Two options are available when considering the placement of the implant:

Implants are available with two types of surfaces:

The design of the shell is available in two forms:

There are different types of silicone gel-filled implants:

There are different types of saline-filled breast implants:

1.The implant is filled during the operation with saline (salt water) through a valve.
2.The implant is filled during the operation with saline through a valve and the volume may be adjusted postoperatively.
3.The manufacturer prefills the implant.

Breast implants are available in two shapes:

1. 80% high molecular weight silicones
2. 20% finely powdered silica
3. catalyst: small amounts (50-100 parts per million) of a tin or platinum
4. impurities:
-small amounts of (1-500 parts per million) of various smaller silicones
-trace amounts of (<5 parts per million) of volatile (readily evaporating) materials like xylene and other organic compounds (impurities)
-trace amounts (<5 parts per million) of metals (impurities).

The chemical composition of a saline-filled breast implant consists of the following:

1. 80% high molecular weight silicones
2. 20% finely powdered silica
3. catalyst: small amounts (50-100 parts per million) of a tin or platinum
4. impurities:
-small amounts of (1-500 parts per million) of various smaller silicones
-trace amounts of (<5 parts per million) of volatile (readily evaporating) materials like xylene and other organic compounds (impurities)
-trace amounts (<5 parts per million) of metals (impurities).

The shell of a saline-filled breast implant and the shell of a silicone gel-filled breast implant have the same general chemical composition.

More information about rupture/deflation:

Causes of deflation/ rupture include aging of implant,underfilling or overfilling of a saline-filled breast implant,capsular contracture, trauma or pressure, compression during mammography, damage by instruments during surgery,folding or wrinkling of the implant shell, damage during a biopsy or drainage of fluids, and too much handling of implant especially during TUBA procedure (Trans- umbilical breast augmentation).

1.Intracapsular rupture-Gel is contained within fibrous capsule. These ruptures are typically silent ruptures, which means that there isn't a visible change of the breast and the patient doesn't feel a difference in the breast. MRI is currently the best method for detecting a rupture of a silicone-gel filled implant.

2.Extracapsular rupture- Gel migrates out of the scar capsule and can form granulomas in the breast, chest wall, arm, and armpit. Silicone can also travel to organs far from the site of rupture (e.g. the liver). A patient may experience a change in the size and shape of the breast, hard lumps in the chest, tenderness or pain, numbness, tingling, or burning. This type of rupture is called symptomatic.

1.This occurs when saline escapes through a faulty valve or a tear in the elastomer shell.

2.Deflation can be immediate or slow (taking several days to notice).

Systemic complications associated with breast implants include the following:

Mycobacterial infections also occur.

Toxic Shock Syndrome is a rare life-threatening syndrome caused by a bacterial infection that can occur after implantation. Symptoms include the following: fever, headache, sore throat, lethargy, vomiting, dizziness, diarrhea, a rash that looks like a sunburn, confusion and fainting. It may rapidly progress to severe and intractable shock. A patient should seek medical treatment immediately for this condition.

Silicone-gel breast implants and systemic complications

The shell surrounding a silicone gel-filled breast implant is a silicone polymer that can break down due to disruption of the shell or a time-related lipolysis reaction. Silicone gel from the filler can travel into the surrounding tissue. It can migrate to distant organs after it escapes from the capsule. Also, chemicals including silica and platinum can leach from the shell and migrate into the capsule surrounding the implants. Cells in the immune system called macrophages pick up these chemicals, then travel through the lymphatic system, and distribute them throughout the body to the peripheral nervous system, central nervous system, and organs. A chronic illness may develop that can affect every organ system in the body.

Gel bleeds cause systemic complications in some patients with silicone gel-filled implants

A Gel bleed occurs when the silicone gel in breast implants slowly leaks through the semi-permeable membrane envelope. The gel then migrates to the capsular area around the implants. Cells in the immune system called macrophages pick up the gel, break it down into Silica and Silicon, and then distribute these chemicals throughout the body. The result is immune dysfunction. The silicone gel also causes oxidants to form that can damage DNA, enzyme systems, and cell walls. A chronic illness may develop that can affect every organ of the body.

Saline-filled breast implants and systemic complications

The shell surrounding a saline-filled breast implant is a silicone polymer that can break down. Chemicals can leach from the shell and migrate into the capsule surrounding the implants.This occurs in textured implants more than smooth saline-filled breast implants. Cells in the immune system called macrophages pick up these chemicals, then travel through the lymphatic system, and distribute them throughout the body. Silica has been reported in lymph nodes in saline breast implant recipients who have never had silicone gel implants. A chronic illness may develop that can affect any and every organ system in the body.

Symptoms associated with systemic complications

According to Andrew W. Campbell, M.D. , Medical Director of the Center for Immune, Environmental, and Toxic Disorders, these are the most common complaints compiled from over 4,000 patients with silicone prosthetic devices:

Patients with breast implants should be aware that they affect mammography:

Additional surgeries will be necessary at some point after initial augmentation and may include:

Concerns about breast feeding after implantation

Effects on Children

Research has demonstrated that children with ventriculoperitoneal shunts and other types of silicone implants may experience complications. Second-generation effects are also possible, which may be due to one of the following:

-silicone leaching from the elastomer shell of a breast implant

-the rupture of a silicone gel-filled breast implant

• -a gel bleed

Breast feeding a child may result in the development of an illness. An unborn child may also be affected via the placenta.

Factors that are associated with the degree of deformity at explantation include:

The worst deformities after explantation are associated with the following:

Some patients have a procedure called a donut mastopexy when the breast implants are removed. This is a type of breast lift that involves removing the top layer of dermis to reposition the nipple areolar complex and removing excess skin. The surgeon should change gloves and instruments between explantation and the mastopexy to avoid contamination with bacteria found in the scar capsule. Contamination can cause hypertrophic scars at the site of incision. If scarring and asymmetry occur after explant surgery, a revision surgery may be necessary to correct these problems.

If silicone has leaked from a breast implant then en bloc implant resection is necessary

A procedure called en bloc implant resection is used to remove the scar capsule around the implant to keep silicone from being released into the system.

Silicone that is picked up by the lymphatic system travels into the axillary lymph node system and can be detected on an ultrasound. Removal of lymph nodes may not be needed unless they are abnormal. Scarring that can result from excising the lymph nodes can interfere with the channels that normally drain the breasts.