More Women Happy With Saline Breast Implants

Saline Beats Out Silicone Breast Implants in Most Categories By Denise Mann
WebMD Medical News Reviewed By Michael Smith, MD

April 20, 2004 (Vancouver, British Columbia) -- There's no sign that silicone breast implants will be widely available again any time soon, but new research shows that women with saline breast implants are more satisfied than their counterparts with silicone-filled implants.

In the survey of more than 3,000 women with implants, 69% of women with silicone gel implants and 77% of those with saline implants said "getting implants was a great decision."

Moreover, women with silicone gel implants were more likely to require a second revision surgery and/or experience implant-related complications and physical symptoms. But when it came to touch and feel, silicone breast implants came out on top.

The survey results were released at the annual meeting of the American Society of Aesthetic Plastic Surgery (ASAPS) in Vancouver, British Columbia.

"One of the surprises is that the only variable for which silicone had a statistical advantage was in producing a breast with a natural feel," says researcher Leroy Young, MD, a plastic surgeon in St. Louis, in a written statement.

Popularity Surges Despite Safety Concerns

In 2003, more than 280,000 women underwent breast augmentation, according to ASAPS, making it the second most popular cosmetic procedure -- behind liposuction.

In the fall of 2003, manufacturers asked the FDA to allow silicone breast implants back on the market. But in January, the FDA sent a "not-approvable" letter to silicone implant manufacturer Inamed Corp. citing a need to know more about safety and implant rupture rates before allowing them back on the market.

In the 1990s, concerns about potential health risks associated with silicone implants emerged --including leakage/rupture and reports of an increased risk of autoimmune disease and possible cancer risk among women. This prompted the FDA to ban them in 1992.

Enter Saline Implants

Saline implants contain a saltwater solution, so even though they may leak or rupture, the risks are less serious because the body can readily absorb saline water. The downside is that they don't look or feel as natural as silicone. Saline implants may also be associated with more ripples.

Calling the survey results "definitely positive," William P. Adams Jr., MD, associate professor of plastic surgery at University of Texas Southwestern Medical Center in Dallas says, "There is a high rate of patient satisfaction with silicone and saline implants."

Saline implants "have always been a good option for patients. Because of what went on with silicone implants in 1992, saline became the implant of choice for cosmetic breast surgery," he tells WebMD.

"The good news is that women can be satisfied with either," he says.

In the future, cohesive gel breast implants may offer women even more choices.

"There is no perfect implant, but cohesive gel is moving in that direction," he says. These implants have the natural look and feel of silicone implants with the safety of saline implants. They have a gummy bear consistency; meaning that even if the implant ruptured, the silicone can't migrate. Plus, they feel like breast tissue -- not a water balloon.

"In addition to the cosmetic benefits, there are potential safety benefits," he says. So far, there is about 10 years of data on cohesive gel implants in the U.S. and it looks overwhelmingly positive, he says.