Smooth silicone implants are considered the safest option.
In the field of aesthetic plastic surgery, the health aspect of breast implants basically asks which prosthesis results in the highest level of compatibility with the human body and the lowest risk of late complications. For many years, the discussion about saline versus silicone gel breast implants has been at the center of controversies. However, today biomedical-engineering achievements focus both on the nature of the elastomer shell and the topography of the implant surface besides the content of the implant.
At Lin Health Europe Clinic, to us, the “healthiest” implant is one that has the least response of the body to the foreign matter and is in line with the natural tissue movement. The health safety of an implant is on three main factors: chemically the inertness of the filling material, the strength of the shell (which inversely relates to the rupture rate), and finally, the way the surface topography interacts with the immune system. It is useful for those patients going to Turkey for breast augmentation surgery, deciding among different implants, if they grasp the differences and advantages one gets from the old liquid silicone to the now tolerant, highly cohesive gel (form-stable) implants.
Saline vs. Silicone: Which Is More Inert?
Simply evaluating the ingredients for toxicity, saline implants have often been regarded as the safest choice, as they are basically filled with sterile salt water. When a rupture happens in the shell, the saline is naturally absorbed again through the skin and excreted by the body and the breast simply deflates. This feature of the problem is immediately identified and the biological neutrality undoubtedly gives relaxation to most patients. But, on the downside, saline implants are prone to leak more mechanically and can lead to aesthetic complications like visible wrinkling, which then often require surgical correction. Repeated surgeries themselves are a risk to health.
On the other hand, today’s silicone implants are filled with a medical-grade cross-linked gel. Early versions of silicone implants possessed the risk of “gel bleed”, which implied small microscopic leaking, whereas currently, the semi-solid gels used are chemically inert. There is no cause-and-effect relationship genetically between silicone implants and systemic autoimmune diseases which was the assumption for years until the FDA and European health authorities examined the evidence and issued their joint statements. So in terms of healthiness of materials, silicone and saline are equally healthy as clinically confirmed, but from longevity and non-revision-point-of-view, silicone has the upper hand.
Revolution of the Cohesive Gel (Gummy Bear)
The most remarkable development leading to safer implants is the introduction of form-stable or cohesive gel implants, termed colloquially as “Gummy Bear” implants. These implants, contrary to previous generations filled with liquid silicone, contain a gel that is highly cross-linked to the degree that it retains its form even when the implant is cut or ruptured. This characteristic obviates one of the biggest concerns with prior generations which is the dispersion of silicone into the locoregional lymph nodes through migration.
Health-wise, the cohesive gel implant is really the epitome of shell integrity. The gel’s higher viscosity makes the implant a much stronger unit, thus not only preventing the rupture of the implant but also significantly lowering the possibility of rupture going unrecognized. What is more, the fact that the gel replicates the density of the normal breast parenchyma means there will be less irritation and harm to the surrounding tissues. Thanks to this compositional stability, risks such as bottoming out – the breast tissue dropping below the level of the implant and the mulching of the breast tissue leading to atrophy are drastically minimized. Ultimately, with this new technology, preservation of the aesthetics and health of the breast mound even at an older age is ensured.
Surface Texture and ALCL Considerations
The topography of the interface is a major determinant of implant safety – smooth vs. textured. Textured implants were once considered the solution for the problem of capsular contracture (the pathological contracture of the scar tissue). However, with the aid of recent pathology, the association between the usage of textured implants (macro-textured) and the presence of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) has been established. BIA-ALCL is a rare T-cell lymphoma that develops in the tumor capsule.
It is, therefore, not surprising that the hallmark of the “healthiest” surface is no longer the same as before. New surgical protocols prefer smooth and nano-textured surfaces, such as Motiva’s, which have a low surface roughness classification. These micro-surfaces reduce chronic inflammation and tissue friction at the interface, leading to very high biocompatibility. What’s more, when an implant is naturally mobile within the pocket, it lessens the development of a dense, thick fibrous capsule. By putting in smooth or micro-textured devices, surgeons significantly lower the inflammatory risk generated by the highly-aggressive texturing procedure.
Minimizing Biofilm and Capsular Contracture
The safest implant is considered to be one that is introduced via strict aseptic implanting technique as capsular contracture formation due to implant surgery remains the most commonly experienced problem in the long run. According to the latest biomedical studies, the majority of such reactions stem from either subclinical infections or biofilm culture on implant bacterial colonies mainly (also known as biofilm).
To increase the margin of safety, surgeons often apply the “No-Touch” technique that involves the use of a Keller Funnel. The sterile delivery sleeve enables direct offering of the implant into the breast without physical contact between the skin and the surgeon’s gloves or the patient’s skin. This largely curtails bacterial contamination as well as the risk of contracture which is the subsequent infection phase. Besides that, the implants are primarily placed in the submuscular plane (Dual Plane). In this way, implant access to the breast ducts is restricted, thus preventing bacteria from coming from the ducts to the implant. What is more, the good blood supply of the surrounding soft tissues provides an excellent environment for healing and thereby brings about healthy tissue repair.
Breast Implant in Turkey
Choosing a breast implant together with your doctor is a very personal decision. Lin Health Europe Clinic opts for only top-grade, FDA-approved and CE-marked devices for its patients. We are situated in Turkey where our clinic follows the European highest standards of safety in terms of device sterilization and surgical hygiene. Our collaborations with manufacturing giants such as Mentor and Motiva are exclusive. Not only do they provide a warranty on the long-term of the implants but also have a track record of very safe and reliable products.
We follow the “Tissue-Based Planning” paradigm; this revolutionary concept confines the patient’s tissue-based measurements and elasticity instead of recklessly going for a volume increase. An implant whose size is in harmony with the body and with adequate tissue support may be the one to last decades without any problem. Lin Health Europe Clinic has the perfect combination of sterile No-Touch, cutting-edge cohesive gel technologies to give you the best result, one which is not only aesthetically stunning but also biologically sound and consistent over time.
Frequently Asked Questions About Healthy Breast Implants
The lowest recorded rupture rates are for the so-called gummy bear implants or form-stable cohesive gel implants. Their gel stays in place even if the shell is broken because of the highly crosslinked structure of the gel.
Saline implants are only safer in that the filling is just sterile saltwater which gets absorbed if it leaks. On the other hand, today’s cohesive silicone implants are just as safe and have less rippling and deflation.
In fact, switching to smooth or nano-textured implants is one of the ways people try to avoid chronic inflammation. Very rough implants have been linked with a rare lymphatic condition and are therefore less frequently used.
Turkey provides an opportunity to receive treatment from world-class surgeons using the latest FDA-approved implant technologies in accredited hospitals. Patients enjoy the highest level of safety and comprehensive care packages at a great value.
Nowadays implants are not meant to last the whole life of a person but their design is such that they will work much longer than the previous ones. Instead of opting for a replacement, most surgeons advise checking the condition of the implants with an ultrasound or an MRI after ten years.
De Boer, M., et al. (2017). Breast Implants and the Risk of Anaplastic Large-Cell Lymphoma in the Breast. JAMA Oncology.
Adams, W. P., et al. (2017). The Process of Breast Augmentation: Four Steps to Predictable Outcomes. Plastic and Reconstructive Surgery.
Maxwell, G. P., & Gabriel, A. (2014). Biofilm: A visible villain in breast augmentation. Aesthetic Surgery Journal.
Spear, S. L., & Murphy, D. K. (2014). Natrelle round silicone breast implants: Core study results at 10 years. Plastic and Reconstructive Surgery.
