Silicone Implants

Silicone Breast Implants

Silicone-filled breast implants are filled with a silicone gel. They have been around in one form or another for about 40 years. Over the years, the type of silicone filling has changed, as well as the materials and types of shells used.

In the 1990s, reports began surfacing about silicone breast implants breaking down and the silicone oil or gel leaking into the pocket around the implant or even migrating to other parts of the body. The body usually reacts to any foreign object by trying to wall it off from the rest of the body. It does this with the silicone that leaks out of an implant shell and often forms what is called a granuloma around the silicone or a pocket of fibrous material.

At that time, there were many anecdotal reports in the media about health issues with women who had silicone breast implants. Women developing cancer, connective tissue disorders, neurological problems, rheumatoid arthritis and several autoimmune disorders, such as lupus erythematosus and scleroderma, where thought to be from silicone. The leading maker of breast implants at that time, Dow Corning, was hit with large lawsuits and paid out millions in settlements. In the 1990s, the FDA ordered makers of silicone-filled implants to cease marketing them. Their use was limited to women who needed breast reconstruction after mastectomy and to a few other situations.

Several years of epidemiology studies were conducted. The Institute of Medicine, an independent research group, determined that there was no link between silicone breast implants -even ruptured ones- and any known health complication. The FDA approved two brands of silicone-filled implants for use in the United States in 2006, with the requirement that the manufacturers continue to conduct extensive follow-up studies.

Over the years, the consistency of the silicone filling has changed. The first silicone implants were filled with a very thin silicone that was the consistency of oil. Currently, the silicone used in implants today is a gel - along the lines of very thick uncooked egg white - and it is less likely to leak out of the shell if the shell cracks or ruptures. This type of a gel is referred to as cohesive. Even more types of cohesive gel implants are under investigation. These almost solid implants are nicknamed gummy bear breast implants because they are the consistency of the little gel candies.

Unlike a saline implant, where a rupture is apparent quite soon, rupture of a silicone-filled implant can go undetected for years. Because of this, the FDA recommends that women with silicone-filled implants undergo magnetic resonance imaging (MRI) every few years to detect any ruptures. Your health insurance company may refuse to cover the costs of these MRIs or for removal of your implants if you have any problems. There have also been some reports that health insurers have raised premiums for women with silicone breast implants.

The minimum recommended age for silicone-filled implants is 22. This is a different minimum age than for saline implants because the risks of silicone-filled implants may be greater than with saline implants and thus require a greater level of maturity.

Other fillers besides silicone gel and saline have been used in the past or are being used outside of the United States. Breast implants filled with soy oil were used in Europe for a few years, but were shown to have problems including reactions to oil that leaked out of the shells. Several implant makers worldwide are investigating breast implants filled with materials similar to those used for injections to fill wrinkles and pockmarks.

One type of breast implant that has been used for women who want enormous breasts is the polypropylene (PPP) string implant. These are not approved in the United States and will probably never be approved here. The string implants absorb fluid in the body and continue to expand and grow to huge proportions - and do not stop growing! Breasts with string implants reach absolutely absurd proportions. String implants have primarily been used by exotic entertainers.