Silicone vs. Saline Breast Implants: Which Is Right for You?

surgeon holding breast implants at a consultation

Even though patients thinking about getting breast augmentation at our Boston practice do quite a bit of research before their consultations, many women are quite surprised about the range of breast implant options available. Silicone versus saline is just the beginning when choosing breast implants.

And beyond the choice of implant filling, breast augmentation patients also need to make decisions about implant size and profile, in addition to whether they want implants in front of or behind the chest muscle and where they want the surgeon to make incisions. In this blog post, though, we’ll focus primarily on the difference between silicone and saline implants and which one would be right for you.

Comparing Silicone and Saline Breast Implants

When choosing breast implants, women often begin by deciding whether they want silicone or saline implants. When a board-certified, experienced plastic surgeon performs breast augmentation, the results can look beautiful and natural, whether the patient chooses saline or cohesive silicone gel implants.

So, why would a patient choose one over the other? It’s all about personal preference.

Saline Breast Implants

First used in the 1960s, saline implants have an outer shell made of silicone. The plastic surgeon creates a pocket in the breast, inserts the implant shell, and fills the implant with sterile saltwater. This sterile saltwater is biocompatible with the patient’s body. That means that if the shell tears or leaks, the fluid is harmless.

Because surgeons don’t fill saline implants until after inserting them, they can make smaller incisions for saline implants than for silicone gel implants. Plus, saline implants are usually less expensive than silicone gel implants. The popularity of saline implants, however, has decreased steadily for several years. Less than 15% percent of patients choose saline breast implants at our Boston, MA, practice and nationally.

Patients often say that saline implants feel firmer than natural breast tissue and that they don’t move like natural breasts. Another drawback is that saline implants tend to be seen below the skin more easily than silicone gel, with visible rippling or wrinkling. That’s why patients with little existing breast tissue who get saline implants should have them placed behind the chest muscle.

Another option for patients who choose saline-filled implants is to combine the augmentation procedure with fat transfer—a technique often called hybrid breast augmentation. During the surgery, the surgeon harvests fat from another area of the patient’s body using liposuction and then uses the fat to soften the look and feel of the implants. This creates more natural-looking results.

Silicone Gel Breast Implants

The increase in the types of cohesive silicone gel breast implants available to patients enables breast surgeons to truly customize the outcomes based on the look and feel that each patient wants. Silicone gel implants now come in various consistencies, including so-called “gummy bear” implants. These implants earned that nickname because the silicone gel behaves much like gummy bear candies, remaining in place even if they are cut in half.

Patients often believe that less cohesive silicone gel tends to have more in common with natural breast tissue—firm but still soft when squeezed. Silicone gel implants also behave more like natural breasts than saline implants, especially when lying down.

Because silicone gel implants arrive at our practice pre-filled, the incisions are a bit longer than those needed for saline implants. The difference, though, is barely noticeable because most patients choose to have incisions made in the inframammary fold where the bottom of the breast connects to the chest wall. And, with proper care, breast augmentation incisions fade quite a bit after about a year.

Patients who choose silicone gel implants should also be aware that if the implants do rupture or crack, they may not notice until a diagnostic test such as a mammogram or MRI reveals it. This situation, sometimes called a “silent rupture,” can lead to the gel seeping into the body.

Which Implant Is Right for You?

Both silicone gel and saline breast implants are considered safe. Because the FDA has approved silicone gel implants for patients aged 22 or older, I recommend that younger women get saline implants for augmentation. If the cost of implants is an issue, saline implants are less expensive.

The bottom line, however, is that patients should choose the implants that they personally prefer. During consultations, I answer any questions patients may have about the implants and discuss the benefits and disadvantages of each type. Neither type necessarily lasts longer than the other, and some patients may end up deciding at some point to exchange one type for the other.

If you’ve been researching breast augmentation and want to discuss your breast implant options with a breast surgeon in the Boston, MA, area, request a consultation using the online form to meet with Dr. Dax or call us at (781) 740-7840 to schedule an appointment.

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