After more than ten years of controversy and scientific study, the US Food and Drug Administration has approved silicone gel breast implants for general usage. They are now available to all women ages 22 and higher for both reconstructive and cosmetic breast surgery.

The availability of silicone implants will greatly expand the options for women seeking cosmetic breast augmentation. In many situations, they have real advantages over saline breast implants. They tend to look and feel more natural than saline implants. They are less prone to rippling or crinkling which can sometimes be felt and occasionally can become visible under the skin. They are lighter than silicone implants. However, they are thought by some to have a higher rate of capsular contracture, which is scarring around the implant and can make the breasts hard.

In countries where both silicone and saline implants have been available the vast majority of patients and surgeons select silicone implants. This is testimony to their advantages. In the US, we are likely to see a large number of patients select silicone breast implants.

But there will still be a place for saline implants. Some people might simply prefer not to have silicone placed in their body. Silicone implants are more expensive than saline implants. In some cases, the implant is used as a sort of platform to elevate the normal breast tissue rather than to give the breast the entirety of its shape. In this situation, saline implants function just about as effectively as silicone implants.

Silicone implants have not been shown to cause autoimmune diseases such as arthritis and lupus, as had been feared. But patients should realize that any breast augmentation procedure is essentially temporary. Body shape and anatomy can change, there might be problems with healing or the body's reaction to the implant. At some point, it is likely that additional procedures may be necessary. At Rodeo Drive Plastic Surgery, we are already doing quite a few breast augmentations with silicone implants. I expect we will see many more people interested in the procedure in the next few months.

Lloyd Krieger
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