Dr. Ted Eisenberg Publishes Saline vs. Silicone Breast Implant Article

    PHILADELPHIA, PA, April 28, 2009 /24-7PressRelease/ -- There's an opinion that's asserted by breast implant manufacturers -- and echoed by many physicians -- that silicone gel-filled implants are better than saline-filled implants. In the view of Philadelphia, Pennsylvania cosmetic breast surgeon Dr. Ted Eisenberg "it ain't necessarily so."

Ted. Eisenberg, DO, FACOS, FAACS, www.lookingnatural.com/about.html who has performed breast augmentation surgery on more than 4,000 women, expressed his opinion in a guest editorial published in the March 2009 issue of The American Journal of Cosmetic Surgery.

When the FDA moratorium on silicone gel-filled implants began in 1992, cosmetic surgeons in the United States were limited to using saline implants for primary breast augmentation surgery. In November 2006, the FDA approved silicone gel implants. Soon after, the San Diego Union-Tribune reported "that plastic surgeons said they would quickly become preferred among the nearly 300,000 women in this country who have breast implants each year." Mentor, a breast implant manufacturer, called the decision a "historic moment," while Allergan, the other silicone gel implant manufacturer, said it "created new options for women." The main selling point was that silicone gel implants feel more natural.

Plastic surgeon Dr. Ted Eisenberg reported that in the two-year period from November 2006 through October 2008, only 4 of his 709 patients requested silicone gel-filled implants. "They have not become preferred over silicone implants," he says. "Obviously, I have not placed silicone gel implants in an equal number of patients, so I cannot make a direct comparison." In his article, he explained what he considers the obvious advantages of saline and why he will continue to recommend saline when asked.

When you hold a saline implant in one hand and a silicone gel implant in the other, the gel feels softer. But when the saline implant is placed behind the muscle (Dr. Eisenberg places them in the subpectoral dual space plane), it feels similar to a silicone gel implants in most patients. Also, because a portion of her own breast overlies the muscle and implant, a woman usually can't differentiate an implant -- whether silicone or saline -- from her breast.

Availability: Saline breast implants are available to women 18 and older who wish to improve their appearance, while silicone gel implants are restricted to women 22 and older. Although only about 10 percent or less of Dr. Eisenberg's patients are in the 18-21 age range, these young woman who have not developed report that they are self-conscious when they are on the beach with their peers and that they can't find clothing or swimsuits that fit.

Implant Size: The Mentor Product Insert Data Sheet warns that silicone gel implants larger than 350ccs "may increase the risk of developing complications." Dr. Eisenberg says, "On average, my patients want more volume than 350ccs. Saline implants range in size from 125 ccs to 775 ccs, and I've used all of these sizes, with an average size of 433 ccs. I've experienced very few complications using saline implants."

At Dr. Eisenberg's office in Philadelphia, patients choose their size by looking at pictures of women similar to them in height, weight, breast diameter and starting volume of breast tissue, as if they are looking in a mirror at themselves. They see pictures of women at nine months post-op, when the implants have fully settled, and pictures of women in clothes. His website features information about breast implants and includes a section of before and after pictures from some of Dr. Eisenberg's breast augmentation patients. www.lookingnatural.com/beforeandafter.html

Incision Size and Ease of Placement: "The saline implants, which are empty, can be folded and then placed through a small incision. My incisions are usually about 3 cm, whereas the pre-filled silicone-gel implant requires a 5-7 cm incision on average," Dr. Eisenberg explains. "Also, it's much easier, and requires less dissection, to put an empty implant through an incision than to try to manipulate --- without breaking -- a gel-filled implant."

Rippling: In Dr. Eisenberg's experience, rippling is a very rare occurrence -- even nine months or more after surgery, when the skin is fully stretched, the muscle fully relaxed and the breasts completely healed into their final shape. Rippling might occur if a woman has had a significant weight loss with a corresponding loss of body fat, or if moderately droopy breasts get significantly droopier and the skin becomes very thin after childbirth.

"If a woman were dissatisfied with the feel or look of the rippling, she would be a good candidate for an exchange to a silicone gel-filled implant, but only at this point," Dr. Eisenberg says.

Implant Rupture: When a saline implant deflates, the breast returns to its original size, and the deflation is very obvious. When a silicone gel implant ruptures, the cohesive gel relatively maintains its shape, and there is usually no physical sign of this change. Therefore, to evaluate these implants for rupture, the implant companies recommend that patients have an MRI three years after surgery and every two years thereafter. These MRIs are not covered by insurance.

To top it off, silicone gel implants cost about $1000 more per pair than saline implants.

Saline vs. silicone? "If a patient requests silicone gel implants, no problem," Dr. Eisenberg says. "But if a patient asks my opinion, I recommend saline, without hesitation."

Dr. Eisenberg has over 20 years of experience with cosmetic breast surgery and is double board-certified in General Surgery and Plastic and Reconstructive Surgery. For more information regarding cosmetic surgery and breast augmentation in Philadelphia, Pennsylvania, visit www.lookingnatural.com.

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