Saline Breast Implants VS Silicone Implants

By Margarita Nahapetyan

According to a new report by the American Society for Aesthetic Plastic Surgery (ASAPS), saline-filled implants remain the most popular choice for primary breast augmentation, in spite of the highly anticipated Food and Drug Administration (FDA) approval of silicone gel implants for cosmetic purposes in 2006.

Last month the ASAPS surveyed their member surgeons who most likely perform the highest volume of primary breast augmentation procedures. The aim was to find out what are the current trends in breast augmentation. According to the results, the natural looking breasts are still preferred by the absolute majority of plastic surgeons as well as their patients. For instance, the average implant size used by most of the surgeons who took part in the survey is 300 - 400 cc in size, or a small to full C-cup breast.

More than 60 per cent of plastic surgeons prefer to place the implants under the chest muscle rather than on top of the muscle, again opting for the most natural outcome. The survey found that a vast majority of ASAPS plastic surgeons - 96 per cent - would choose round implants over the anatomically shaped, or teardrop shaped implants. Most doctors feel that round implants look way more natural when the correct size and position is selected, and, in particular, when placed under the chest muscle. Sixty four per cent of surgeons prefer an incision near the crease underneath the breast. In spite of the fact that there are few other options, notably around the areola (preferred by 25 per cent of surgeons), an incision under the breast can give the surgeon optimal access.

The ASAPS survey showed that 60 per cent of plastic surgeons still were using saline implants, and the absolute majority of these doctors chose saline implants for 75 per cent to 100 per cent of their patients who were undergoing breast augmentation for the first time. It was also revealed that 80 per cent of responding plastic surgeons had used silicone gel implants more often since their approval in 2006. There were a number of reasons for selecting one implant type over the other one. The most common factor to determine the choice of silicone gel implants was "patient preference." In addition, smooth implants, rather than implants with a textured surface, were most often preferred by 92 per cent of surveyors because they had less wrinkling, and overall, better results for the patient.

"Although the reintroduction of silicone gel implants was accompanied by expectations of a sharp increase in their use, this survey revealed that, among Aesthetic Society members, saline implants are used more often than silicone gel implants," said Dr. Rod Rohrich, MD and Dr. Edward Reece, M.D., the study's lead investigators. "However, both saline and silicone gel implants are used frequently, safely and reliably."

According to the latest data from ASAPS, breast augmentation was the top plastic surgical procedure in 2008, ahead of lipoplasty for the first time. In 2008, there were 355,671 breast augmentation surgeries, up over 250 per cent since 1997. According to the Society's most recent statistics, 46 per cent of breast augmentations in 2008, which included both primary and implant replacement procedures, were carried out with the use of silicone gel implants.

The report is published in the March/April issue of Aesthetic Surgery Journal.