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The saline-filled versus gel pre-filled breast implants discussion is ongoing with gels having captured 65-80% of the market since gels were unfrozen 4 years ago, since it was concluded that gels don't cause medical conditions.  I see the differences as gels being more natural to feel and sometimes to see (less chance of rippling) and salines easier to detect leakage (goes flat), doesn't migrate into tissues (since saline absorbs), and less expensive.  All implants with both manufacturers have replacement and warranties for leakage for lifetime, and both carry 10 year warranties for the costs encountered in replacing leakers.

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The recent furor about the infamous French PIP silicone gel implant highlights the caution required when trying unproven products.  That process ordinarily takes a decade or so, beginning with basic science and carefully controlled and limited use of implants by a few researchers, then cessation of use for 5-10 years to see if problems occur.  However, PIP dropped the ball before any clinical trials should have been able to commence as the industrial grade silicone gel has now been proven to contain toxic contaminants which can cause unknown but potentially serious reactions if the implants leak or rupture.  Leakage rates have been estimated to be between 2-7%.  These implants hould never have been approved for use. The French regulatory agency equivalent to the FDA in the United States should be held accountable for its substandard investigation, as should the principals of PIP who should never have utilized non-medical grade silicone gel.

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