The Great Implant Debate

Breast implants are a popular area of plastic surgery. This leads us to the debate on the type of implants that are best and the government’s role in the decision

The Great Implant Debate

The debate on silicone and saline implants is a hot one. For a long period of time, silicone was dominant, but health concerns led to saline coming to the front.

Silicone first became a popular enlargement resource after World War II. Doctors would shoot silicone directly into women’s breasts to create enlargement. This direct approach resulted in numerous complications including cysts, sores and systematic illness. These complications led to the reduction of interest in silicone, but it would make a comeback. 

In the early 1960s, two Houston plastic surgeons developed the first contained silicone implants with Dow Corning. To say the two plastic surgeons, Thomas Cronin and Frank Gerow, revolutionized plastic surgery would be a minor understatement. The procedure because very popular and there was practically more demand than there were plastic surgeons to satisfy it.

The implant was made of a harder silicone sack covering soft silicone gel. The implant was very popular because it held form better than saline implants. The implants, however, were not regulated at the time. As time passed, the Federal Drug Administration was given oversight and concerns started to arise regarding problems associated with leaks or complete failures of the implants. This was particularly true for second generation implants which were designed to be as soft as possible per surgeon requests, a situation that led them to be very thin and result in failures. One version had a polyurethane coating that actually degraded into a carcinogen, a product quickly pulled from the market.

The debate on silicone implants is heated, but surprisingly bereft of facts. What is clear is silicone implants leak silicone into the body. Silicone in the body is assumed to be a bad thing, but the exact correlation to specific diseases and problems are not clear. The primary reason is there has not been sufficient time to study the issue long-term and get verifiable results. Many women, however, have shown distinct negative health problems when suffering from leaking silicone implants, complaining of chronic fatigue, neurological and rheumatologic problems. While studies have found conflicting results, it is clear women who have had ruptured silicone implants removed tend to show improved health. The debate continues to this day, but the FDA restricted the use of silicone implants to medically necessary procedures as of 1992.

With the restrictions on silicone implants, saline implants have come on the scene. Originally developed in the 1960s, the implants were overshadowed by silicone until the 1992 ban. Saline implants have a rubberized surface and are filled with a saline solution. In general, they are considered safer than silicone because leaking results in fewer health risks as saline is not toxic in the body. That being said, there have been some complaints regarding saline implants. Specifically, the implants can be difficult to manipulate into the correct form, they can wrinkle and can bottom out – a situation where they sag at the bottom. While these are concerns you should discuss with your plastic surgeon, what is clear is the saline implants do not involve the risks associated with silicone implants.

There is an ongoing debate regarding implants. Since the FDA has banned silicone, it is a debate being won by saline breast implants.