Breast augmentation is a common operation to improve the appearance of the breast. There are two types of breast implants-saline and silicone. The most common implant in our practice is the silicone gel mammary prosthesis. The outer shell of each implant is exactly the same-it is a silicone elastomer. What is different about each implant is what goes on the inside. The saline implants we fill with saline in the operating room. The silicone implants come pre-filled with silicone gel. Both saline and silicone implants ripple. The silicone implants ripple less. Silicone is softer, lighter, and feels more natural. It is almost impossible to tell by looking at someone if they have silicone or saline. The difference is in the feel of the implant. The saline implants require no “up-keep”. When the saline implant ruptures the body absorbs the saline almost immediately and the patient has one small breast and one large breast. The silicone implants require some monitoring at about 5 years and then again at 10 years to evaluate for a silent rupture. When we place breast implants for a cosmetic reason, the patient may be responsible for the cost of the MRI. When we place implants for breast cancer, the patient gets an MRI every year for surveillance. While not dedicated implant views we can get some information regarding the status of the implant. Patients may be responsible for the cost of the MRI depending upon insurance, co-pays, deductible, etc.
