The non-cosmetic clinical indications for the use of breast implants are for breast reconstruction, sex reassignment surgery, and for abnormalities, usually congenital, that affect the shape and size of the breast. Non-clinical indications, which are the most common reason women get breast implants, are considered cosmetic and are not covered by any health insurers. And of all the breast plastic surgery procedures performed in 2006 in the United States, 329,000 were for breast augmentations.



Back in 1962 the first woman was implanted with silicone implants. There are two primary types of breast implants: saline-filled and silicone-gel-filled implants

Doctors Thomas Cronin and Frank Gerow, two Houston, Texas, plastic surgeons, developed the first silicone breast prosthesis with the Dow Corning Corporation in back in 1961. Current saline implant devices are manufactured with thicker, room temperature vulcanized shells. There have been several types of breast implants developed other than the two most common, saline filled and silicone gel filled, including polypropylene string and soy oil, but these are not commonly used, if at all; leakage of oil into the body during a rupture would not be good..

Because the saline implants are empty when they are surgically inserted, the scar is smaller than is necessary than for the silicone gel breast implants which are already filled with silicone before they are placed. Saline-filled implants are the most common implant used in the United States due to some restrictions on silicone implants. This may change. They are seldom ever used in other countries. Silicone gel implants have a silicone shell and are filled with a viscous type silicone gel.

An intracapsular rupture can progress to outside the capsule, called an extracapsular rupture, and it is generally agreed that both conditions indicate the need for removal of the implant. Since the early 1990s, a number of independent reviewers have examined studies concerning links between silicone gel breast implants and systemic diseases and the consensus of these reviews is that there is no clear evidence of a causal link between the implantation of silicone breast implants in breast plastic surgery and systemic disease. It is always good to know who is funding these studies and that should clearly be stated.

Countries outside the United States have not endorsed routine MRI screening, and have taken the position that MRI's should be reserved only for cases involving suspected clinical rupture or to confirm mammographic or ultrasound studies that suggest rupture.

When silicone implants rupture they rarely ever deflate, and the silicone from the implant can leak out into the intracapsular space around the implant. Thousands of women claim to have become ill from their breast implants. These complaints include neurological and rheumatological problems. When breast implants are removed that have been implanted for a long period of time, a mastopexy is often performed to tighten up the loose skin. This is additional surgery usually done at the same time and at an additional expense.

One study reported that only 30% of ruptures in asymptomatic patients are accurately detected by experienced plastic surgeons, compared to 86% that were detected by MRI. The age and design of the implant is an important factor in rupture, but estimating rupture rates of contemporary devices has been difficult for a variety of reasons, mainly because implant designs have changed somewhat over time.

Local complications that happen with breast implants include post-operative bleeding, fluid collections, surgical site infection, breast pain, alterations in nipple sensation, interference with breast feeding, visible wrinkling, asymmetric appearance, wound dehiscence with potential implant exposure, thinning of the breast tissue, and disruption of the natural plane between the breasts.

Manufacturers and doctors are required to let women know that implants are not permanent devices and that most recipients will probably need additional surgery to replace or remove their implants.

And make sure the plastic surgeon you choose, if you decide to do so, is board certified. Some doctors in specialties other than plastic surgery, like dermatologists, perform breast plastic surgery like breast augmentation. Choose a board certified plastic surgeon instead. And it's just a reminder that breast augmentation is an elective cosmetic breast plastic surgery. Make sure to be aware of all the risks and complications and ask others who have implants for an honest evaluation of their experience.