Silicone and the myths surrounding it

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

In the 90s, silicone 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, to this day, spreads misinformation about silicone and breasts.

To demystify what revolves around the subject, Dr. Priscila Beatriz Oliveros, a mastologist on my team and a member of the Sociedade Brasileira de Mastologia, and I answer the main questions about silicone implants.

Silicone implants have an expiration date.

MYTH - There is no defined срок for replacing breast implants, especially since, over the years, the material has been perfected and today the segment boasts high-quality material.

Silicone implants can rupture during mammography or hide possible nodules.

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

Silicone implants can be indicated for breast reconstruction.

TRUTH – They can be indicated, but their 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 performed in breast reconstruction.

TRUTH – Some of them are:

- Reconstruction with silicone breast implants;

- Reconstruction with the latissimus dorsi muscle (located on the back) and silicone implants;

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

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

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

Silicone cannot be placed at the time of mastectomy.

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

If a larger amount of skin needs to be removed during a mastectomy, the patient must use a breast expander, a type 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 achieved. This process allows the skin to gain elasticity – then – it becomes possible to perform surgery to replace the expander with a silicone implant.

Implants prevent breasts from sagging over time.

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

Women with silicone can have problems breastfeeding.

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

Silicone implants remove breast sensitivity to touch.

MYTH - It does not affect 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 within a few weeks.

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