While saline implants are filled with a salt water mixture, silicone breast implants are filled with a special gel. The primary difference between the two materials is that implants filled with saline can break, although the fluid is simply absorbed by the body, whereas silicone breast implants do not break.

Although there are numerous benefits associated with breast augmentation using silicone implants, the one women love most is that the breast looks, feels, and moves so naturally. For women who are athletic, there is the huge advantage of being able to work out, run, or be active while the silicone breast implants move with the body.

When comparing saline with silicone, the actual choice is based on an individual patient’s needs and wants. However, today we are seeing a growing number of women choosing silicone simply because of the natural look and feel. In addition, breast augmentation surgery performed using this type of implant is also very safe.

The FDA approved silicone breast implants in 2006, but in addition, the new implants are designed so that in the case of leakage or rupture, the gel would not leak into the body, a concern with the older style of gel implants. This cohesive silicone is solid so that there is no leakage, allowing the implant to remain intact until removal. This new type of implant is also made with a denser shell, making them more durable and safe.

As with any type of breast augmentation, there are potential risks, including: hardening of scar tissue, infection, and scarring. Working with a qualified plastic surgeon will help reduce any risk and choosing the newer silicone breast implants also helps in that if broken, the gel does not leak. The one thing to note is that since some women cannot tell if there is any damage to a silicone implant, doctors recommend annual mammograms.

The bottom line is that with silicone breast implants, there are pros and cons. Therefore, the key to success and achieving the desired results is working with a surgeon who is board certified, and one that can do an assessment of your needs and provide you with the best information so an educated decision can be made.

The biggest concern and risk for any woman undergoing breast augmentation is capsular contracture.

Normally, tissue will surround the implant and form a scar which will be unnoticeable on the outside of the breast. In the case of capsular contracture, the scarring is extreme and becomes visible, tightening around the implant and giving it an unnatural squeezed look. The condition is unsightly and depending on the severity, can cause physical discomfort as well as emotional problems.

It is unknown exactly why certain individuals are more prone to capsular contracture than others, but one method that seems to aid in its prevention is after surgery breast implant massage.

Usually this technique is only used with smooth implants, as textured ones are not meant to be shifted. It is best to consult with your surgeon on what he or she suggests before attempting a post operative breast massage.

The basic theory is that by “massaging” the breast after surgery, the device shifts within the pocket, allowing it to stay open, making it difficult for the tissue to constrict around the implant. The technique is normally begun a few days after surgery and is performed once every few hours.

You will still be very sore and tender so be gentle with your motions. The point is just to shift the implant. The actual massage is usually a simple squeezing motion. You are trying to move it around in the pocket that was created for it. They should be moved up and also to the sides of the breasts.

Your surgeon will recommend the length of time the practice should continue for. Some will recommend only a few months while others believe that breasts should be massaged for the lifetime of the implants. Implant compression might also be suggested as a course of treatment. This involves squeezing the actual implant.

There are other preventative measures to take in order to avoid capsular contracture:

1) If you’re a smoker, stop as soon as possible. The longer you quit before your surgery the better your chances of a smooth recovery.

2) Stop taking aspiring and other pain relievers that are unnecessary at least two weeks before surgery or as your doctor recommends.

3) Certain placements, such as sub-glandular, have a higher risk for development of capsular contracture, as do smooth textured devices. Discuss placement and options with your surgeon to determine the best course of action.

4) And of course, always follow of your doctor’s instructions before and after surgery.

There is no certainty if any of these measure will prevent the occurrence of capsular contracture, so be prepared to accept it as a risk if you choose to undergo breast augmentation. Fortunately, if you do find that one or both breasts have constricted, revising the problem is usually a simple process that will cause little if any long-term damage. Many women have the problem successfully removed and are still able to keep their implants.

The main advantages of submuscular or Subpectoral implant placement as compared to subglandular placement are:

1. Lower Risk of Capsular Contracture: (3% vs. 30%) The body builds a scar capsule around any foreign material including a breast implant. This capsule is usually very thin and soft in the submuscular/subpectoral pocket. On the other hand this capsule can become very hard and thick in the subglandular pocket causing the implants to become very hard and spherical. In severe cases, this can cause much pain and deformity, requiring removal of the implant from the subglandular pocket and placing them in the subpectoral/submuscular pocket.

2. Less Sagging of Breasts: The Pectoralis Muscle tends to hold the breast implants up and prevents them from sagging.

3. Less Visible or Palpable Rippling: Although all saline implants do ripple, their placement under the muscle will better camouflage them.

4. Better protection of the Implants: In case of the need to perform breast biopsy or surgery on the breasts.

5. More Natural Shape: Pectoralis Muscle pads the upper pole of the implants, therefore, making the upper breast slope appear more smooth and gradual.

6. Less Obstruction of the Breast Tissue with Mammogram. Placement of the implants away from the breast tissue and under the muscle interferes less with mammography and breast examination.

Disadvantages of submuscular or subpectoral implant placement as compared to subglandular placement is:

1. Implants take longer to drop or settle after surgery.

2. Possible creation of a Double-Bubble deformity in sagging or ptotic breasts. Because implants are held up by the muscles, the sagging breast tissue can hang over the implant as a separate entity. This can give the appearance of a double-bubble. This can be avoided by lifting the sagging breast tissue and centering it on the breast implant.

3. More post-operative pain. As a rule, the difference in the degree of pain is insignificant.