Post-mastectomy, women prefer silicone implants
November 8th, 2010
12:01 AM ET

Post-mastectomy, women prefer silicone implants

Women who choose silicone implants after a mastectomy tend to be more satisfied with their breasts than women who get saline-filled implants, according to a new study.

Like women who get cosmetic implants, those who get silicone implants as part of breast reconstruction tend to be happier with the look and feel of the breast.

"This is not to say that every woman should choose silicone," said Dr. Colleen McCarthy, the study's lead author and assistant attending surgeon at Memorial Sloan-Kettering Cancer Center. "But many women [in the study] were comfortable with the idea of silicone."

Women in the study who received saline implants were also satisfied, said McCarthy. It's just that those who chose silicone implants were slightly more satisfied.

Study participants included 482 women who had had either one or both breasts removed after a cancer diagnosis. Each filled out a questionnaire about how satisfied she felt about her breast shape, feel, appearance - and their own feelings of "normalcy" - post-mastectomy.

According to the study, appearing today in the journal Cancer, "reconstruction of the breast mound using a silicone gel implant generally allows for a softer, more natural-feeling breast with less visible... wrinkling compared with saline-filled devices."

That said, silicone implants' somewhat checkered past (they were restricted by the Food and Drug Administration for 14 years because of safety concerns) is a deterrent for some patients, according to McCarthy.

"What we tell women is that silicone implants are safe," said McCarthy. "But some women say, 'I don't need anything else to worry about.'"

The concern stems from the possibility of an implant rupturing. With saline, a tear or leak would be obvious: As the water leaked out, the breast would quickly deflate. Conversely, silicone tends to stay put.  Leakage or tearing might not noticeably change how the breast feels - and no long-term studies exist about the risk, if any, for women if some silicone migrates from the breast to the rest of the body.

For that reason, women who get silicone implants post-mastectomy are advised by the FDA to get an MRI three years after implantation, and every two years after that.

soundoff (52 Responses)
  1. fuyuko

    why is their air in the one on the right? Is that deliberate? Personally, I'd go for saline myself. Less risk.

    November 8, 2010 at 09:36 | Report abuse | Reply
    • Bluebird71

      After a bilateral mastectomy I had immediate reconstruction and we (my plastic surgeon and I) opted for saline implants. The saline implants were ok, but that air bubble was disturbing. Because of needing radiation I had to have one removed and after I healed up from radiation I replaced both with silicone. I love them!! So much softer and no funny air bubble. I did wear a prosthetic one for a while, and its fine in the winter, but in the summer... hot and uncomfortable. I'm thrilled with my results and it really helps normalize my life again. I'm 39.

      November 8, 2010 at 15:47 | Report abuse |
  2. All Girl

    I know that there are Dr's who suggest Pambra's bra liners as a way of comfort after a mastectomy.. also used along with a prosthesis, forget an implant.. less risk later.

    November 8, 2010 at 09:52 | Report abuse | Reply
  3. Michelle

    What's sad is that we live in a world where women are made to feel unfeminine, unattractive, and undesirable unless they have a perfect set of breasts. These women survived a devastating disease, and now we need to pressure them to get prosthetic implants just to make their chests look more appealing? Yes, some of them want to do it, but ask yourself WHY. They've been trained to believe they have to do it, in order to look good enough.

    November 8, 2010 at 10:01 | Report abuse | Reply
    • Alex

      I agree in general with your argument, but I think it's about more than vanity in the case of post-mastectomy breast reconstruction. I think it is a way to get back what was taken from you. I almost look at it the same way I would a prosthetic arm, or leg (having said that, I do see the counter argument of using an arm more directly than breasts, but at the same time it's a way to help return to who you were physically following afight with a terrible disease). I think though, that your argument applies very well to some people who decide to get implants not to please themselves, but rather the societal ideal (and so as not to infuriate people with that comment, I think that getting implants for cosmetic reasons is fine as long as they are to make you happy and not the rest of the world).

      November 8, 2010 at 13:54 | Report abuse |
    • Pam Noonan Saraceni

      Michelle....VERY WELL STATED!! I am a 32 yr survivor...I waited 5 yrs after my mastectomy to have silicone reconstruction and it has been a nightmare ever since...If I had it to do all over again, I would NEVER have opted for the reconstruction...silicone or otherwise. So many doctors seem to make the reconstruction part of the treatment. They should be treating the cancer. You do NOT need breasts to live a wonderful full life!

