One of the many decisions that women must make when they undergo breast augmentation or reconstructive surgery is whether to receive artificial implants that are filled with saline or silicone or to have their breasts reconstructed or augmented with fat taken from other parts of their own bodies.

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Saline And Silicone Implants

Saline and silicone implants are artificial implants. Most saline implants are empty sacks that the surgeon will position in the breast and then fill with a saline solution to the desired size, though some saline implants come to the surgeon pre-filled. Silicone implants are shipped to surgeons already filled.

The age requirements for the two types of artificial implants are slightly different. While women of any age may receive either type of implant if they are undergoing reconstructive surgery, only women 18 and older may receive saline implants and women 22 and older may receive silicone implants if the surgery is elective.

The benefits of saline and silicone include considerations of feel and texture as well as medical side effects.

  • If a saline implant ruptures, the body absorbs the saline solution without any harmful side effects.
  • Silicone implants provide women with a more natural appearance and feel than do saline implants.
  • Because saline implants can be filled after the shell is inserted into the body, the patient usually has a smaller scar than with silicone implants.
  • Both types of implants provide women with a variety of choices in size, giving the patient and surgeon the freedom to customize the augmentation as much as possible.

The dangers of saline and silicone implants are fairly similar:

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  • Patients may suffer from pain and infection after the surgery at the incision site.
  • Patients may develop scar tissue that causes the breast to become misshapen.
  • Patients may experience a ruptured or leaking implant.
  • If a saline implant ruptures, the rupture will cause the breast to lose its shape, and surgery is required to remove the shell and put in a new implant.
  • If a silicone implant ruptures, the body cannot absorb the material, and the implant must be removed. When the surgeon removes the implant, he or she can also insert a new implant. Patients are encouraged to have an MRI done every two years to detect ruptures or leaks in silicone implants. Medical insurance plans generally do not cover these MRIs.
  • Routine mammograms used to screen for breast cancer may be more difficult to interpret because of distortion caused by the implant.

Natural Augmentation From Fat Or Autologous Augmentation

Autologous augmentation requires surgeons to remove fat from other parts of the body, usually the abdomen, thighs, or buttocks, and transplant that fat into the breasts. This procedure can be used both for women undergoing elective augmentation and women undergoing breast reconstruction surgery after a mastectomy.

Though the American Society of Plastic Surgeons banned natural augmentation in 1987, after a 2007 task force study, the society reinstituted the procedure.

Natural augmentation has specific benefits that saline and silicone implants to do not have.

  • The process uses a woman’s own fat, and no foreign substance is placed in the body.  
  • The process of removing the fat from other parts of the body serves as liposuction, allowing the patient to undergo two cosmetic procedures at the same time.
  • Routine mammograms after natural augmentation are not affected.
  • The procedure may not leave scars because the fat can be injected into the breast with a syringe (the procedure to remove the fat may leave scars).

Like all procedures, natural augmentation also poses some complications.

  • The procedure requires multiple injections with small amounts of fat transferred at one time.
  • Fat grafts often die over the course of the woman’s lifetime, causing the breasts to shrink, and requiring additional fat grafts.
  • Serious complications like graft necrosis may occur, causing infections in the breast.