Title: Breast implants - the news now. (saline breast implants)
Authors: Berkman, Sue Citation: Good Housekeeping, April 1993 v216 n4 p257(1)
Subjects: Breast implants_Health aspects
Reference #: A13568259
Abstract: The FDA is currently investigating saline breast implants. Doctors fear the implants may be associated with autoimmune disorders, and the implants can become hard when scar tissue forms. Breast lift may be the only available alternative if the implants are discontinued.
Full Text COPYRIGHT Hearst Corporation 1993
Last year, the Food and Drug Administration (FDA) restricted silicone breast implants - a silicone shell filled with silicone gel - because of safety worries. Now, saline implants - a silicone shell filled with sterile salt water - are under scrutiny as well.
While saline is not thought to be harmful if leaked into the body, the FDA wants to rule out a reported link to autoimmune disorders from the silicone shell.
Another concern is that any implant can obscure breast tissue. "It is almost impossible to do state-of-the-art mammography with an implant in place," says Melvin Silverstein, M.D., medical director of The Breast Center, in Van Nuys, Calif.
In addition, saline-filled devices, like the silicone-filled type, may become hard when scar tissue forms around the implant. Some women also complain that the saline implants look and feel unnatural and that the salt water settles into the lower portion of the breast.
Silicone-gel implants are currently available only to mastectomy patients who desire them for reconstruction and who also agree to be part of a clinical study to determine safety.
If saline implants are similarly restricted, the only remaining choice for women seeking augmentation (a majority of the 150,000 women who get implants each year) will be breast lift - if there is enough tissue for the surgeon to work with. There is more choice for women who want reconstruction.
A "natural" breast
"Women who lose one or both breasts to cancer now have an option that is superior to implants," says Melvyn Dinner, M.D., director of The Center for Plastic Surgery in Cleveland, Ohio.
The alternative is a surgical procedure called "flap reconstruction," which involves transferring tissue (skin and fat) from another part of the body to create a breast.
In one type of flap surgery, tissue from the abdomen or back that is still partially attached to a muscle and blood vessels is moved under the skin to the chest. In another technique, a flap of tissue is detached from the abdomen, buttock, or thigh and transplanted to the chest using microsurgery.
Flap surgery can take place at the time of mastectomy or months to years later. A key advantage of the method is that the tissue is accepted as "self," so the body won't try to isolate it by surrounding it with hard scar tissue, as with an implant.
In addition, the new breast looks more natural because it ages and fluctuates in weight like a woman's own breast.
On the downside, flap surgery results in scars at the tissue-donor site as well as the breast. And since it is major surgery, it is not suitable for women who are heavy smokers, very overweight, diabetic, or have heart disease.