There are a variety of options you need to discuss with your
physician.
Saline and silicone
At this point, FDA has banned the use of silicone implants in the United
States except in certain cases of reconstruction following cancer. Almost
all implants produced and used in the US contain saline.
Saline Implants
The following is from FDA's breast implant information site
Although many of the local complications of gel-filled implants are also
associated with saline implants, the latter were permitted to remain on the
market unrestricted for both reconstruction and augmentation. FDA considers
saline-filled implants less risky, because although they have the same silicone
rubber envelope as gel-filled implants, leakage or rupture would release only
salt water, not silicone gel, into the body.
Nevertheless, FDA is requiring manufacturers to collect data on the saline
implants as well, because the incidence of known risks (for example, deflation
and capsular contracture) is not well defined. When the Medical Device Amendments
were passed, it was determined that these devices would also eventually require
premarket approval. In January 1993, FDA notified saline implant manufacturers
that they would have to submit safety and effectiveness data for their products.
In December 1994, the agency told them what type of safety and effectiveness
data were needed, and delineated objectives and time frames for the trials.
Saline implants will stay on the market while the studies are conducted, but
the companies must report the laboratory, animal and clinical data in stages,
and must provide written information on the known and possible risks of their
products.
"Women considering saline implants should ask their doctor for a copy
of the manufacturer's information sheet, a copy of the product insert sheet
for the specific implant to be used, and a copy of the hospital informed consent
form," says Barbara Stellar, FDA's breast implant information and outreach
coordinator.
Stellar recommends women be given these documents at least a month before
surgery is planned, if possible, so they can thoroughly discuss benefits and
possible risks with surgeons, radiologists, and other women. These women should
also ask their physicians about participating in the saline breast implant
trials.
Brown hopes that further studies will more clearly define risks associated
with all types of implants.
"It should be made clear that implants do not last forever, that they
may break, and in what time period it is thought they might break. Most women
have no idea implants break and there's very little information about rupture
rates.
"The same is true for other complications, some of which may require
further surgery or may cause the woman to be displeased with the cosmetic
effect, which, of course, is the reason she got them," Brown says. "For
a product that a person is putting in her body presumably for 20 years or
more, we should have this information."
Silicone
a plastic material. When formed into a gel, it provides an excellent match
for breast tissue and is used as a filler in breast implants. When formed
into a slightly denser version, it is used as a shell for both silicone gel
and saline implants. A solid form is used for implants for other parts of
the body, including chin and cheeks.
Soy Implants
Soy oil-filled implants were conceived of by Dr. Leroy Young, and others
at Washington University in St. Louis in the early 1990's. Their concept was
to use presumably metabolizable Soy Triglyceride Oils (Trilipid Z6) to fill
the implants, and thus provide a material less dense than silicone gel, or
saline solution, to allow for better visualization of mammograms in the presence
of implants. The goal was also to achieve a material of similar safety to
saline to allow clearing once the implants eventually fail and leak. Approval
by the FDA for use in the US is reported to be "at least 3-5 years away,"
if ever.
Inframammary - underneath the breast. Indicates the location of one
of the possible incisions for breast enlargement, namely, under the breast.
Periareolar - around the areola, which is the dark area around the
nipple on the breast. Indicates the location of one of the possible incisions
for breast enlargement, namely, around the lower one-third to one-half of
the areola.
Axillary - of or referring to the underarm. Indicates the location
of one of the possible incisions for breast enlargement, namely, under the
arm.
Umbilical - of or relating to the umbilicus (belly button). Indicates
the location of one of the possible incisions for breast enlargement, namely
within or through the umbilicus. Sometimes called "transumbilical."
The method of transumbilical breast augmentation is often referred to as the
"TUBA" method. TUBA or transumbilical - see umbilical.
