For Surgeons

Cosmetic Surgery

Breast Augmentation & Reconstruction

The modern type of silicone breast implant has been available for 35 years. Since 1963 there has been a process of change and improvement and breast augmentation is today known to be extremely safe.

All breast implants now in use consist of a silicone shell, which is either factory filled with silicone gel or is filled at surgery with saline. Other fill materials are being investigated experimentally.

In Europe today 70% of prostheses inserted are of the gel filled type. It is probable that everyone in the civilised world has some form of silicone in their body. Silicones are used in lipstick, hair spray, food processing, skin creams and cosmetics. Many over-the-counter medications contain silicone and many medical devices are made of silicone or are coated with it e.g.: finger joint prostheses used in arthritis, needles, syringes, catheters, intravenous tubing, chin and other facial implants. There are more than 1000 medical products in which silicone either is a component or is used in the manufacturing process.

Despite the many reports in the media, there has never been a systemic illness definitively attributed to silicones.

Silicone implants do not cause cancer. Women who have implants seem to have up to 30 percent less breast cancer than would be statistically expected. Silicone implants do not cause arthritis. The American College of Rheumatology has concluded that silicone implants expose patients to no demonstrable additional risk for connective tissue or rheumatic disease.

Mothers with implants can breast feed with no risk to the baby. The most common side effect of breast implants is capsular contracture. This can occur soon after surgery or even years later. The contracture is not a health risk but may detract from the quality of the result. Research has shown that texturing of the surface of the implant reduces the incidence of capsular contracture. The presence of an implant does not delay the diagnosis of a breast lump and may make a lump easier to feel. Mammography requires special views but a woman with implants remains on the same schedule of routine mammography as all other women. To date there has never been a case reported in the medical literature in which a diagnosis of breast cancer was delayed by the presence of an implant.

The Association of Plastic and Reconstructive Surgeons of Southern Africa regards silicone breast augmentation for cosmetic reasons or after mastectomy as a safe procedure.

Apart from the side effect of capsular contracture, the complication rate of augmentation approaches that of any clean elective procedure. There is no convincing evidence to date of any systemic disorder that can be attributed to the silicone.

The November 1999 volume of the journal of Plastic and Reconstructive Surgery, which is the official journal of the American Society of Plastic and Reconstructive Surgeons carries an article by Rod J.Rohrich, M.D. entitled “Safety of Silicone Breast Implants: Scientific Validation / Vindication at Last”.

In essence the relative safety of Silicone implants has now finally been accepted by the Institute of Medicine of the National Academy of Sciences after a two year investigation.

The September 2004 issue of the journal of Plastic and Reconstructive surgery carries an editorial by Joseph K. Mc Laughlin Ph.D entitled "Long-Term Follow-Up of Women with Cosmetic Breast Implants: How Long Is Long Enough?"

A clear statement regarding the safety of silicone runs as follows: "With the exception of an elevated risk of suicide among women with cosmetic breast implants compared with the general population, the collective epidemiological evidence does not indicate any long-term health risks associated with silicone breast implants." Finally, in April 2005 the FDA issued a statement to the effect that gel filled implants are also regarded as safe. On 17th November 2006 the FDA issued a directive allowing two American manufacturers to produce gel f

20 November 2005
Acknowledgements:
Silicone Update