There are two types of synthetic breast implants available in the UK; silicone gel and saline solution. Both are contained in a firm, silicone shell, which is made from a type of elastic called elastomer. Modern synthetic implants have a textured surface to reduce the risk of hardening and deforming (capsular contracture).

Silicone gel implants may be filled with a firm, jelly-like silicone or a softer, fluid silicone. The firm silicone keeps its shape even if the implant ruptures (tears) inside the body. This reduces the risk of the silicone entering the bloodstream. Soft silicone is less likely to wrinkle, making it feel more like a natural breast.

Silicone implants have received a great deal of media attention in recent year, with some reports of unsafe or dangerous side effects. In 1998, the government commissioned an Independent Review Group to look at the available evidence about the risks of silicone breast implants and publish a report based on its findings. The group found no evidence that silicone implants pose a risk to women.

Saline breast implants are filled with a sterile salt-water solution, which can be pre-filled or filled through a valve during implant surgery. As the solution is similar in consistency to natural body fluids, it can be absorbed safely into the body if the implant ruptures. Some women find that saline implants decrease in volume over time and are more likely to deflate. Saline implants are also more prone to wrinkling and can feel or appear less natural than silicone implants.

Acknowledgement and Thanks to NHS

There are no restrictions on the sale or use of CE-marked silicone gel-filled breast implants in the UK.

Silicone gel breast implants were first introduced in around 1962, when there were no specific statutory regulations in place to control the marketing and use of medical devices in the UK, the rest of Europe, or in the USA. Since then, the use of breast implants has increased gradually and it is now estimated that over 10,000 people receive breast implants each year in the UK, 80% of these opting for silicone gel-filled implants.

Department of Health policy on the supply of breast implants is based on the principle of evidence based medicine and, where appropriate, reflects conclusions drawn by groups of independent experts. Currently only breast implants filled with silicone or saline are available for use in the UK.

Information for women considering breast implants
The Department of Health has taken action to ensure women considering breast implants have appropriate advice. Every medical intervention carries some risk. It is because such risks exist that women need to have accurate and complete information prior to deciding to have surgery. The risks associated with silicone gel breast implants have been investigated on three occasions by independent expert groups working on behalf of the Department of Health. The latest of these, the Independent Review Group, concluded that the risks were no greater than for other implants, such as hip joints. A booklet was originally published in September 2000 and updated in April 2002, summarising the key issues and suggesting questions women could ask to help them make an informed choice about surgery.

Local complications and known risks
Complications, such as capsular contraction or loss of sensitivity, have long been known to be associated with breast implantation, although good information on the incidence of such problems is lacking. The possibility of these complications should be fully explained to patients by their surgeon before surgery. There is also a possibility of rupture of the implant, which will normally necessitate reoperation. Some early implants are known to have remained intact for over 30 years, but the actual lifespan varies greatly with the circumstances; it should not be assumed that breast implants will last indefinitely. The technique of "closed capsulotomy" which has been used to relieve capsular contracture, is known to increase the chance of rupture and is not recommended by manufacturers. Silicone gel can be released into tissue on rupture of implants and silicone oils can "bleed" through the silicone elastomer shell.

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