Saline breast implants

Top specialists of plastic surgery worldwide deal with comparison of these two types of breast implants. There is still not a unified opinion on this theme. There are two different trend of the usage of implants in the United States and in Europe. In the United States the surgeons prefer rather saline filled implants, on contrary silicone implants are preferred in Europe with great experience.

List of implants

• Implants filled with physiological saline = SALINE FILLED IMPLANTS
• Implants filled with silicone = SILICONE FILLED IMPLANTS
• Implants with combination of silicone and saline = BAKER’S EXPANDERS (they are used much less)

Both types of implants are available on our and foreign market in many sizes and in two basic types. Both types of implants are produced as round silicone/saline implants and/or teardrop silicone/saline implants. Usually both implants have silicone surface although there are also implants with polyurethane surface, they are used less.

What is SILICONE?

Silicone is inorganic-organic polymer. It is very close to human body thanks to its organic component, which is attached on atoms of silicon. In natural human tissue we can find polymer structures that are mainly of organic origin, it means that they contain mainly carbon, oxygen, hydrogen and nitrogen. This organic-silicon-oxygen unit repeats regularly. Silicone is thanks to its unique features widely used not just in medicine but also in technical industry and cosmetics. All silicone implants and devices used in medicine must be tested according to law about health care and it must have CE certificate (notification of products that fulfilled standards of European Union.)

What is PHYSIOLOGICAL SALINE?

Physiological saline is 0,9% solution of sodium Chloride (NaCl) or also kitchen salt. It is an isotonic solution i.e. of the same osmotic pressure as blood serum. It is mainly used as infusion solution, in medicine it has broader usage though. Wounds can be washed with it or it can be used for scientific reasons. It does not cause water transport to the cell and not even from the cell and therefore it is very well accepted by surrounding cells.

Saline filled implants

The development in the area of saline implants has concerned mainly improvement of shape and covers. Silicone cover is most often used, they can be smooth saline implants or textured saline implants. There are still used polyurethane covers but in less extent. This material is also very unique polymer compound that consists of repeated units. It is similar to own body tissues. Silicone and saline fillers do not vary in the type of covers at all. Beside the shape and type of surface implants vary of course by size of their filler, which is evaluated by two parameters – diameter of the base and projection. Newly there are also saline implants with high profile that have been profiled by raise of projection by smaller diameter.

There are two types:
- By the first type pre-filled implant is inserted already as finished filler.
- The second type is placed into the breast pocket with no refill and is filled with sterile saline during the surgery. The advantage of this second type is small scar even by larger size of breasts.

What are the factors that influence the surgeon’s right choice of the implant?

The surgeons choose between silicone and saline implants mainly by their experience. There is a large choice of implants depending on the right shape, surface and size. According to what factors do the surgeons decide?

• 1) The anatomy of patient’s chest is the basic principle of the choice.
• 2) Another factor is placement into the pocket under the muscle or only under the mammary gland.
• 3) Surgeon’s individual experience with different types of surface and shape of breast implants plays also great role. Every surgeon wishes to have most natural result.
• 4) The patient should also rely on aesthetic feeling of the surgeon that will help her to choose the optimal size and type of implant.
• 5) Important is also the chosen surgeon’s approach (through incision in the inframammary fold, incision around the areola or incision in the armpit and or exceptionally used incision through the navel.)

Controversial themes silicone vs. saline implants

Questions that have been discussed among professional and general public concerning safety of silicone implants.

Do the silicone implants cause cancer??

Due to very known cases in the United States scientists from all over the world dealt with this problem. Hypothesis of relation of silicone with cancer was not proved in any of these studies. Thanks to this silicone has greatly expanded in medicine. Now we can find it mainly in the field of plastic surgery (artificial valves, vascular replacements and so on.). Mammography specialists say that silicone implants do not cause cancer but hinder greatly examination methods. Surgeons warn against late diagnosis of tumor disease. Therefore a special approaches of examination for women with breast implants have been done. Special mammograms or magnetic resonance imaging are used. Although there was never proved any relevant connection between breast cancer and silicone filled implants surgeons in the United States prefer use of saline filled implants. It has been caused by several lawsuits that ended successfully mainly thanks to the ability of lawyers.

Do the polyurethane implants cause cancer??

Like by silicone fillers also polyurethane coating was considered to be potential cancerous substance. It has naturally never been proved and even American agency for drug control FDA indicated this risk as minimal and recommended to the surgeons to use polyurethane.

Do silicone implants cause autoimmune diseases???

Again it has been proved thanks to many studies that there is no relevant connection between silicone and autoimmune diseases. It was mostly speculated about damage of connective tissue and its association with evoked autoimmune disease but any connection has been denied.

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