Some alternative breast implants have the same silicone elastomer shell that surrounds a saline-filled or silicone gel-filled implant. Other types have shells consisting of a different chemical composition. The filler in an alternative breast implant may or may not consist of a gel.
No alternative breast implant is FDA approved.
Polyurethane Foam-Coated Implants
These implants were removed from the market in 1991 because the polyurethane foam coating released a toxic material called TDA. In some patients undergoing explantation, the entire polyurethane foam coating was no longer present because it dissolved into the tissue.
Toxic hydrolysis product from a biodegradable foam implant
Exposure to toluenediamines from polyurethane-covered breast implants
Urinary excretion of free toluenediamines in a patient with polyurethane-covered breast implants
Polyurethane coated implants return to the market in the UK (2005)
Soybean–Filled Breast Implants
Trilucent breast implants contain soybean oil that is surrounded by a silicone elastomer shell. They were never FDA approved but were permitted to be used in a study in 1994. They were approved in the United Kingdom until 1999, when the Medical Device Agency removed them from the market due to concern that the filler could degrade into a carcinogen. At explantation, the shells of Trilucent breast implants showed degradation caused by the lipid in the filler weakening the shell.Lipid bleed throughout the implant shell also occurred. Problems with anterior and posterior patch delaminations made the implant prone to rupture. Soybean oil in Trilucent implants prostheses underwent peroxidation, yielding aldehyde by-products in concentrations that were over 1000 times that thought to be potentially genotoxic.
The history of Trilucent implants, and a chemical analysis of the triglyceride filler in 51 consecutively removed Trilucent breast prostheses.
What exactly was wrong with the Trilucent breast implants? A unifying hypothesis.
Hydrogel-filled breast implants
Hydrogel breast implants consist of a silicone elastomer containing hyrogel filler. Hydrogels are polymeric materials that swell in water without dissolving and retain water in their structures.Two models were on the UK market including PIP Hydrogel breast implants and NovaGold breast implants. In December 2000 the MDA issued two Device Alerts regarding the withdrawal of hydrogel-filled breast implants. Adverse events included breast swelling associated with fluid around the implants and capsular contracture.
The material damaged the health of rabbits in laboratory experiments.
Long-term results of MISTI gold breast implants: a retrospective study
China bans hydrogel for breast implants
High cohesive silicone gel-filled implants
Cohesive gel is a form of silicone that is semi-solid. The shell of this implant is made from silicone rubber. According to the manufacturers of these implants, the shape and position of the cohesive gel implants are not likely to change over time and silicone gel supposedly does not leak from the shell if it is disrupted; however, one case report published in 2006 has described complications occurring with cohesive gel including silicone granuloma formation in the implant capsule and silicone lymphadenitis.
Locoregional silicone spread after high cohesive gel silicone implant rupture
Leakage and silicone lymphadenopathy with cohesive breast implant.
Cohesive gel-filled implants may be more useful in reconstructive surgery because of the density but women seeking breast augmentation for cosmetic purposes may not prefer to have this type of implant. Also, the shell of this implant contains silicone and other chemicals which may cause complications.
Titanium-coated breast implants
These breast implants are filled with cohesive silicone gel and coated with titanium. The titanium is covalently bonded to silicone but the body only comes in contact with titanium. According to the manufacturer, titanium is supposedly biocompatible so a reaction of the body to the implanted material is unlikely to occur. Reoperations are less likely to be needed when augmentation is performed with this type of implant.
Aussie women to get metal breast implants