Can One Breast Implant Be Safer Than the Others?
As a plastic surgeon and with extensive knowledge of breast implant design, manufacture and experience in breast augmentation for over three decades, I have been asked this question many times. I am going to dispel some myths and provide some new information.
Many patients think saline implants are safer than silicone because they contain saline. The truth of the matter is that ALL breast implants have a shell (the “bag”) that is made of silicone. The bag can be filled with either saline or silicone gel. The body is exposed to silicone either way. Recent scientific data demonstrates that silicone does not cause cancer, autoimmune disease nor is there any biologic basis for “breast implant illness.” Implants filled with silicone gel are just as safe as saline implants, are far more natural in feel, having far less rippling than implants filled with saline. I would not allow my spouse and daughters to get silicone gel implants if I had even the slightest concern about their long term safety. I will also note that macrotextured breast implants, both silicone gel and saline, have been removed from the market because the macrotextured implant was associated in very rare cases with health issues.
So what implant choices are available and how do they match up in safety? Prior to September 2024, there were three manufacturers that were cleared by the FDA to sell breast implants in this country: Allergan, Mentor and Sientra. I have used primarily Allergan but also have experience with the other two. In September, 2024 a fourth manufacturer obtained FDA clearance to sell Motiva implants in the United States.
It is important to note from the outset that every one of these implants is safe. So what makes one implant “more safe” than the others? Here are the “safety parameters” that I would use when making a decision about one device (implant) over another one:
Rupture Rate
Breast implants are mechanical devices and as such, will not last forever. That said, there is no set time period (ie “ten years”) that implants need to be removed/replaced.
Capsule Contracture
This is where the thin, fibrous tissue sac that forms around all foreign bodies implanted (including breast implants) become thick, hard, and contract, making the breast feel hard and sometimes displacing the implant upwards.
Reoperation Rate
This is how frequently another surgery is performed. This metric is a little harder to interpret, as many of the reasons for reoperation have nothing at all to do with the implant. That said, reasons for reoperation due to the implant would relate to rupture, capsule contracture formation, and lower breast stretching and malposition that is attributed to the device itself. Some of the latter is attributable to the implant, some is not and it is hard to distinguish how much for each.
Based upon the data submitted to the FDA by each implant manufacturer, for round, smooth silicone gel implants (Mentor, Allergan and Sientra at 10 years, Motiva at 5 years)
| Motiva | ||||
|---|---|---|---|---|
| Rupture | 9% | 2% | 3% | .6% |
| Capsule Contracture | 16% | 10% | 12% | .5% |
| Reoperation | 30% | 25% | 24% | 8.8% |
Motiva clearly has the best safety profile of all four manufacturers of breast implants. Although the Motiva data is only reported at year 5 of the ongoing ten year study, the data has been the same since year 2!
In my practice, I have shifted towards Motiva implants, however. I offer my patients a choice, It is my opinion Motiva offers the most natural feeling breast (my spouse Amy has them for five years!), and the safety data is the strongest, I believe that the Motiva implants will not only offer the best results but also be far more cost-effective in the end.
Sections - Motiva Breast Implants
- What is the Motiva Breast Implant?
- Ergonomix vs Round: Breast Shape and Movement
- Dr. Epstein’s Six Year Motiva Experience
- What Makes the Motiva Implant Different?
- Motiva – Is it Smooth or Textured?
- Motiva vs Other Implants
- How Motiva Implants Are Different from Allergan Natrelle, Mentor and Sientra Implants
- MOTIVA US Clinical FDA Trial
Chapters – Breast Augmentation Guide
- Motiva Breast Implants
- Intro to Breast Augmentation
- Five key decisions you need to make
- One-Day Recovery Breast Augmentation
- Anesthesia – General, Sedation or Local?
- Breast Lift (Mastopexy) with/without Implants or Fat
- What else should I know about breast augmentation?
- Important Things to Consider When You Decide to Move Forward With Breast Augmentation
- Revision of breast augmentation
- ALCL and Breast Implant Illness
