In 1992 the FDA withdrew their clearance for silicone implants to be used for cosmetic augmentations over safety concerns if the implant were to rupture.
Silicone breast implants have since become the most closely studied medical device of any kind and have definitively been shown to be safe, even in the event of rupture.
The gel inside modern implants has the consistency comparable to gummy bears candy. In fact, "rupture" really should be called "shell cracking" because there is no spillage of gel or change in shape of the implant.
Today, 80% of breast augmentations in the U.S. are done with silicone implants. Outside of the U.S., all breast augmentations are performed with silicone.
What makes the surgery so appealing are the range of options available to patients in terms of the size, shape and texture of the implant. In years past, there was only one scale of implant sizes - meaning as the implant volume went up, they got wider. Today, for any given breast implant width, there can be as many as four implant "profiles", meaning how far the implant projects away from the chest wall. This allows the patient and surgeon to be able to choose an implant that exactly matches the patient's desired breast size.
Although teardrop-shaped or "anatomical" implants have been available for several years, only recently have implants been introduced that maintain their shape over time. The main difference between these implants and the traditional round implant is the amount of upper breast fullness.
Shaped implants are less full in the upper breast, creating a more subtle slope when compared to the fuller look provided by round implants.
Finally, implants with a textured (as opposed to smooth) surface decrease the chance of capsular contracture, meaning tightness of the tissue surrounding the implant.