What Is The Difference Between Silicone In Breast Implants And That Used As An Injectable Filler?

Q:  Dr. Eppley, what is the difference between the silicone used in breast implants as opposed to that used as as ‘black market’ soft tissue filler? if it is so dangerous to inject silicone into other parts of one’s body like the buttocks and the breasts, why then are silicone breast implants considered safe? Since silcione breast implants could rupture and leak out, how is that silicone in your body any different than injecting it elsewhere? This doesn’t make any sense to me.

A: This is a good question and it doesn’t make sense to you because, although the name silicone implies that all is the same, they are somewhat different chemically and how they are packaged. This turns out to make a big difference when introduced into the body.

Injectable silicone used for illegal soft tissue augmentation is an oil that is less polymerized and less stable. It is also dispersed in the soft tissues in small droplet form. This leaves a lot of surface area of the oil onto which inflammation and scar tissue can form. Silicone in breast implants is in a more highly-polymerized (stable) form that is encased in its own protective bag or barrier. This results in no actual silicone being exposed to the body so no reaction to it occurs. The only reaction the body as is to the bag that contains it. If ruptured, the released silicone is further protected by the body by the natural scar (capsule) that always forms around the implant. (a second bag or barrier if you will) The more polymerized silicone gel causes less inflammation or reaction from the body than oil even if it does become exposed to it. Silicone gel in breast implants has also been highly studied and evaluated by the FDA with rigorous scientific scrutiny as to its bodily effects. Injectable silicone oil has never been exposed to such scientific scrutiny as a soft tissue filler and thus has never been approved for an injectable augmentation approach.

Dr. Barry Eppley

Indianapolis, Indiana