Alternatives to Silicone Breast Implants

For those considering breast augmentation, breast implants are the most commonly used technique with the most predictable results. Due to recent reports about possible complications with breast implants, there is considerable demand for alternative methods of breast enlargement. Unfortunately, an alternative with the same results does not (yet) exist, but in this article we explain alternatives such as breast lipofilling and saline-filled implants. Lipofilling Lipofilling is a technique in which fat tissue is transferred from one area to another area of the body. The fat is removed from one location using liposuction at very low pressure, so that the fat cells remain intact, and then injected elsewhere. Fat cells are living cells and must receive a new blood supply within 72 hours at the injection site in order to survive. The advantage of injecting one's own fat tissue is that it is not a foreign material, thus eliminating the risk of immune-related reactions by the body. Furthermore, no large incision in the skin is required for the injection of fat, meaning the scarring is negligible, and the breast feels and looks natural and soft. However, lipofilling also has a number of disadvantages compared to breast implants. A prerequisite for undergoing lipofilling is that there is sufficient fat tissue to transfer; for individuals with a low BMI, this means lipofilling is not an option. When harvesting fat from areas where little fat is present, there is a risk of dimples or irregularities remaining. Furthermore, good blood circulation is crucial for the transplanted fat tissue to survive, which also makes lipofilling a poor option for smokers. The survival rate of transplanted fat cells varies, making the outcome of the procedure uncertain. A realistic expectation is that approximately half of the transplanted fat cells survive. The elimination of fat cells that did not survive the procedure takes approximately 3 months. As such, it is possible that the result immediately after the procedure is spectacular but diminishes fairly quickly. In practice, this means that multiple procedures are often required to achieve the desired volume and result. Injecting large quantities of fat reduces the survival rate because there is insufficient blood supply to sustain all of that fat. Furthermore, fat cells that do not survive the transplantation can encapsulate and give rise to so-called oil cysts, which can be felt as lumps in the breast. It is therefore never possible to gain a large amount of volume with fat in one go; even with multiple operations you can typically gain just one cup size. Because multiple operations are required, the treatment is also considerably more expensive than breast augmentation with an implant. Finally, injected fat may be visible on an X-ray of the breast as small calcification spots. These calcification spots are indeed distinguishable from those seen in a precancerous stage of breast cancer and are therefore fundamentally different (lipofilling cannot cause breast cancer), but it is always advisable to mention that you have had fat injections in the breast when an X-ray is taken of the breasts. At Blooming Plastische Chirurgie, we work with a closed 'power-assisted' liposuction system. This reduces the risk of infection and increases the survival rate of the transplanted fat. Saline-filled implants Another alternative to silicone-filled implants are implants filled with a physiological saline solution. The advantage of these implants is that if they leak, only saline enters the body, which is harmless. The reason they are nonetheless not widely used is that they behave differently from silicone implants: the volume drops more quickly, making it more difficult to achieve upper pole fullness (which in many cases is actually an important motivation for breast augmentation). In addition, they feel less soft and cause more wrinkling. The outer casing of the implant is still made of silicone. Saline-filled implants carry the same risk of complications as silicone implants. Symptoms such as those of Breast Implant Illness are described just as frequently in patients with saline-filled implants as in patients with silicone-filled implants. This is because any immune-related reaction by the body is independent of leakage and can occur in rare cases when a foreign material is implanted into the body. Temporary fillers There are currently no high-quality temporary fillers on the market with which to truly create volume in the body, such as for the breasts or buttocks. Permanent fillers are prohibited in the Netherlands. The risk of complications following the injection of permanent fillers is very high. We therefore strongly advise against the use of body fillers. Conclusion In conclusion, alternatives to breast implants are available, but these procedures are also not entirely without disadvantages or the risk of complications. Every operation carries certain risks, which we discuss during a personal consultation. At Blooming Plastische Chirurgie, safety and transparency are our priorities. Should you have any questions following this article, we will be happy to answer them. Send your question to info@bloomingpc.nl.