Two options are available when considering the placement of the implant:

Implants are available with two types of surfaces:

The design of the shell is available in two forms:

There are different types of silicone gel-filled implants:

There are different types of saline-filled breast implants:

1.The implant is filled during the operation with saline (salt water) through a valve.
2.The implant is filled during the operation with saline through a valve and the volume may be adjusted postoperatively.
3.The manufacturer prefills the implant.

Breast implants are available in two shapes:

Chemical Composition

The chemical composition of a silicone gel-filled breast implant includes the following:

1. 80% high molecular weight silicones
2. 20% finely powdered silica
3. catalyst: small amounts (50-100 parts per million) of a tin or platinum
4. impurities:
-small amounts of (1-500 parts per million) of various smaller silicones
-trace amounts of (<5 parts per million) of volatile (readily evaporating) materials like xylene and other organic compounds (impurities)
-trace amounts (<5 parts per million) of metals (impurities).

The chemical composition of a saline-filled breast implant consists of the following:

1. 80% high molecular weight silicones
2. 20% finely powdered silica
3. catalyst: small amounts (50-100 parts per million) of a tin or platinum
4. impurities:
-small amounts of (1-500 parts per million) of various smaller silicones
-trace amounts of (<5 parts per million) of volatile (readily evaporating) materials like xylene and other organic compounds (impurities)
-trace amounts (<5 parts per million) of metals (impurities).

The shell of a saline-filled breast implant and the shell of a silicone gel-filled breast implant have the same general chemical composition.

Complications

Local complications associated with breast implants include the following:

More information about rupture/deflation:

Causes of deflation/ rupture include aging of implant,underfilling or overfilling of a saline-filled breast implant,capsular contracture, trauma or pressure, compression during mammography, damage by instruments during surgery,folding or wrinkling of the implant shell, damage during a biopsy or drainage of fluids, and too much handling of implant especially during TUBA procedure (Trans- umbilical breast augmentation).

1.Intracapsular rupture-Gel is contained within fibrous capsule. These ruptures are typically silent ruptures, which means that there isn't a visible change of the breast and the patient doesn't feel a difference in the breast. MRI is currently the best method for detecting a rupture of a silicone-gel filled implant.

2.Extracapsular rupture- Gel migrates out of the scar capsule and can form granulomas in the breast, chest wall, arm, and armpit. Silicone can also travel to organs far from the site of rupture (e.g. the liver). A patient may experience a change in the size and shape of the breast, hard lumps in the chest, tenderness or pain, numbness, tingling, or burning. This type of rupture is called symptomatic.

1.This occurs when saline escapes through a faulty valve or a tear in the elastomer shell.

2.Deflation can be immediate or slow (taking several days to notice).

Systemic complications associated with breast implants include the following:

Mycobacterial infections also occur.

Toxic Shock Syndrome is a rare life-threatening syndrome caused by a bacterial infection that can occur after implantation. Symptoms include the following: fever, headache, sore throat, lethargy, vomiting, dizziness, diarrhea, a rash that looks like a sunburn, confusion and fainting. It may rapidly progress to severe and intractable shock. A patient should seek medical treatment immediately for this condition.

Silicone-gel breast implants and systemic complications

The shell surrounding a silicone gel-filled breast implant is a silicone polymer that can break down due to disruption of the shell or a time-related lipolysis reaction. Silicone gel from the filler can travel into the surrounding tissue.It can migrate to distant organs after it escapes from the capsule. Also, chemicals including silica and platinum can leach from the shell and migrate into the capsule surrounding the implants. Cells in the immune system called macrophages pick up these chemicals, then travel through the lymphatic system, and distribute them throughout the body to the peripheral nervous system, central nervous system, and organs. A chronic illness may develop that can affect every organ system in the body.

Gel bleeds cause systemic complications in some patients with silicone gel-filled implants

A Gel bleed occurs when the silicone gel in breast implants slowly leaks through the semi-permeable membrane envelope. The gel then migrates to the capsular area around the implants. Cells in the immune system called macrophages pick up the gel, break it down into Silica and Silicon, and then distribute these chemicals throughout the body. The result is immune dysfunction. The silicone gel also causes oxidants to form that can damage DNA, enzyme systems, and cell walls. A chronic illness may develop that can affect every organ of the body.

Saline-filled breast implants and systemic complications

The shell surrounding a saline-filled breast implant is a silicone polymer that can break down. Chemicals can leach from the shell and migrate into the capsule surrounding the implants.This occurs in textured implants more than smooth saline-filled breast implants. Cells in the immune system called macrophages pick up these chemicals, then travel through the lymphatic system, and distribute them throughout the body.Silica has been reported in lymph nodes in saline breast implant recipients who have never had silicone gel implants. A chronic illness may develop that can affect any and every organ system in the body.

