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'Breast' Intentions - Saline or Silicone? Options Return ~  

By Patty Kovacs

Part I

Let's face it. Breast augmentation to increase fullness of the breasts can indeed improve the balance in a woman's figure, enhancing her self-image and her self-confidence.  Whether to restore breast form due to mastectomy, injury, or loss of volume resulting from child bearing, weight reduction, or other significant life events, women around the world are increasingly more interested in choosing fuller, more natural appearing breasts by undergoing breast augmentation surgery to achieve a renewed sense of femininity.  Once considered within reach only by the wealthy, cosmetic enhancement is growing and is increasingly popular among the middle and upper class.  And the age range of younger and older patients continues to stretch wider on either end of the spectrum.

On November 17, 2006, the FDA rescinded a 14-year ban on silicone gel implants for cosmetic breast enhancement, a decision praised by some, criticized by others.  


Though over 90% of augmentations outside the U.S. in 2006 and 2007 were for silicone implants, the FDA approval here came with conditions and warnings.  After rigorous review the FDA offered "reasonable assurance" that silicone implants are "safe and effective".

In 2007 in the United States alone, over 350,000 women had cosmetic breast enhancement surgery, the majority of which were saline implants, in procedures costing $6,000 to $10,000, and not covered by insurance. Now that the FDA has lifted the ban, silicone implants return as a viable and safe option and choice returns for women. And... everyone knows we prefer choice.

Concern about the health consequences of leaking implants prompted the FDA in 1992 to ban silicone implants for cosmetic procedures. However, the implants remained available for cancer survivors, partly because the doctors and patients insisted on it. Studies by the FDA concluded no association between silicone implants and cancer or other life-threatening diseases, although the FDA says it will continue to monitor for any such risk.

This raises the bar on choice for women.  There are many important decisions that must go into any surgery, but particularly breast augmentation surgery. Selecting a highly credentialed and experienced surgeon is the first consideration. Selecting the right type and size implant according to one's health and lifestyle is the next most important decision. Implant incision and vital medical decisions must then be decided between patient and surgeon. Women now have the opportunity to research more data, discuss options with their surgeon, and choose which type of implant best suits their anatomy, professional pursuits, lifestyle, recreational interests, and personal preferences.

Women with silicone implants will be encouraged by the FDA to undergo follow-up screening with regular MRI exams – three years after the operation and every two years thereafter - to catch possible "silent ruptures", leaks that cannot be detected visually or by touch.

Every woman must make sure she understands the benefits and risks of this type of surgery as well as all of her options from both an aesthetic as well as a medical perspective.  Every patient needs to speak candidly with a surgeon who is experienced and sensitive to the issues at hand rather than one who downplays the seriousness of this or any other surgical procedure.

To be continued....just like your research if you‘re considering breast augmentation needs to be continuous...


Patty Kovacs has been the Executive Producer & Host of the weekly radio show, The Health & Beauty Revolution Show, since 2002, interviewing over 800 physicians, surgeons, lifestyle experts, and authors, over 500 of whom are NYTimes best-selling authors.  

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