Opinion on Breast Augmentation typesby Joseph Perlman, buy MD

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By Joseph Perlman, MD

Approximate 400,000 women will have breast augmentations this year. About one half of that group will be between the ages of 20 and 35 and the other half between 35 and 60.Most of the women in the first age group are seeking breast augmentation before they’ve had children. In the second set, most are women who have already had children and have lost volume and have a slight sagging.

As in all cosmetic procedures, the treatment plan has to be individualized for that particular patient. Patients need to understand the technical aspects of the procedure itself, such as implant size, incision location, and risks associated with the procedure. They also need to know about the types of implants.

Implants today are all made with a silicone shell. The saline implants come from the manufacturer empty and are filled with saline once they are placed into the pocket. Silicone implants come pre-filled. Although the silicone implants were off the market in the United States for 15 years while the FDA investigated their safety, they are now back on the market and in my practice account for 60% of all breast implants that I use. A recent FDA panel of experts reviewed the data compiled over the last four years since silicone implants were allowed back on the market in the US for breast augmentation. Their data confirm the fact that there are no documented medical illnesses related to silicone implants.

There are pros and cons to silicone and saline. Both have a rupture rate of about 1% per year. When a saline implant ruptures, it goes flat within a matter of a few days. A silicone implant, because of its thick gel, would be difficult to determine if it’s ruptured. There may not be any change at all in the shape. For this reason, the FDA recommends that women have an MRI performed every 3-5 years. This is only a recommendation and not a requirement. The silicone implants feel much softer in most instances and hence more natural in look and feel.

Implants do not have to be replaced on a regular basis, unless you are having problems with them or wish to change to a different size.


Dr. Joseph Perlman is a double American Board Certified Plastic Surgeon, who earned his Medical Degree from the prestigious Brown University in 1976. Dr. Perlman is currently an active member of multiple medical organizations around the country which include: The American Society of Plastic Surgeons, The American Society for Aesthetic Plastic Surgery, the Texas Medical Association and the American Society of Bariatric Plastic Surgeons.
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