implants is purely cosmetic. A woman's body or preferences may have changed and with this comes the desire for different size, shape or placement of implants. Only careful screening and radiological review and a candid discussion with your plastic surgeon will determine what is best in your individual case.

Q: I have saline implants. Now that silicone will be available again, should I make the switch?

A: Silicone may feel somewhat more like natural breast tissue but that doesn't mean silicone implants are the right choice for every woman. If you are happy with your appearance and there is no other reason to replace the implants, you should wait. However, if you are looking for a change in size or shape, if your implants no longer match your body image or if you are experiencing any condition that warrants replacement, you should consult with your plastic surgeon.

Q: Is silicone now the only breast-implant option?

A: No. Around the world, there are two accepted breast-implant fillers: saline and silicone. It is estimated that roughly 90 percent of the implants in use around the world today are silicone. Choosing an implant filler is a decision a woman must make after an examination by, and careful discussion with, her plastic surgeon.

(Marie Kuechel is an editor of New Beauty, a semi-annual magazine about cosmetic enhancement. Robert Singer is a medical doctor. Reach them at editors (at)newbeauty.com. Distributed by Scripps Howard News Service.)