The standard implant in the United States has been saline filled, ever since the FDA moratorium on silicone gel filled breast implants in 1992. The type of implants that were available before the ban are available today as part of an "adjunct study," which is open to patients with congenital deformities or having a revision for particular reasons.What distinguishes cohesive implants is that the silicone gel is firmer, essentially a soft solid. If a cohesive implant is cut in half, there is no gross movement of gel, and the implant maintains its shape.

The way these are made is that the company uses more "crosslinker" in the making of the implant. The ingredients are the same, but with more crosslinker added, it makes the gel firmer.The term "cohesive" has been bastardized in recent years. Cohesive breast implants implies form stability, or form retention. That means that in any position, the implant maintains its shape. That is an important distinction, because it means that the shell should not fold, and that it will maintain a particular shape.

Silicones are a family of chemical compounds. They are made from silicon, a naturally occurring element found in sand, quartz and rock. Next to oxygen, silicon is the most common element in the earth’s crust and becomes silicone when it is combined with oxygen, carbon and hydrogen. Depending on the arrangement of the molecules, silicones(implants) can be manufactured in a variety of forms including oils, gels and solids.

Silicones have been part of the consumer industry for over 50 years. Because they can be manufactured in various ways, silicones appear in a wide variety of products that most of us use everyday. Hairsprays, suntan lotions and moisturizing creams are just some of the consumer products that contain one form of silicone called dimethicone. Medical devices utilizing silicone include artificial joints, catheters, drainage systems, facial implants, tissue expanders and silicone breast implants. Silicone products have been shown to be biocompatible, reliable, flexible and easy to sterilize, making them an ideal choice for both implantable and non-implantable medical devices.

Now, there is a long list of safety measures that plastic surgeons take during surgery to enhance the recovery experience for breast augmentation patients and reduce the risk of complications following surgery.

Some side effects following breast augmentation may include: swelling, bruising, inflammation, nausea, pain, and muscle spasm.

Pain following breast augmentation has been markedly reduced case of several techniques used in surgery. The delicate techniques used today are not as invasive as those in the past. Also, plastic surgeons may use pain medication in the breast pocket that they create for the breast implant during surgery. Techniques today often do not result in the need for drains to be placed in the breast following surgery. The strategies that are used to reduce infection and bruising also impact the level of breast augmentation pain.

Nausea following breast augmentation may be due to anesthesia given during the procedure and/or due to pain medication that is taken during recovery. Plastic surgeons today use approaches to the procedure that involve less dissection of the breast and more delicate techniques to reduce the need for pain medication during recovery. In addition, there are anesthetics available today that do not produce as much nausea as in the past. In fact, many patients today may undergo the procedure with local anesthetics and sedation which further reduces the risk for nausea following surgery. Finally, there are anti-nausea pre and post medications that may be used to reduce of nausea after surgery.