Symptoms associated with systemic complications

According to Andrew W. Campbell, M.D. , Medical Director of the Center for Immune, Environmental, and Toxic Disorders, these are the most common complaints compiled from over 4,000 patients with silicone prosthetic devices:

Multiple Chemical Sensitivity

Multiple Chemical Sensitivity is an acquired chronic condition with symptoms that recur reproducibly in response to low levels of exposure to multiple unrelated chemicals affecting multiple organs. Symptoms improve or resolve when incitants are removed. MCS may occur after single, high-dose exposures (i.e. chemical spills) or repeated low-level exposures to chemicals. Chemicals may be inhaled, ingested, absorbed by the skin or implanted (i.e. breast implants). A patient with MCS may not be able to eliminate chemicals in his or her body because the chemicals enter the body more rapidly than the body is able to eliminate them. The chemicals may then be stored in the heart, liver, and brain.

The symptoms of M.C.S. include, but are not limited to, the following: fatigue, headache, trouble breathing, muscle pain and joint pain, dizziness, irregular heartbeat, seizures, cognitive dysfunction including confusion, lack of memory, and lack of concentration. M.C.S. is similar to an allergy in that patients who are affected react to substances that are not harmful to others, but the biological mechanisms are dissimilar. Those with M.C.S. may appear healthy even when they are very ill.

The elastomer shells of breast implants contain the component silica. Silica is a potent stimulant of nitric oxide synthesis and may act, therefore to stimulate the NO/ONOO- cycle in multiple chemical sensitivity.

A specific sensitivity to the silicone elastomer is more likely to be a true allergy.

Please read Multiple Chemical Sensitivity - The End of Controversy for more information about MCS.

Biotoxins and Implants

A biotoxin is any toxin produced by a living organism (animal, plant, fungus, bacteria). A toxin is a biologically produced substance that causes injury to the health of a living thing on contact or absorption, by interacting with biological macromolecules such as receptors and enzymes. Toxicity may be acute, chronic, or both.

Biotoxins from mold cause an illness in some symptomatic patients with silicone and saline-filled implants. A deficit in the ability to detect visual patterns in these patients can be documented by using the VCS test. Patients with neurological symptoms may have abnormal myelin basic protein antibody tests. Implant recipients with endocrine problems may have abnormal MSH tests. Patients with mental clouding may have abnormal VEGF tests. Implant recipients who have a great deal of pain may have abnormal MMP-9 tests. Some patients have a certain HLA type known to be sensitive to biotoxins.

Visit www.chronicneurotoxins.com for more information regarding biotoxins.

Platinum Toxicity

Platinum is used as a catalyst in the manufacture of gel components and the elastomer shell of silicone breast implants. Women exposed to silicone breast implants have platinum levels that exceed that of the general population. In the human body implants are exposed to stress and heat which can cause deterioration and oxidation. The oxidation states of the platinum indicate that the exposure may be toxic. Platinum species remain in the body for a long time after implants are removed.Platinum salts have been associated with carcinogenicity and neurotoxicity.

Petition to the FDA

Additional concerns

Some patients may develop breast pain after augmentation mammoplasty:

Patients with breast implants should be aware that they affect mammography:

Additional surgeries will be necessary at some point after initial augmentation and may include:

Concerns about breast feeding after implantation

Effects on Children

Research has demonstrated that children with ventriculoperitoneal shunts and other types of silicone implants may experience complications.

Second-generation effects are also possible, which may be due to one of the following:

• silicone leaching from the elastomer shell of a breast implant
• the rupture of a silicone gel-filled breast implant
• a gel bleed

Breast feeding a child may result in the development of an illness. An unborn child may also be affected via the placenta.

Breast Implants and Suicide

According to at least four studies in recent years, women with breast implants are more likely to commit suicide than women in the general population.Psychiatric illnesses may be related to systemic complications occurring after augmentation. In most cases warning signs are evident to those closest to the patient.

Persons who are seriously contemplating suicide may:

• Give away prized possessions, make a will, or put affairs in order
  
• Withdraw from others around them
  
• Have a change in sleeping or eating habits
  
• Lose interest in prior activities and relationships
  
• Experience a lift in spirits after being very depressed due to the fact that the person feels a sense of relief thinking that all of her problems will be solved by suicide and the person has the energy to follow through with an attempt
  
• Have a prior suicide attempt
  
• Have a recent loss (i.e. death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, and loss of sexual interest)
  
• Have a change in personality
  
• Have menstrual abnormalities (missed periods)
  
• Have a fear of losing control
  
• Have low self-esteem
  
• Feel hopeless
  
• Have difficulty concentrating and a decline in the quality of work
  
• Have a plan to commit suicide
  
• Be unwilling to communicate
  
• Neglect appearance
  
• Be careless
  
• Exhibit hostile behavior
  
• Be late frequently
  

Threats of suicide must be taken seriously. The National Suicide Prevention Lifeline provides aid to individuals in a suicidal crisis by connecting them to the closest suicide prevention and mental health service provider: 1-800-273-TALK (8255). For more information about suicide visit the Suicide Crisis Center Web Site.

Explantation

Explantation may be necessary at some point for patients with breast implants.Patients who have their implants removed without replacement may have a cosmetically undesirable appearance of the breasts that may be irreversible.

Changes in appearance may include:

Factors that are associated with the degree of deformity at explantation include:

The worst deformities after explantation are associated with the following: