You should discuss the different types of breast implants (silicone and saline) with your surgeon.
There are advantages and disadvantages with each type of implant. The most suitable implant for you will depend on your individual circumstances and personal preference.
Both silicone and saline implants are surrounded by a firm, elastic silicone shell that helps prevent the implant from rupturing (bursting). The surface of the shell can either be smooth or textured.
Silicone gel implants and saline (sterile salt water) implants are discussed in more detail below.
Silicone gel implants
Silicone gel implants are filled with a silicone substance that can vary in its firmness and consistency. They are pre-filled before they are inserted.
Advantages of silicone gel implants include:
- They have a long history of safe use.
- They may be less likely to wrinkle than other types of implant.
- They are available in round or anatomical (contoured) shapes (often referred to as tear-drop shaped).
- Silicone gel is a very soft and pliable (supple) implant filler, which means it allows for movement and gives you a natural feel.
- Most silicone gel implants used in the UK have a textured surface, which can reduce the risk of excessive movement, and may also avoid problems, such as hardening, due to capsular contracture.
The silicone gel used in cohesive gel implants is firmer than the gel used in traditional silicone implants. Due to its firmness and thick consistency, in the unlikely event of the implant’s shell rupturing (splitting), there is a greater chance that the gel would stay inside and not leak into the surrounding tissue.
Like other types of silicone gel implants, cohesive gel implants have a soft, natural feel. They are also less likely to wrinkle or fold, due to their ability to retain their shape and integrity.
Saline implants
Saline implants have a strong, silicone shell and are filled with a sterile salt water solution. They are either pre-filled or can be filled through a valve once they have been inserted into your breast.
Advantages of saline implants include:
- They have a long history of safe use.
- As the saline solution is similar to your body fluids, it can be safely absorbed or excreted (got rid of) by the body if the implant ruptures (splits).
Disadvantages of saline implants include:
- They may rupture or deflate at an earlier stage than other implants.
- They are more prone to wrinkling or folding.
- They are only available in round and not breast-shaped (anatomical) shapes
- They may not feel as soft and natural as silicone implants
Other types of implant
Some types of breast implant, such as soya bean oil-filled implants and hydrogel implants, are no longer licensed for use in the UK.
In 2000, the Medicines and Healthcare products Regulatory Agency (MHRA) recommended that women with soya bean implants should have them removed.
Although hydrogel implants are no longer available in the UK, women who have them have not been advised to have them removed because they are not thought to cause an immediate risk. However, the MHRA is continuing to monitor their safety. See the MHRA’s website for more information about hydrogel breast implants.
PIP implants
In 2011, French PIP implants caused concern after it was revealed they contained industrial silicone rather than medical-grade fillers. They may also be more prone to rupture. Some 40,000 women in the UK are believed to have had the implants, with the majority of operations done for cosmetic reasons through private clinics.
There is not enough evidence to recommend the routine removal of PIP breast implants, a government expert review has concluded. However, any implants put in by the NHS can be removed and replaced without charge.
If you are worried about your implants speak to your surgeon or GP.
For more information read our NHS PIP implant removal Q&A.
Safety
In 1991, polyurethane-coated silicone implants were withdrawn from use in the UK following fears they could increase the risk of cancer. However, research has shown the risk is very low (less than one in a million) and in 2005 polyurethane-coated implants were re-introduced.
Implant life expectancy
Women who have breast implant surgery rarely keep the same implants for their entire lives. Anyone who has a breast implant inserted (for whatever reason) will need further surgery at some point, either to change the implant or remove the scar capsule that has formed around it.
Most breast implants have a life expectancy of 10-15 years, after which time they may need to be replaced. However, breast implants can sometimes last longer without problems, and some manufacturers guarantee against certain types of implant rupturing for the lifetime of the patient.
Sometimes it is difficult to detect implant rupture. You may have to pay for scans if rupture is suspected, as the NHS will not fund investigations, or replace your implant, if the surgery was performed privately in the first place.
