When you are about to perform a breast augmentation, cosmetic surgery presents numerous options related to the type of prosthesis to be implanted. When the patient visits the plastic surgeon, the surgeon will give her recommendations based on the result she wants to obtain, body and breast shape, age and skin characteristics among other factors that must be taken into account.
Currently, prostheses are made of different materials. A breast prosthesis is basically a pouch formed by a coating that is filled with a liquid. The coating is the same in all of them and consists of one or more layers of elastic silicone, with different finishes that end as smooth and rough prostheses. The fillings can be of two very different types of products: saline serum or silicone.
Saline Serum Prostheses
In these prostheses the serum is a mixture of water and salt, which has a concentration similar to that of the human body. The main characteristic of this type of substance is its safety, because it will be completed absorbed by the body in case of leakage. With this perspective, saline implants are biologically less dangerous.
The weight of the saline filler as well as its volume is less than the silicone filler. Their lower density makes it possible to provide the outer layers with a valve so the surgeon can place deflated implants within the breast and subsequently introduce the indicated amount of filling to achieve the desired aesthetic effect in each case. The advantage of using this technique is that the cut or incision through which the prosthesis is introduced is a little smaller.
But not everything can be perfect. The disadvantage of these, due to their fluidity and inconsistency, is that the liquid can escape more easily through pores or holes developed on the implant. And in the case of a greater rupture caused by wear and tear over the years or by some trauma, the implant is left empty immediately, causing the breast to have a very soft consistency. Also, in certain cases, leakage occurs by the valve when it deteriorates. When this happens, the patient is usually subjected to a new surgery to remove the prosthesis replacing it with a new one. There is no danger because the saline solution is reabsorbed by the body in a few hours without causing any damage.
On the other hand, if implants need a refill, it would be necessary to subject them to manipulation in the operating table that can produce bacterial contamination as well as dust particles on the surface which could cause in rare cases unwanted infections.
Perhaps, the biggest drawback, is the sensation of a water balloon when touching the breast and the feeling of coldness. Both characteristics are a disadvantage to the quality of the sexual life of the patient, as well as the possibility of feeling the implants in cold weather. Another problem is the appearance of air bubbles inside that could generate unpleasant sounds.
Prosthesis technology is constantly evolving and manufacturers are now designing multilayer casings to decrease the filtrations described. There is a type of implant that has a silicone shell and saline in the interior, and they are already filled and sealed by the factory, therefore it does not have the risk of being infected, forming bubbles or having premature leaks.
Silicone has been the traditional filling. Its gel consistency it’s very similar to the breast itself as it can be soft and firm. The softness provides a more natural finish and the firmness is achieved by being a very cohesive gel. It has certain advantages, since it’s more difficult to produce folds and its consistency prevents that it can be filtered by the small breaks or pores that can appear in the outer cover.
Silicone is not something that the body can absorb and if for some reason, like a big accident, the silicone gets to spread through the tissues, it could produce inflammation and other side effects and surgery should be performed to remove it. There was some concern or fear years ago when using the silicone gel because it was thought that it could lead to an autoimmune reaction. Studies now show that these fears are false, and silicone implants are perfectly tolerated by the body if they are removed in the event of a leak or rupture within a reasonable time.
It is normal for the human body to develop a protective membrane or capsule around an implant. In many cases, the capsule may be too thick and hard and would cause the so-called capsular contracture. Several factors intervene in their formation but the truth is that their appearance is becoming less frequent. Capsular contracture affects the aesthetic result of the breasts and can cause discomfort. Sometimes it can be corrected with medicines but in others it’s necessary to resort to a new plastic surgery. To prevent their appearance many surgeons advise to use rough wrapping implants and place them behind the pectoralis muscle.
In some cases the implants are manufactured without being completely filled to avoid being too tense. This results in more malleability and a more natural look, similar to that of the breast.
Lastly, it’s important to know that silicone implants are manufactured in standard sizes, because their wrapping is sealed, therefore the amount of liquid cannot be modified. This is why it’s very important that the patients decide exactly the size and the aesthetic result they expect.