      November 8, 2010 at 13:59 | Report abuse |
    • happymom

      As others have said, do not judge unless you have been there. I am having my implant exchange next week and I am happy to say that I am having the silicone implants put in. This is something I want and I have researched it very thoroughly. My husband, friends, and kids don't care if I don't have breast but it is my choice, not yours to judge. And yes I will get my MRIs. Now lets concentrate on finding a cure for all cancers so nobody has to go through hell.

      November 8, 2010 at 14:35 | Report abuse |
  4. Dez

    Great for them that they survived a disease, but you know what? Some of them would probably still enjoy having sex, and sorry, but looking at one or NO tits isn't going to cut it.

    November 8, 2010 at 10:57 | Report abuse | Reply
    • Disgusted

      What a boorish, immature, disgusting and shallow comment. Hope no one you care about (if there is anyone) ever has to deal with this devastating disease.

      November 8, 2010 at 12:41 | Report abuse |
    • evoc

      Maybe these women get to have sex with someone who loves them.

      November 8, 2010 at 13:29 | Report abuse |
    • beenthere

      I certainly hope with that atttitude that you are dog person because with that attitude, you may only have them as a companion as you get older! May you never have a life saving surgery that affects how you look... but if it were on you, you would probably not feel that same way.

      November 8, 2010 at 14:59 | Report abuse |
  5. mary ferraro

    Hats off to Sloan Memorial and Dr. McCarthy for doing studies that look how women feel, and caring how they feel in addition to to treating their illness.This is an extra mile that could easily be ignored in a busy environment. Bravo !

    November 8, 2010 at 10:59 | Report abuse | Reply
  6. Jeff

    No Michelle, what's sad is that we live in a world where men's cancers are virtually ignored and men have shorter life expectancies than women and no-one seems to care about that inequality. Get on board for issues that affect me and I'll be glad to do it for you.

    November 8, 2010 at 11:09 | Report abuse | Reply
    • Donna

      Instead of posting off-topic comments, why don't you do some advocacy instead?

      November 8, 2010 at 11:28 | Report abuse |
    • Megan

      So take the energy you spend COMPLAINING to raise awareness yourself.

      November 8, 2010 at 12:02 | Report abuse |
    • Don

      Men's cancers aren't ignored. The only reason breast cancer (which men also get) has a massive movement behind it is because a woman who's sister died started a foundation, marketed it well, and has grown it into a huge phenomena.

      As to women longer, there are several reasons for this:
      1) They have less testosterone, so their system (especially heart) wears down slower.
      2) Women are statistically less likely to kill each other, and don't have a slew of teen/twenty-something deaths to bring down their average as a result.
      2) Women are statistically less likely to destroy their bodies with cigarettes, drugs and alcohol.
      3) Men are statistically less likely to go to the doctor for annual check-ups, and also wait longer to get a known problem looked at.

      So that's one part biology, three parts men being stupid. If you want things to change, start your own foundation and treat your body and your fellow men with more respect. Don't try and pretend it's somehow women's fault we live longer.

      November 8, 2010 at 12:05 | Report abuse |
    • Hmmm...

      I have to say that you have made one of the most ridiculous arguments I have ever heard regarding an illness. There are many organizations dedicated to male cancers. My husband is fundraising for prostate cancer right now by participating in "Movember." To say that you won't support research for women's cancer because you don't feel like there is adequate support for other diseases doesn't support your cause. It makes you sound like an idiot. Why not get on board with the fights against all cancers that affect both men, women and children. Don't be petty, losing a friend or family member to breast cancer is just as devastating as losing one to prostate cancer.

      November 8, 2010 at 14:16 | Report abuse |
  7. Dr Cohen

    Comparing saline to silicone recontruction you are ignoring other current recontruction methods such as DIEP flap and TRAM flap. Another issue is the fact that silicone is dense radiographically, can obscure findings on mammography.

    November 8, 2010 at 11:24 | Report abuse | Reply
    • Donna

      Um, once you have a mastectomy, you aren't having mammograms where the implant is, correct? The breast would be gone.

