Breast augmentation continues to be one of the most popular plastic surgery procedures because….the results are immediate and very gratifying for nearly every single woman that undergoes the procedure. Breast augmentation can be done with either saline or silicone implants, both of which work well and create identical results in the end. But there are a few disadvantages with either saline or silcone breast implants and patients need to understand what these are so they can make the best decision for themselves.
Saline breast augmentation has a long history of success and offers two distinct advantages. First, it is less costly than silicone implants and it is the only implant type that can be placed through a very small incision off of the breast in the armpit. Its single greatest long-term risk is implant failure. In others words, what would happen if the implant should get a small hole or tear in it. Implant failure is a good medical term but the practical outcome of this problem is better appreciated as deflation, In most cases, this will be immediate…creating the effect of a flat tire. There are some cases where a saline breast implant deflation can be slow, gradually getting smaller over weeks or months. But most of the time the deflation is relatively immediate and the change in breast size acute. Why this happens has nothing to with what the patient has done. If you were to get a high energy level of force delivered to your chest, such as a car accident or get kicked by a horse (to pick two extreme examples), that may be enough force to cause the implant bag to tear. But this is very unusual. The main reason that saline breast implants deflate is due to fatigue of the material that makes up the bag or shell of the implant. The constant movement and stretching of the implant eventually causes microscopic tears in the material which eventually leads to a hole or crack that goes through the thickness of the implant wall. Much like a tiny crack in a dam which eventually spreads and causes ultimate dam failure.
What is the likelihood that saline breast implants will deflate? No one can give an exact prediction for any patient. I like to tell my patients that it is not a matter of if…it is just a matter of when it will occur. That is the right mindset to have. You must accept that this may happen. I hope that it never does for any patient, but I know it will for some. According to one of the largest breast implant manufacturers in the U.S., their reported delation rates for saline breast implants was 1% at one year after surgery and 3% at 3 years after surgery in a very large study involving thousands of breast augmentation patients. If you apply simple math to this trend, that would be 10% (1 out of every 10 patients) at 10 years after surgery. So the risk of saline implant deflation is not irrelevant. And the concept that your breast implants will last a lifetime is not realistic. (possible yes, but not very likely) Plan for their eventual replacement is what I tell my patients.
The good news is that replacement of any deflated saline breast implant is much easier and less costly than the original procedure. And the manufacturers (currently) offer free implants for those deflated anytime during your lifetime and cash payouts to help cover the cost of replacement surgery should the deflation happen within the first ten years after placement.
Dr. Barry Eppley
Indianapolis, Indiana