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New silicone breast implants more durable, but doctors advise regular exams

Dr. Gregory Sexton drops a silicone breast implant on the floor of his office and stands on top if it.

"This kind won’t leak as much," he says of a new generation of silicone implants, recently allowed on the market.

In 1992, safety concerns spurred a 14-year federal ban. In November, the FDA approved silicone implants again after concluding there is no scientific link to systemic diseases.

Charleston plastic surgeon Anne Edwards echoed Sexton’s assessment.

"These implants are better designed than the product used years ago," she said. "I think they’re the best we’ve seen yet."

The earlier silicone models were prone to leakage and triggered thousands of lawsuits, which sent manufacturer Dow Corning into bankruptcy. The new implants are manufactured by two companies, Allergan and Mentor.<<<<

Because of earlier problems, durability is a major consideration for patients.<<<

Unlike the silicone used in earlier implants, the newly approved gel forms are made to last. They remain uniform and flexible and can withstand heavy impact and extreme pressure.

Still, physicians advise patients to have their implants checked regularly. The Food and Drug Administration also recommends women get regular MRI exams to detect possible ruptures.

"Get a good breast exam every year. Check for softness, contracture, shape, firmness and any changes in the breast," said Sexton, who has performed about 800 implant surgeries.

"If a saline implant leaks, we know immediately because the breast will flatten. But if a silicone implant leaks, we may not know because of its gelatinous consistency."

Another factor to consider when choosing implants is cost. The American Society for Aesthetic Plastic Surgery lists surgeons’ fees at an average of $3,583 for saline implants and $4,005 for silicone in 2005, excluding associated expenses.

Silicone models also require larger incisions because they are pre-filled.

In addition, capsular contracture — hard tissue forming around foreign objects in the body — occurs more often with silicone than saline.

"The major positive of silicone implants is that they look and feel more natural," Sexton said. "But it’s really about the patient’s needs and preferences."

Doctors suggest that women verify their surgeon’s board certification before scheduling a procedure. Women also should talk with their doctor about family history of breast cancer and ask about risks and complications.

"We have a professional responsibility to our patients," Edwards said. "I want them to know that their welfare and safety are my primary objective, more so than any aesthetic reason."

Federal officials say possible complications of implants include hardness, breast pain, reduced nipple sensation, implant rupture and the need for additional surgery. But most women have reported being satisfied with their new silicone implants.

Though the new models have been proven safer than their predecessors, the FDA has encountered opposition.

The nonprofit National Research Center for Women and Families called the government’s decision to OK implants a "triumph of corporate lobbying" over women’s health. The center contends much research needs to be done on breast cancer patients and minorities.

Diana Zuckerman, the group’s president, also worries that women will opt not to pay $2,000 for chest MRIs, which the FDA recommends to detect leaks.

Wire services contributed.

WANT TO KNOW MORE?

Last year, about 364,610 women had breast augmentation, up 9 percent from 2004. For more information:

• www.plasticsurgery.org/public_education/Silicone-Breast-Implant-Surgery.cfm

• www.fda.gov/cdrh/breastimplants/

Thank you, Diana Zuckerman.

http://www.thestate.com/mld/thestate/living/health/16629317.htmhttp://www.thestate.com/mld/thestate/living/health/16629317.htm