Breast implants - Types of breast implant

You should discuss the different types of breast implants available with your surgeon.

There are two types of implant available in the UK – silicone gel or saline (sterile salt water).

Both types of implants are surrounded by a firm, elastic silicone shell that helps prevent the implant rupturing (splitting). The surface of the shell can either be smooth or textured.

There are advantages and disadvantages to each type of implant. The most suitable implant for you will depend on your individual circumstances and personal preference.

Silicone gel implants

Silicone gel implants are the most common type of breast implant used in the UK. The silicone can vary in its firmness and consistency. Unlike some saline implants, they are pre-filled before they are inserted.

Advantages of silicone gel implants include:

• they have a long history of safe use
• they may be less likely to wrinkle than other types of implant
• they are available in round or anatomical (contoured) shapes (often referred to as teardrop shaped)
• silicone gel can be a very soft and pliable (supple) implant filler, so it allows for movement and gives you a natural feel
• most silicone gel implants used in the UK have a textured surface, which can reduce the risk of excessive movement and may also avoid problems such as scar tissue shrinking around the implant (capsular contracture)

A disadvantage of silicone implants is that if the implant ruptures, the silicone may spread outside of the scar tissue around the implant and into your breast. This can lead to small lumps developing that are known as siliconomas.

Siliconomas can be tender to touch and may need to be removed if they cause significant pain.

Soft and cohesive silicone gel implants

Either soft or firm silicone gel can be used in breast implants. Implants filled with the firmer gel are called cohesive gel implants.

An advantage of cohesive gel implants over softer silicone implants is that in the unlikely event of the implant's shell rupturing, there is a greater chance the gel would stay inside and not leak into the surrounding tissue.

Cohesive gel implants may also be less likely to wrinkle or fold because of their ability to retain their shape and integrity.

However, cohesive implants may have a slightly less natural feel than the softer silicone implants, and may mean a larger incision has to be made to allow them to be inserted.

Polyurethane-coated silicone implants

It is thought these implants may be associated with a reduced risk of capsular contracture (where scar tissue shrinks around the implant).

However, some surgeons believe they are slightly more difficult to use than other types of breast implants available, and most surgeons in the UK have little experience with their use.

Your surgeon may suggest using these implants as a replacement for your original implants. This is usually if you require further surgery to correct a problem with your implants and you have been experiencing problems with capsular contracture since you had your initial operation.

Saline implants

Saline implants have a strong, silicone shell and are either pre-filled with sterile salt water or filled through a valve once they have been inserted into your breast.

Advantages of saline implants include:

• they have a long history of safe use
• as the saline solution is similar to your body fluids, it can be safely absorbed or excreted (got rid of) by the body if the implant ruptures
• they are available in round or anatomical shapes

Disadvantages of saline implants include:

• they may rupture or deflate earlier than silicone implants
• they are more prone to wrinkling or folding
• they may feel less natural than silicone implants

Other types of implant

Some types of breast implant, such as soya bean oil-filled implants and hydrogel implants, are no longer licensed for use in the UK.

In 2000, the Medicines and Healthcare Products Regulatory Agency (MHRA) recommended that women with soya bean implants should have them removed.

Although hydrogel implants are no longer available in the UK, women who have them have not been advised to have them removed because they are not thought to cause an immediate risk. However, the MHRA is continuing to monitor their safety.

PIP implants

In 2010, French PIP implants caused concern after it was revealed they contained industrial silicone rather than medical-grade fillers and were more prone to rupture than other implants.

Around 47,000 women in the UK are believed to have had the implants, with the majority of operations done for cosmetic reasons through private clinics.

There is not enough evidence to recommend the routine removal of PIP breast implants, a government expert review has concluded. However, any implants put in by the NHS can be removed and replaced without charge. 

If the implants were originally fitted privately, they may be removed by the NHS, but you will usually need to pay privately to have them replaced.

If you are worried about your implants, speak to your GP or the clinic where the implants were fitted.

Read more about PIP breast implants.

Implant life expectancy

Women who have breast implant surgery rarely keep the same implants for the rest of their lives. Anyone who has a breast implant is likely to need further surgery at some point, either to change the implant or remove the scar tissue that has formed around it.

Most breast implants have a life expectancy of 10 to 15 years, after which they may need to be replaced. However, breast implants can sometimes last longer without problems, and some manufacturers guarantee against certain types of implant rupturing for the lifetime of the patient.

Sometimes it is difficult to detect implant rupture. You may have to pay for scans if rupture is suspected, as the NHS will not necessarily fund investigations or replace your implant if the surgery was performed privately in the first place.