Breast augmentation is currently the most common aesthetic procedure performed. In my practice, I use silicone gel implants the vast majority of the time. I prefer them over saline because they are much softer and look more natural. Creating natural results is my priority as well as something desired by most of my patients. There are still lingering concerns about silicone in some of my patients, so I wanted to provide some information to dispel some commonly held misbeliefs.

I began using cohesive gel silicone implants as part of a national study that began over seven years ago. These newly designed implants had thicker shells and much thicker gel inside them. The thicker shell has resulted in leakage rates of only 8%—as measured seven years after surgery, compared to rates as high as 70% with the older, thin-walled implants. The rate of scar tissue development around the implants called capsular contracture has also dropped from over 25% to 15%. The newer gel is so thick, that even when the shell develops a hole, the gel cannot ooze out into surrounding tissues.

The big question is: “When will I need new implants?” At present, the answer is unclear. We have seven years of data about silicone gel breast implants from the US and ten from Europe. As described above, it would be very unlikely to have a problem with the implant that would develop within the first seven years. We simply don’t have data past that at this point. The studies are ongoing, and new data will be made available as it comes out. There is no such thing as a lifetime breast implant, but with newer implant designs, the durability of implants continues to improve.

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