One of the issues that we talk about is which type of breast implant would you prefer. Now we have two types of implants that are available. The saline implant which is a silicone shell, which is filled at the time of surgery with saline, which is salt water, which is a very soft, natural implant. We used these for about the last 10 years exclusively, because the FDA had some concerns about the safety of the silicone gel implant. Today, we offer both. We have patients who opt for saline. We have patients who opt for silicone. The advantages of the saline are that we can adjust the fill volume and we can correct for some asymmetry and if there is an accident or injury, say steering wheel to chest high-speed motor vehicle accident, if the saline were to leak out, there is no harmful effect from that. Right now, I would say in my particular practice, about 30 percent of people are opting for the saline and about 70 percent of the people are opting for the silicone gel. Now the silicone gel is a soft viscous material that is in a silicone shell and it feels much more like normal breast tissue. The reason that these were taken off the market was that the FDA was concerned that there might be some connection with vaguely understood connective tissue disorders like lupus and rheumatoid arthritis and scleroderma. What they found out with extensive studies at some of the best medical centers in the United States is that there is no obvious or known connection in any way and these implants have been back on the market since late November last year of 2006. So, more and more in my practice people are opting for these, because they feel soft or they feel more natural. There are concerns that if these were to leak or tear that the silicone may migrate and that could theoretically be a problem and we would be evaluating that over the next two to three years.

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