Materials used in breast implants for reconstruction - after risk-reducing mastectomy

Other materials have been used in the past but saline and silicone have so far been shown to be effective and safe.

The outer layer is made of a material called silicone elastomer, a material similar to rubber. This reduces the risk of leakage.

Saline implants Back to top

Saline has the advantage of not causing any problems if it leaks out into the body. However, saline-filled implants don’t have the natural feel of silicone-filled implants and give a less realistic reconstructed breast. They are more likely to leak or wrinkle than silicone implants and can make breast x-rays (mammograms) slightly more difficult to read.

Silicone implants Back to top

Silicone implants are very commonly used in the UK.

These are bags of silicone gel enclosed in a thin silicone shell. They are designed to feel soft and flexible, like a natural breast, and there are many different types. They can be tear-drop shaped or round, textured or smooth on the surface, and filled with either soft liquid silicone or, a more solid (cohesive) silicone gel. These days, most surgeons use cohesive gel implants.

The silicone gel filling gives a more natural feel to the reconstructed breast than saline. If a silicone implant ruptures, you may need surgery to remove it.

Like saline, silicone implants can appear cloudy on x-rays, making mammograms slightly more difficult to read. It’s possible to get a good mammogram of a breast containing an implant, but you need to tell the radiographer that you have an implant.

One problem that may occur with a breast implant is capsular contracture|. This is more likely if you smoke or develop an infection.

Are silicone implants safe? Back to top

There have been concerns about possible health risks if silicone leaks from the implant. Over the years, silicone implants have developed and improved so that the risk of leakage has been greatly reduced. However, there will always be a very tiny amount of leakage, which is safe.

Silicone implants have been successfully used for many years for breast enlargement. In the past however, there were concerns that some women developed health problems as a result of having silicone implants. These problems included auto-immune illnesses (where the body has an inappropriate immune response to its own tissues) such as rheumatoid arthritis, connective tissue disease or even cancer. When this was looked into it was found that most problems were associated with liquid silicone injections, where the silicone was injected directly into the breast, and not to silicone implants. Silicone injections are now banned in the UK and the US.

A lot of research in different countries has been carried out to see whether silicone implants cause health problems. No link has been found between silicone implants and the development of cancer or auto-immune illnesses. In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring the safety of breast implants. The Department of Health (DH) set up an Independent Review Group in 1997 to review their safety.

They reported originally in 1998 and last met in 2004. They found no good evidence of an abnormal immune response to silicone and no evidence for a link with connective tissue disease. They therefore believe that there is no reason to stop using silicone implants. The full report is available on the MHRA website|.

It’s important to talk through any concerns you have with your surgeon, breast care nurse, or a cancer support organisation before you have an implant.

How long do silicone implants last? Back to top

All implants have a life span and will need to be changed after a number of years. Some last longer than others – the newer ones will last for at least 10–15 years and probably longer. If you have implants you may need to have them changed if you:

• have a capsular contracture (formation of tough, fibrous tissue around the implant)
• have an infection
• put on, or lose, a lot of weight.