      November 8, 2010 at 11:30 | Report abuse |
    • Diane

      Good luck being a candidate who qualifies for any flap surgery! maybe if your 20 and never been sick or had any kind of injury ever, I had my appendix out at 4, I had NO CHANCE and NO CHOICE for flap surgery

      November 8, 2010 at 11:44 | Report abuse |
    • Pam Noonan Saraceni

      THANK YOU !!, Dr Cohen. The fact the the FDA advises MRI every 3 years after implants is good, however who is going to pay for the MRI's. The majority of women will NOT follow that guideline. ALSO DONNA....i had a modified radical mastectomy and I STILL have a mammogram on that side. There are still lymph nodes and some tissue under the arm that have to be watched.

      November 8, 2010 at 14:06 | Report abuse |
    • Dee

      Women who had reconstruction with implants are not supposed to have mammograms. I wish all general practioners were knowledgable about what sort of care woment need after mastectomy. My gen practitioner seems clueless and afraid to even advise me about 'breast' exams (which even with implants women should do). Its not like I'm going to make an appointment to see my oncologist every year for my general physical. I was told no more follow up needed (this was based on the stage of the tumor they removed from my breast). Its frustrating.

      November 8, 2010 at 14:20 | Report abuse |
    • Tatt

      I am 27, 5'5 about 130lbs and I undergoing a bilateral mastectomy and breast reconstruction with implants. i am unalble to have Tram flam or lat dorsi reconstruction as I do not have enough 'excess' there for these procedures to be useful especially as i have not had children for tram flap. And to add to this, if you have any muscle, spinal or shoulder weakness, this makes lat dorsi and tram flap procedures risky as they effect the intergrity or your core strength. Tough given the option, There is less risk associates with implants, though the other reconstruction types have an apparent 'more natural' look about them. As long as you are happy with the choice you make, and most importantly HEALTHY, go with what is more suited to you. I wish everyone whom has and is about to embark on this journey every success and i am sending positive energy your way!

      November 17, 2011 at 00:20 | Report abuse |
  8. Dee

    I had silicone gel implants after a bilateral mastectomy. Actually the only option if a woman gets the gel implants is to be automatically enrolled in a long-term research study (if you don't want to be a study participant you can't get the gel implants). It comes with selecting the gel style silicone. They do have results from about 10 years of study and found that rupture with gel is minimal and migration typically doesn't happen if the implant ruptures. Whatever a woman decides after masttectomy-become educated about your options and be sure to scrutinize your sources; not random websites, but information from established medical sources. TRAM flap and other recnstruction using a woman's own skin and tissue are complicated procedures-with infection and scaring and a poor results not uncommon. My breasts were never that important to me until I saw myself, post mastectomy-believe me, it didn't matter how beautiful my husband told me I was. I was disturbed to see a part of my body gone. I had complete reconstruction including nipple reconstruction and areola tatooing. Never thought I would choose that before this happened...and a little compassion wuld go a long way; please don't judge a woman on her choices! You don't know what you woudl really do until you get there.

    November 8, 2010 at 11:39 | Report abuse | Reply
  9. Diane

    I got the silicone jell implants (new and set like a jello mold no leakage ever) after my double massectomy and I HATE them, after my 5 years clean is up I am going to get the silicone bag implants, bad enough to have the cancer but what ever makes the woman feel better is what she deserves!!!!

    November 8, 2010 at 11:42 | Report abuse | Reply
  10. tina

    Dr.Cohen is right, there is other options . I am going to have the free tram done next month as my body is rejecting my expanders . I am not 20 years old ( I'm 47) and I weight 200lbs plus..BUT the reason why I qualify for the Free tram, is BECAUSE I have NEVER had any stomach work. I had two children vaginally and had a hysterectomy vaginally....So thinking you have to be a size 2 and young to get a tram reconstruction is hog who who.

    November 8, 2010 at 12:33 | Report abuse | Reply
  11. momto4

    Until you have lost a body part do not judge. You have no idea how you would feel or what you would do unless you are there. I never thought my breasts were that big of a deal until I lost them to cancer. My husband loves me with or without breasts, it's not that, it's how I feel as a person. Cut your hand off and see how you feel.

