For implants, the saline solution


I AM THE proud and happy owner of two very nice, soft, untroublesome saline-filled breast implants that were inserted in front of my chest wall a few years ago after my second mastectomy.

Sadly, many women think the implant choice is between silicone or nothing, when they have a perfectly good alternative in saline.

I know something about how women feel about losing a breast. I know that some women, hearing of the dangers of silicone implants and not being aware of a good alternative, will avoid mammography, self-examinations, visits to their physicians -- actions that could save their lives.

At the Food and Drug Administration hearings on silicone implants recently, I heard an opponent of the silicone implant ban say she would rather die than be breastless. "What about saline?" I wanted to shout at the hearings (and I sort of did).

One reason that few women get saline implants is that, cosmetically, saline has gotten a bad rap. They're like little water beds, some say. They can harden. And if they break, it's not a gradual leak, it's vroom, you go from souffle to flapjack.

Well, would you rather be a flapjack or a cripple? That, it seems, has been the fate of some whose silicone has leaked. If saline leaks, it's only water. Moreover, flapjacks can be fixed with quick surgery under local anesthesia. Same for hardening (I had it). As for water beds: Women with reconstructed breasts are always running into ladies' rooms, lifting up their blouses for show-and-poke. I've seen and poked and been poked and found my water beds stand up nicely to silicone.

My surgeon, one of the few who now uses saline exclusively, implanted silicone breasts in the early '70s and found that they leaked. He tried using them with polyurethane covers, but they still leaked and the polyurethane often caused severe allergic reactions and infection.

He says most surgeons don't use saline implants because they are difficult to insert. Silicone implants come prepackaged like frozen pizzas. You just throw them in a woman's chest and sew her up. Saline implants must be individually filled by a surgeon who knows what he's doing. It's not that other plastic surgeons ** can't learn. But many find it easier to deny the possible dangers of silicone than to change.

Though most women who have silicone implants may not have problems, how does one know who will be lucky and who will be unlucky? So in addition to the fear of recurrence, there is this new fear that women with cancer needn't have had, except for the indifference and ignorance of the manufacturers of the silicone implants and the surgeons who inserted them in their bodies.

Betty Rollin is author of "First, You Cry" and "Last Wish."

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