There are a number of decisions that you will have to make in advance of male-to-female breast augmentation, including breast implant type. There are currently two types of implants available in the United States – saline and silicone. Before making your final decision, there are few things you should consider.
Both saline and silicone breast implants are contained within a solid silicone shell, the difference is what’s inside.
Saline breast implants –Saline implants contain sterile saltwater. They’re typically inserted empty, and then filled once they’ve been surgically placed.
Silicone breast implants – Silicone implants come pre-filled with silicone gel – a cohesive fluid that resembles the feel of human fat.
Both saline and silicone breast implants have been in use since the 1960s. Since their introduction, silicone implants have been the most popular implant type due to their natural look and feel. In 1992 however, silicone implants were banned by the Federal Drug Administration (FDA) over concern that they may increase the risk of developing auto-immune disorders such as rheumatoid arthritis or lupus. From 1992 to 2006, saline breast implants were the only option available in the United States.
Throughout their ban in the U.S., silicone implants remained the most popular implant type in Canada, Europe and South America. In 2006, the FDA removed their ban after they were unable to find evidence to support their initial concerns. Through several years of research, it was determined that the risk of developing an auto-immune disease is the same whether someone had silicone implants or no implants at all.
The key advantage of silicone implants is aesthetic. Though both implants types can give you a natural look, silicone breast implants have a reputation for providing a more natural look and feel. Additionally, silicone implants are softer and less prone to rippling, making them an ideal choice for transfeminine patients who have little natural breast tissue to cover their implants.
Because saline implants are often filled at the time of surgery, they require slightly smaller incisions than silicone implants. There is also more versatility when it comes to incision placement. Unlike silicone implants, which can only be placed through an incision along the armpit (transaxillary incision) or at the breast fold (inframammary incision), saline implants may also be inserted through an incision made along the border of the areola (periareolar incision) or rarely through an incision made through the navel (TUBA incision).
Breast implants are not designed to be lifetime devices. It’s possible that you will require revision surgery in the future.
Ruptured saline implant – If a saline implant ruptures, you’ll be able to tell within a few hours. The implant will deflate, causing the affected breast to diminish in both size and shape. Though saline poses no health risks to the body and will be naturally absorbed, surgery will be necessary to remove the remaining silicone shell, and to replace your implant, if desired.
Ruptured silicone implant – If a silicone implant ruptures, it’s far more difficult to detect. You may not notice symptoms for months, years – or ever. Because of its cohesive nature, free silicone tends to remain trapped in the fibrous capsule that forms around the implant after surgery. Though leaking silicone has not been linked to an increased risk of long-term health concerns, a ruptured silicone implant may eventually result in breast pain, or changes in breast shape or contour. Regular MRIs are recommended by the FDA to detect the presence of leak or rupture, though this is somewhat controversial. Surgery will be necessary to remove the implant shell and leaking silicone.
As a general rule, breast implant manufactures charge approximately $1,000 more for silicone breast implants. As a result, breast augmentation using silicone implants is somewhat more expensive. Additionally, because of the FDA recommendation that silicone implant recipients receive regular MRIs to detect the presence of a silent rupture, they may also be more expensive in the long run if you choose to follow that recommendation.
Choosing an implant type based on the advantages and disadvantages can be an overwhelming process. Dr. Mosser is more than happy to help guide you through this decision-making process.