    November 8, 2010 at 14:25 | Report abuse | Reply
    • Narendra

      I would say 23 is a good age. You're done growing, that's the mtiorpant thing.I've been considering it too. I'm 27, but I've been thinking about it for a few years. They're a lot safer than they used to be. You may want to have your kids first if you're going to though. I heard they hurt really bad during pregnancy because the skin stretches so bad, and I know my breast got SO MUCH BIGGER when I was pregnant, I could only imagine if I had implants at the time. I say go for it girl. Was this answer helpful?

      March 5, 2012 at 22:14 | Report abuse |
  12. Rose

    A dear friend of mine opted for the tunneling proceedure; is that the same as 'tram' ?
    Fat from her abdomen was tunneled up to breast to reconstruct. I is over a year now, and
    that fat has become very hard and has formed unsightly ridges. Has anyone out there had
    the tunneling ? If so, how successful was the proceedure ?
    Also, can by friend now, choose to do the saline or silicone ?

    November 8, 2010 at 15:11 | Report abuse | Reply
  13. Lily

    What planet does JEFF live on ? Historically, there has been more influence on men's health. Think heart attacks.
    BTW, Jeff, men get breast cancer too.
    What are the statistics on tunneling fat from the abdomen to use as reconstruction. Sounds more natural but one doesn't
    hear too much about this type of reconstruction.
    Any thoughts out there ?

    November 8, 2010 at 15:17 | Report abuse | Reply
  14. mari

    the last few months of my life has been a world wind of fear. I was diagnosed in August with stage 1 situ, six weeks later i have no breast. never thought i would care I WAS WRONG. After the bandages were removed i cried for weeks, in fact i am still crying. All of my cancer has been removed and i didn't have to undergo any chemo or radiation. I am in the process of reconstruction and things are going well. However, i feel like i cheated cancer cause i didn't have to have any treatments it doesn't seem fair. I never felt sick, still don't just sorry for myself, which makes me feel guilty cause so many others have gone through so much. next week i go for my implants, i am scared to death. God help and bless thoes that have had to suffer to get to the place where i am now, when it is all over i plan to advocate for all cancer patients who suffer and intend to do what i can to elleaviate their pain and suffering.

    November 19, 2010 at 17:12 | Report abuse | Reply
    • s

      I am 33. I had a double mastectomy last year. I do not have breast cancer, but rather another breast growth (very rare) that nececitates mastectomy. I too went through suddenly crying and grieving the loss of my breasts. For me it happened in less than a year. I sometimes get sad when i think that they are gone and that is that. I have saline tissue expanders in and they are hard as rocks! They have softented up quite a bit, but I can not lie on my stomach (or on top of my husband, no more hugging while lying down). I have battled through the decision to get saline or silicone. After having the saline expanders I have opted for silicone. I always thought silicone was for the man, I now realize it is the woman who feels them every day. My DR says you do not need MRI's if you get them after a mastectomy, this scares me a bit. But I hate having a constant reminder that this happened to me. Because I did not have cancer I have not felt like anyone can relate to my position, and I too at times feel guilty about feeling bad for myself. But cancer or not, I too had a disorder that required a mastectomy. Although rare, it happens. And to those women who talked about trams and diep's. Not all women are canidates, you have to have enough fat to turn your stomach, inner thighs or buttox into your breasts. It also requires 8 weeks off work. Plus you have major scars at the donor sight and your breasts. And if they use your abdominal muscle you are more prone to back injuries. I am glad there are options out there. I will have my implant exchange next month, I will be glad to put this behind me (although I will never be the same after having this experience).

      February 5, 2011 at 13:23 | Report abuse |
  15. Suzanne

    I was diag. with bc in 2000, and due to work/family/life, chose mastectomy, 6 mos later, 2nd bc, same decision. Long story short, expanders and implants failed (10 surgeries in 2-year period). Left with one breast area looking like surgeon used can opener. Husband never could touch me after that. He finally "reconnected" with gf from 38 years ago (we were married 30 years), well, because SHE HAD BREASTS. Good bye and good riddance. For those who don't think breasts matter, well, I am glad to be alive, for me, my kids, and my grands, but...I'm hoping there's a man out there looking for a 60 y/o woman, who still loves life, but doesn't have breasts to feed his ego. Oh, yea, he told me about his gf 11/10/2010, and left me 11/11/2010. And I filed for divorce 12/09/2010.

    December 13, 2010 at 10:31 | Report abuse | Reply
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