How Silicone Is Used in Breast Implants

Silicone is a polymer with many uses in personal care products and surgical implants. It can be found in liquid, gel, or rubber-like solid forms. 

Breast implants are used in breast augmentation and can be placed under or over the muscle. They are also used in breast reconstruction after a mastectomy to recreate a breast mound. Implants are silicone sacs filled with either sterile salt water (saline) or silicone gel.

Learn more about silicone's advantages, use in breast implants, risks, and safety.

Advantages

Silicone is made of silicon, oxygen, and other elements, usually carbon and hydrogen. Silicone has many advantages, including:

• Stable at high temperature
• Resistant to aging
• Resistant to sunlight
• Resistant to moisture
• Resistant to extremes in temperature
• Soft consistency (feels like a natural breast when used in implants)
• Less rippling when compared to saline implants
• Cohesive (maintains shape even with leakage)

Silicone Breast Implants

The most well-known use of silicone is as breast implants for breast surgery. Breast implants are medical devices implanted under the breast tissue or muscle of the chest to either increase breast size (breast augmentation) or help reconstruct the breast after a mastectomy.

Breast implants are either saline-filled or silicone gel-filled. Both types of implants have a silicone outer shell. Silicone implants are those with a silicone inner filling. They are very popular and come in various shapes, volumes, and textures.

Traditional silicone gel can cause a silent, slow leak, that is only detectable with magnetic resonance imaging (MRI). "Gummy bear" implants are newer silicone implants that are highly cohesive. They will maintain their shape and do not leak, even if there is a tear.

For patients with silicone gel-filled breast implants, an MRI is recommended every five to six years after implantation and every two years afterward. The MRI screens for a silent rupture which is the leakage of silicone from the implant into the tissue around the implant. This recommendation also includes gummy bear implants as the MRI can detect a rupture in the outer shell.

Risks

The risks for silicone and saline breast implants are similar. They include:

• Capsular contracture (scar tissue that forms around the implant, creating a capsule)
• Pain in the breast
• Infection (rare)
• Numbness in the nipple
• Leakage or rupture of the implant
• Undesired aesthetic (appearance) results and reoperation
• Breast implant illness

To correct some of these complications, additional surgery may be required. The United States (U.S.) Food and Drug Administration (FDA) notes that breast implants are not meant to last a lifetime, and the longer you have them, the more likely you will need surgery to remove or replace them. Most saline implants last 10 to 20 years before needing to be replaced.

Safety

The FDA issued a safety update in 2011 and said silicone gel breast implants are reasonably safe when used as labeled. They stated there is "no apparent association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems."

There have been ongoing studies to continue to monitor safety risks. In 2019, the FDA gave recommendations to increase the safety of silicone implants including:

• Better product labeling with a boxed warning to inform patients of significant risks of breast implants
• Updated silicone gel-filled breast implant rupture screening recommendations
• A patient decision checklist
• Description of materials and chemicals used in breast implants
• Patient device cards

One 2016 review published in the Annals of Internal Medicine concluded, "The evidence remains inconclusive about any association between silicone gel implants and long-term health outcomes. Better evidence is needed from existing large studies, which can be reanalyzed to clarify the strength of associations between silicone gel implants and health outcomes".

Summary

Silicone is a substance that comes in liquid, gel, or rubber-like form. It is used in breast implants during augmentation or reconstructive surgery. All breast implants have a silicone sac, some contain saline (salt water) while others are filled with silicone. 

Silicone implants are known for their soft feel which is an advantage as it feels more like real breast tissue. They also have less rippling under the skin than saline implants. 

Overall, the FDA has deemed silicone implants safe. However, there are risk factors including pain in the breast, decreased nipple sensation, poor cosmetic outcomes, and more. Most saline implants last 10-20 years before needing to be replaced.

A Word From Verywell

Deciding to have breast augmentation or reconstruction are big decisions that require a lot of choices, including the type of breast implant. Saline is a popular choice as many people say they look and feel more like a natural breast.

If you are considering implants, talk with a plastic surgeon who specializes in breast surgeries. They can show you different implants and before and after photos. This will give you a better idea of what may best suit your body type and desired results.