16 mars, 2007 11:58

Silicone vs. Saline Breast Implants

By Anita Brikman

March 15, 2007 - It's been 14 years since silicone breast implants were widely available in the U.S. They were pulled off the market for cosmetic purposed after many women claimed leaks were making them sick. Now, silicone is back but what's different and are women ready to give it a try?

"It looks better, it feels softer, it is a more natural look," said Dr. Ronald Lohner from Bryn Mawr Hospital.

The "look", said plastic surgeon Ronald Lohner is why so many doctors and patients were waiting for silicone's return. That day came just before Thanksgiving after the Food and Drug Administration looked at six years' worth of new studies and deemed the implants "reasonably safe."

Dr. Lohner took part in those trials, and firmly believes silicone gels don't cause connective tissue or auto-immune diseases in women.

"They don't make them sick. We know there is no systemic effects to silicone implants in the body," Dr. Lohner said.

He also said the silicone in the new generation of implants is more cohesive than the syrupy stuff of years past. So, if the covering breaks, it's less likely to run out.

But the new implants DO still break. One manufacturer's data shows 4 out of every 10 new patients have some kind of complication, and some need a second operation. That's why some plastic surgeons like Kirk Brandow just won't use silicone.

"I have changed many implants which were silicone, which had ruptures, and I spent hours in the O-R, trying to get that silicone out," said Dr. Brandow of the Brandow Clinic.

One of his patients, Stephanie Sullivan, said her mysterious pain and joint problems went away after her silicone implants were switched with saline.

"The pain that radiated through my body left almost instantaneously. It was incredible to see the difference," Sullivan said.

With stories like that, its no wonder women are cautious.

Dr. Algird Mameniskis of Rittenhouse Plastic Surgery said, "I'd say the majority of women are not rushing into the new implant."

Dr. Mameniskis said there are both plusses and minuses to both silicone and saline to consider. In saline's favor the safety profile has always been good. And if there's a rupture, the woman knows it because the implant simply deflates.

On the minus side saline implants can look more 'augmented' or fake and can wrinkle or ripple at the edges.

Doctors said the plusses for silicone implants are that they may last longer. They can also look better on very thin women, and in reconstructive patients following breast cancer.

The biggest minus for silicone remains the chance of "silent" rupture that can lead to hardening or scarring. That's why the FDA says all women getting silicone implants need follow up MRI's every few years to check for problems.

After mulling all of that over with her husband Peggy Muller is going with silicone. The breast cancer survivor said she simply wants the most comfortable, natural looking option for her.

"I feel that if the FDA has approved them, then they can't be all that bad," Muller said.

One more difference, silicone implants cost about a thousand dollars more than saline. And the MRI screenings can be 15 to 18-hundred dollars out of pocket.

Another interesting note is that in countries where both types have been available for years and there was never a safety controversy, like here in the U.S., the vast majority of women do choose silicone.

For more information:

Dr. Ronald Lohner
Lohner Aesthetic Surgery
(610) 519-0600
email: DRLOHNER@aol.com