Silicone and the myths surrounding it

In the 80s, plastic surgery underwent a great revolution when it was discovered that silicone could be used as an alternative for breast reconstruction in women.

In the 90s, silicone breast implants gained the spotlight and became a great ally for self-esteem, as they began to be used for aesthetic purposes to enhance the female body. But with all this, came the fake news that, even today, spreads wrong information about silicone and breasts.

To demystify what revolves around the topic, I and Dr. Priscila Beatriz Oliveros, a mastologist from my team and a member of the Brazilian Society of Mastology, answer the main questions about silicone breast implants.

Silicone breast implants have an expiration date.

MYTH - There is no defined deadline for replacing breast implants, especially because, over the years, the material has been perfected and today the segment has material of excellent quality.

Silicone breast implants can rupture during a mammogram or hide possible nodules.

MYTH - The implant does not prevent mammography, an examination that should be performed annually after 40 years of age. When the silicone is inserted, an extra position called Eklund is used to mobilize the implant, which allows for better visualization of the breast tissue.

Silicone breast implants can be indicated for breast reconstruction.

TRUTH – It can be indicated, but its use is not mandatory. This decision depends on the patient's breast shape, her wishes, and her clinical condition, as well as the relationship of trust between her and her doctor.

There are several techniques that can be used in breast reconstruction.

TRUTH – Some of them are:

- Reconstruction with silicone breast implants;

- Reconstruction with the latissimus dorsi muscle (located in the back) and silicone implant;

- Reconstruction with a breast expander, with the objective of preparing and stretching the tissues for receiving the silicone implant;

- Reconstruction with fat grafting removed from the abdomen or thighs through liposuction;

- Reconstruction of the nipple and areola so that the reconstructed breast looks as much like the original breast as possible.

Silicone cannot be placed at the time of mastectomy.

DEPENDS - First of all, it is necessary to analyze the proposed oncological treatment, since breast reconstruction with silicone implants cannot always be performed immediately, especially in cases where a lot of skin is removed or a complementary treatment with radiotherapy precedes it.

If, during the mastectomy, a larger amount of skin needs to be removed, the patient needs to use a breast expander, a kind of silicone balloon that is placed during the mastectomy surgery under the pectoral muscle so that, after the surgery has healed, it can be filled with saline solution during outpatient visits until the desired volume is reached. This process allows the skin to gain elasticity – then – it is possible to perform a surgery to replace the expander with a silicone implant.

Implants prevent breasts from sagging over time.

MYTH - Many factors interfere with breasts sagging over time, such as skin elasticity, the weight of the mammary gland, and when there are silicone implants, the weight of the implant can also interfere.

Women with silicone can have problems breastfeeding.

It NORMALLY does not interfere. This is because the implant is below the gland or even under the pectoral musculature. During placement, there is almost no trauma to the mammary gland.

Silicone breast implants remove breast sensitivity to touch.

MYTH - It does not interfere with sensitivity, but it will depend on the surgery performed on the breasts. If the implant is very large, it can happen, but sensitivity usually returns in a few weeks.

*Dr. Fernando Amato is a plastic surgeon, a full member of the Brazilian Society of Plastic Surgery, a member of the International Society of Aesthetic Plastic Surgery (ISAPS) and the American Society of Plastic Surgeons (ASPS).