Dr. Ric Izquierdo member for 36 weeks 6 days Send a message

We had a little get-together at the office this week with several dozen former patients and others with questions. There have been two questions that are always asked during a consultation for breast enhancement. “Do I have to exchange my implants after 10 years?’ “Won’t silicone spread through my body or give me weird diseases?” Breast augmentation has been around for over fifty years in its present form. The first implants used were saline filled. In the 60’s, because of demands from patients and surgeons for a better look and feel, silicone implants were first manufactured.

In 1991, after much media exposure from Jenny Jones, Connie Chung, and others, silicone implants were banned in the U.S. and saline implants were put under experimental status. They remained available in Europe and South America. Up to that time, implants had not undergone any pre-market approval testing that was standard practice with the FDA. To be honest, some manufacturer’s implants in the 80’s felt like their shells were as thick as wet Kleenex to me. There’s no doubt that a complete rethinking of the product was required.

In 1994 I enrolled as an investigator in the FDA Adjunct Study for breast implants. This study was designed to systematically evaluate primarily silicone implants but also saline implants. During the study period until November 2006, silicone implants were restricted for use only in patients needing breast reconstruction or revision. A lot of good things came out of this study. First of all, there was a total rethinking of how implants were designed and manufactured. The shell of both types of implant is now a triple laminate layer; akin to a Ziploc freezer bag as opposed to the cheapo sandwich bag from years before. Secondly, the valves in saline implants were re-engineered to help decrease the rate of deflation. The silicone filler is now not a liquid, it’s more like Jell-o, so it won’t flow. Thirdly, several major studies, as well as the Adjunct Study itself, showed no significant correlation with autoimmune diseases, chronic fatigue syndrome, or breast cancer with either implant.

Like any other implant in the body such as heart valves, knee or hip joints, wear and tear will have an effect. The good news is that breast implants are not in a high impact position like knee joints. The data available from the Adjunct Study covers only 10 years, so that’s the data that we can discuss, and that’s why the 10-year myth is out there. In my experience with the new implants since the early 90’s, the deflation/rupture rate is much lower than before, somewhere at the 3% level. So I tell my patients that at 10 years, if it’s not broken, don’t fix it. By that I mean obvious deflation, contracture (hardening), or other issues that make them look unnatural. Silicone implants can be a little harder to assess clinically, but usually the patient will notice a vague shape change or difference in feel or texture. An MRI can give us the best view for defining any problems.

The best thing that’s come out of all of this is choice. Women now have credible information to make an informed decision.

Ricardo Izquierdo, M.D., FACS
Board Certified Aesthetic Plastic Surgeon
ric.izquierdo@faceandbodychicago.com
http://www.FaceAndBodyChicago.com