At a recent American Society of Plastic Surgeons meeting, it was announced that the FDA had approved silicone breast implants, and that soon, all plastic surgeons will be able to provide their patients with a new breast implant option.

At times, the announcement caused fever pitched conversation and a large buzz within the crowd. It seemed as though the announcement was like the Holy Grail was now being provided to plastic surgeons across the country. Why?

The approval of silicone implants is a great thing, but the choice between the two is something the patient needs to decide, not the plastic surgeon, says Dr. Fata in Indianapolis, Indiana.

Since 1992, when the FDA banned silicone implants, breast augmentation surgeries have grown 306%. Clearly, not having a silicone breast implant option is not that big an issue.

There are two questions that must be answered: First, Are saline implants really that bad? Second, What are the benefits (or possible benefits) of silicone implants?

To answer the first question, no. Saline implants are a very good option for women who want to enhance their appearance, says Dr. Fata Obviously, if saline implants were an inferior product, the number of breast augmentation procedures would not have sky rocketed in the past 13 years.

The benefits of saline implants include:

· High Approval Rate (Over 90% of breast augmentation patients would recommend the procedure to another woman)

· Proven Track Record

· Sterile saline solution is basically harmless to the body

· The complication rate has dropped

· Fewer number of ruptured implants

· Fewer number of capsular contractures (formation of hard scar tissue)

Unfortunately, saline implants are not as soft as natural breasts, they are heavier, they can cause sagging over time, and sometimes they can cause noticeable ripples in the skin.

So what will silicone implants provide? At the moment, since they have not been widely used since 1992, there is not a proven track record that can provide us with all the benefits silicone implants can provide. So why are all of these plastic surgeons so excited about the approval of silicone implants?

The possible benefits of silicone implants include:

· Softer than saline implants

· Less chance of rippling

· Less chance of capsular contracture

· Lighter, and thus less sagging

At the moment, silicone implants are not being widely used, and because of this, we cannot tell if they will in fact be able to provide women with less chance of rupture, capsular contracture, or leaking into the body. What is known is that the new cohesive silicone implants are lighter and feel more natural.

Silicone implants are now being made out of a cohesive silicone solid gel. This means that the inside of a silicone implants should stick together, so that if the shell of the implant was to break or rupture, the gel inside would not leak into the body. This is a great advancement over the silicone oil that was used in older implants.

In saline implants, the sterile saline solution is harmless to the body, so if there was an implant rupture, then there was no harm done. With the older silicone oil implants, if there was an implant rupture, then the silicone oil used to fill the implant could create a number of different problems after entering the body.

So what should plastic surgeons do? The choice between silicone and saline implants should be the patients. At the moment, it isnt really possible to tell which implant is better than the other. Plastic surgeons should provide their patients with both options and the available information about them; once that is done, the patient can determine which one is right for them.

There is no reason for breast implant patients not to try the newest generation silicone implants. However, they should be shown all available data, or lack there of, on both implants. The only thing missing from silicone breast implants is a track record of their advantages and disadvantages. Only time will be able to show what type of implant is better, or which implant is chosen more by patients.

It is completely plausible to undergo a mammogram after having a breast augmentation. The suggestion is to have a pre-operative mammogram as well as another mammogram 6 months after the procedure has been completed in order to create a baseline to follow by. However, caution should be made as it is possible to rupture the implant from the mammogram. The squeezing during the procedure may cause the implant to rupture. Even afterwards, excessive c-rays can slowly tear down the shell that surrounds the implant. Always make sure that you inform the technician that you have breast implants. It is also important to note that there are clinics across the country whose technicians have been certified to work with breast implants and you should choose one of these centers for safety reasons.

There are many issues associated with implants and the mammogram. For starter, the mammogram cannot see clearly through the implant and therefore multiple images may need to be made so that a clear image can be seen. On top of this fact, there is also another issue associated with the implants themselves. Over time, breast implants can slowly build up calcium deposits. These calcium deposits can be interpreted as a cancerous growth even when there is not one. This further leads to biopsies and further surgery to check for the growth as well as removal of the implant itself.

Remember that care must always be taken and that informing the technician of your implants is an important precaution as we don’t need the stress of being told that we may have cancer when it is actually a false positive. This becomes an emotional issue that no one wants to come to terms with, especially not if it is a false positive.

If you have any questions regarding the possible complications associated with breast implants and mammograms, it is imperative that you not only discuss this with your doctor, but the mammogram technician as well. Being well informed is better than being giver\n the surprise of a false positive.

Within the United States, most implants are saline – simply salt water, encased in a silicone envelope. The solution may also contain other chemicals. Even with saline breast implants, you still have a little bit of silicone in your body. Your other option is the silicone gel, which is regaining popularity after some earlier health concerns.

The advantage of saline fillings is that should a rupture occur, the salt water is dissolved by your body with no adverse side effects. The disadvantage is that saline implants can show ripples or look less natural, especially in women that are naturally small. The new silicone gel implants provide a more natural look and feel. Studies were unable to link silicone implants to autoimmune diseases. However, you should discuss with your surgeon which type is best for you, based on your medical history.

Should you decide to have augmentation surgery, you will have many things to consider:

1. A textured or smooth envelope

2. A teardrop or round shape

3. The profile of the envelope once it’s implanted

4. The volume in cubic centimeters (usually between 120 cc and 800 cc)

5. Saline or silicone filling

There are many considerations when making your choices, which is why you and your surgeon will discuss what’s best for you during your consultation. Textured envelopes reduce the chance of capsular contraction developing. In fact, it was the reason they came to market. The problem with textured breast implants is that they are likely to be visible through the skin. Of course, placement plays a role in this, but in most cases, they can be seen.

Your goals will determine the shape and volume of the breast implant. It will also determine where their placement. The best location for your implants will depend on your personal anatomy, the size you choose, and several other factors, which you and your surgeon will discuss.

When the fluid filled envelope is placed under the breast tissue but above the muscle in the chest, it is called a sub glandular placement. When it is placed under the tissue and partially under the chest muscles, it is called a partial sub-muscular placement. Finally, there is the complete sub-muscular placement, which occurs when it is placed completely under the chest muscles.

There are four types of incisions that are used in augmentation procedures. This is a cosmetic surgery procedure so it just makes sense that you are going to want the least noticeable scar, which is why you and your surgeon will discuss what’s right for you.

The inframammary incision is placed where the breast and chest meet near the crease. The peri-areolar incision is placed along the outline of the areola, which is the pigmented area around the nipple. A transaxillary incision is when the incision is placed in the folds of the skin of your armpit. Finally, there is the TUBA incision, which is when an incision is made within the navel. This is a more complex procedure but the big advantage is that there are no scars on the upper chest. Breast enlargement surgery involves personal choices and knowing what your options are means you’ll be better equipped to intelligently discuss those options when you meet your surgeon for your consultation.