Q: Are all breast implants pretty much the same?
A:”Not really,” says Lara Devgan, MD, a plastic surgeon in New York City and an attending plastic surgeon at Lenox Hill Hospital. “If you have your breast augmentation done in the United States by a board-certified plastic surgeon, you can be confident that your implants have passed the rigorous standards of the U.S. Food and Drug Administration.” So they are the same in that they have been tested for quality, sterility, durability, and outcomes, and that thousands of women have had a good experience with them. However: “Implants can be smooth or textured, low projection or high projection, round or teardrop-shaped, and filled with cohesive silicone gel, gummy-bear cohesive silicone, or saline.” There is no one-size-fits all breast implant, says Dr. Devgan. “The best implant for a given woman depends on her unique anatomic characteristics, as well as her desired results,” she says.
Q: What are breast implants filled with?
A: “Traditionally people have thought of implants as either silicone—soft and natural feeling, but made from a polymer—or saline, which are filled with salt water, but prone to rippling,” Dr. Devgan says. Now, plastic surgeons have added a third category to the mix: Structured Ideal implants, which are filled with saline but have an internal structural integrity that is supposed to make them look and feel more natural, she says.
Q: Will I know if my silicone-filled breast implant ruptures?
A: “If a saline implant ruptures, you will know it right away because your breast will flatten,” says Dr. Devgan. “But with silicone implants, you might not be immediately aware of a rupture,” she says. The newest generation of silicone implants are form stable, meaning that even if you cut the implant, it will retain its normal overall shape (imagine a gummy bear). The downside? “If your implant ruptures, you might not realize it because your breast shape will remain very much the same,” says Dr. Devgan. For this reason, the U.S. Food and Drug Administration recommends that women with silicone implants get an MRI three years after receiving their implants and every two years thereafter. There are no screening or MRI requirements for women with saline implants.