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Leading plastic surgeon dispels myths on this increasingly popular option

New York, NY, November, 2007 – After a 14- year ban, the Food and Drug Administration once again gave its blessing to silicone breast implants, announcing late last year that silicone-gel implants from two companies – Mentor and Allergan – are now available to women ages 22 and older seeking to reconstruct or augment their breasts.

It didn’t take long for American women to get the news: breast augmentation is now the top surgical procedure for women, according to the American Society for Aesthetic Plastic Surgery. In fact, the ASAPS reports that there were nearly 384 thousand breast augmentation surgeries in 2006. Breast augmentation, technically known as augmentation mammoplasty, is a procedure in which a surgeon inserts an implant behind each breast to enhance its size and/or shape. Most people think of increasing breast size as the only reason a woman might consider breast augmentation surgery, but many choose to have the procedure in order reconstruct one or both breasts after a mastectomy, to restore breast volume lost through pregnancy, dramatic weight loss or the simple fact of aging.

“Surgeons have been using silicone implants since the 1960s,” says Eleanor Barone, MD, an aesthetic plastic surgeon at Advanced Dermatology and The Center for Laser and Cosmetic Surgery. Some people had suggested a link between silicone and a variety of health problems, and in 1991, the FDA concluded that the data submitted by silicone-implant manufacturers did not provide adequate information on the benefits and risks of these devices. “But we know now that silicone implants are both safe and effective.” In fact, she notes, a study just published in The Annals of Plastic Surgery found that silicone breast implants do not increase the risk of any serious diseases.

In that report, researchers at the International Epidemiology Institute in Rockville, Md., and the Vanderbilt University Medical Center in Nashville, Tenn., reviewed more than a dozen studies evaluating the risk of cancer in women with cosmetic breast implants. These studies, the researchers found, have been “remarkably consistent” in showing no evidence of an increase in any type of cancer in women with silicone implants. They also many other studies that concluded that there’s no link between breast implants and connective tissue diseases (such as fibromyalgia, systemic lupus erythematosus, and rheumatoid arthritis) or to neurological diseases such as multiple sclerosis. There’s also no evidence that children born to women with breast implants are more likely to have birth defects or other health problems.

Silicones are a family of chemical compounds made from silicon, a naturally occurring element found in sand and rock that becomes silicone when combined with oxygen, carbon and hydrogen (next to oxygen, silicon is the most common element in the earth’s crust). Silicones have been used for over 50 years in products like hairspray and moisturizing creams, as well as medical devices such as artificial joints, catheters, and facial implants.

The FDA’s decision to approve silicone-filled breast implants is good news for patients looking to improve the appearance of their breasts, says Dr. Barone. For one thing, it gives women an option over saline-filled implants. “All breast implants are made from a solid silicone rubber shell that’s filled with either saline solution (sterile salt water) or elastic silicone gel,” she explains. There are advantages and disadvantages to both types, but, generally speaking, silicone implants just look and feel more natural, Dr. Barone says.

Silicone gel is viscous, she says. “It has a thick, sticky consistency that’s a lot like human fat, which is a large component of female breast tissue.” On the other hand, saline solution isn’t compressible, so it looks – and feels – firmer. “Saline implants can feel like water balloons,” she explains. And the bigger the implant, the more that becomes a problem.

Of course, as with any other medical device or surgery, breast implants are not without risk, Dr, Barone stresses. “Any man-made device has a finite life span,” she says. “It may need to be replaced, and it can tear, although that possibility is rare.” If a saline- filled implant ruptures, the implant will deflate and the water will be absorbed harmlessly by the body. If a silicone implant ruptures, the gel may remain within the shell or rarely escape into the breast. (Today’s silicone-filled implants are less likely to rupture than earlier models, thanks to a multi-layer shell.) “If your silicone implant breaks or leaks, you might not be aware of it,” Dr. Barone cautions. For that reason, you should have an ultrasound exam or MRI screening every year to assess the condition of your implants. And just as you would if you didn’t have implants, you also should practice a monthly breast self-exam and schedule regular diagnostic breast screenings.

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