This year, the most exciting news for women in Taiwan is that the Department of Health lifted the ban on cohesive silicone gel breast implants at the end of July. After waiting for 2 years, local breast implant consumers finally have the same opportunity as women in the western world to receive this procedure. Cohesive silicone gel breast implants will soon be on the market after manufacturers receive import permits.

The government has removed the ban, meaning cohesive silicone gel breast implants are reliable and safe. According to the data from the US for the last 3 years, they show high reliability, proving that they do not have a higher chance of breaking or capsular contracture. However, people still have negative opinions on Micro cosmetic surgery and silicone injection. The general public needs to understand the true characteristics of cohesive silicone gel breast implants, not only from scientific data, but they also need responsible plastic surgeons to inform them of the pros and cons. This will help patients to select suitable breast implants to ensure satisfactory results after surgery.

With accessible information, people can have a better idea of the advantages of cohesive silicone gel breast implants, including that they feel more real to the touch, it is not easy to feel the edges of the implants, and that they will not leak. When consumers believe in these advantages, they also need to be aware of some factors involved in this surgery. Based on the author’s experience, further explanation on silicone gel breast implants are as follows:

1. Are cohesive silicone gel breast implants much softer?
Four factors determine the softness of implants, including the flexibility of the patient’s breast tissue, the surgeon’s skill, the selection of smooth or rough surface implants, and massage after surgery. This does not mean that cohesive silicone gel breast implants will be softer to the touch.

2. Can cohesive silicone gel breast implants make the breast shape more attractive?
Not necessarily. Whether the shape is attractive or not really depends on the condition of the patient’s body, the surgeon’s experience, the size of the implants and massage after surgery. On the other hand, a professional surgeon still can make natural appearing breasts with saline breast implants.

3. Are cohesive silicone gel breast implants closer to the texture of real breast?
It is not easy to feel shell collapse or rippling when cohesive silicone gel breasts implants are touched. They “fit in” with the skin and, as a result, they are more similar to body texture. However, a lack of proper massage after surgery can result in the implant shrinking and becoming hard.

4. Do cohesive silicone gel breast implants last forever?
The usable life really depends on the quality of the implants and individual frequency of use. The author thinks that it should last 15-20 years based on today’s technology. Cohesive silicone gel implants do not gradually deflate compared to saline implants. However, it is difficult to give a life-time guarantee, as they may rupture due to wear or accident.

5. Can silicone gel implants cause breast cancer?
Medical reports around the world clearly show that the leakage of silicone and breast cancer is not related. Therefore, silicone gel breast implants do not cause breast cancer. It is required to have routine follow-up checks for implant leakage yearly. If leakage does occur, the implant should be replaced to prevent tissue damage or fibrosis. Be sure to visit a breast doctor for a routine breast exam after implant surgery.

6. Will silicone gel implants interfere with regular breast exams?
It is common to check breasts with ultrasonic breast scanning and strain imaging. There should not be any problem with breast exams if the implants are placed under the muscle. However, if the implant is performed through a nipple or per areola incision, then the silicone gel implants are very close to mammary tissue. In fact, they might interfere with the breast exam procedure. It is highly recommended to visit experienced professionals at any large medical facility for a safe and accurate exam.

7. Can silicone gel implants be detected by the touch?
It really depends on the skin condition of a patient. With a thin patient (under 40 kg) who has a very thin skin layer (less than 0.5cm on the front of the chest), it is possible to feel the silicone gel implants. However, the feel is much better than saline implants.

8. Isn’t it unnecessary to have massage care if a patient chooses silicone gel implant?
This is a misleading message. Once a patient decides to go with smooth surface implants, regardless of whether the shell is filled with saline or silicone gel, proper massage care for 3 to 6 months is required. Unless the surgeon indicates that the implant has a rough surface and no massage care needed, massage is important to continuously maintain the natural look and softness for better and long lasting results.

With the above brief explanations, readers should have a better understanding of silicone gel breast implants. The explanations also tried to correct some wrong views and opinions. The result of breast implant surgery—shape or size—really depends on a surgeon’s background, experience and skill; it has nothing to do with whether the filling is saline or silicone gel. Is it really true that using silicone gel implant is a better choice? According to the author’s experience with many breast implant surgeries, it is best to have an evaluation with a doctor. It is easier and more pleasant for a patient to choose the best material for her after consultation with her doctor, rather than to focus too much on selecting either saline or silicone gel breast implants, isn’t it?