Tag: Silicone Gel Implants

Breast Implant Ruptures

A saline implant rupture results in quick deflation and is easily removed. Recent FDA approved studies show rupture/deflation rates of 3-5% at 3 years and 7-10% at 5 years. Older studies depended on clinical exams to determine rupture rates.

Recent reports have determined these exams arent adequate to evaluate rupture rates. One study reported ruptures in asymptomatic patients are correctly detected by experienced plastic surgeons 30% of the time. This is compared to a detection rate of 86% by MRIs.

The FDA currently recommends MRIs be used to screen for ruptures beginning three years after implantation and continuing every two years thereafter.

Other countries consider MRIs useful only in cases of suspected ruptures and to confirm ultrasound or mammographic studies suggesting a rupture.

Silicone implant ruptures rarely result in deflation. The silicone leaks into the space around the implant. This indicates the need for removal of the implant. The risk and treatment of extracapsular leakage is controversial. Its agreed the gel is difficult to remove, but theres disagreement about the health effects.

The majority of MRI data for silicone gel implants indicates after 11 years, most women had at least one ruptured implant with silicone leakage outside the capsule of 21% of the women. The available long term data deals with 3rd and 4th generation implants and shows a 15-30% risk of silent rupture. MRI evaluation of the 5th generation implants implies improved durability. A rupture rate of 1% or less at an average age of six years is reported.

Incisions and Scaring

Surgery leaves scars. While most breast augmentation incisions do heal well, a rate of 6-7% of unfavorable scaring has been reported for primary augmentation patients in FDA clinical trials.

The extent of the scaring can be determined by many factors. These include the patients ethnicity, smoking, tissue quality, suture material, wound tension, tissue trauma from surgery and the individuals tendency toward favorable wound healing.

The type of incision also affects the amount and visibility of scaring. The type of planned incision should be discussed with your surgeon prior to the procedure.

The most common incision for silicone gel implants is the inframammary incision. This affords maximum access for precise dissection and placement of an implant. The incision is placed below the breast in the infra-mammary fold. This incision can leave slightly more visible scars in smaller breasts which dont drape over the IMF.

Transaxillary incisions are placed in the armpit. This allows the implants to be placed without visible scars on the breasts. Its also more likely to consistently achieve symmetry of the inferior implant position.

Periareolar incisions are placed along the areolar border. The incision is usually placed around the inferior half of the areolas circumference. Because of the incision length required, silicone gel implants can be hard to place using this method. These scars are often less visible in women with lighter areolar pigment since they occur on the edge of the areola. There is a higher chance of capsular contracture with this incision.