To begin with let’s address the controversy surrounding silicone filled breast implants. There is a well known reporter of Asian descent married to an ex-talk show host who built a career on sensational reporting without any basis in fact, that cheated millions of women out of a perfectly soft, and natural silicone breast augmentation. As is the case with many such issues, the truth was not nearly as well publicized. For a decade, the truth was not made public at all. To add to this, countless cases of alleged harms stemming from the implantation of silicone implants were exploited by immoral attorneys. Since the 1990’s, silicone breast implants have been shown to impart no increase in the incidence of breast, cancer, immune disease, or any other malady so eagerly imparted to them by dishonest litigators, and melodramatic fortune seekers with no regard for the effect it would have on women interested in breast augmentation, and especially augmentation combined with a breast lift. Silicone implants have several drawbacks but in the opinion of many plastic surgeons, such shortcomings are far outweighed by the benefits afforded by their use in breast augmentation. Silicone breast implants are thought to produce a softer breast, less breast contour deformities, and a substantially more natural feel on breast contact than saline breast implants. The drawbacks to silicone mammary prosthesis use are twofold. The first is difficulty in the detection of breast implant rupture. When silicone breast implants rupture, the saline that was used to fill them is reabsorbed, and the discrepancy between what was and what is, or between what the size of the unaffected breast and the side of the affected breast is very obvious. When silicone breast implants rupture, the silicone fill is not absorbed. The change in the affected breast is more consistent with a shape change than a size change. As a consequence, this becomes much more difficult to detect. This would not be a problem, however, silicone incites a significant inflammatory reaction in many patients, leading to a dense capsule, and making it difficult to remove the old breast implant, and achieve a predictable result in placing the new one at the same operation. Staging, or breaking the operation presents the patient with the nuisance of two surgeries. For this reason, a patient with silicone breast implants must be very vigilant in monitoring for signs of implant rupture, as early detection, and re-implantation, makes it much less likely that a significant inflammatory reaction, or a tough breast implant capsule will form.