Seung K. Kim, MD

It is true that silicone gel implants feel better than saline implants. Does that mean everyone should get gel implants? The answer is no. The choice should be individualized considering risks and benefits for each person.

A saline implant is more obvious to touch under a thin cover. Under a thick cover, difference between gel and saline becomes less. However, if a saline implant leaks, detection is very easy and does not require any special tests. Replacement operation is simple. Only the shell needs to be removed since saline disappears soon after the break. Incisions required for insertion and removal can be small.  It is less expensive.

A gel implant is nicer to touch. But in case of breakage, detection is more difficult. It requires an MRI scan. As a matter of fact, the manufacturer recommends that surveillance MRIs be done in regular intervals. Replacement operation is more involved requiring complete removal of the material. Gel implants come pre-filled.  So the incision has be be made larger than for saline which comes empty. Gel implants cost more.

One thing that is not discussed often is the fact that implants are not designed to last the life time. Every young woman undergoing a breast implant operation today will experience implant rupture during her life time. Therefore, in general, if a woman has relatively thick tissue, saline implants would be appropriate. If a woman has rather thin breast tissue and is skinny all around, gel implant would do better despite the drawbacks noted. Of course, there are exceptions in which a woman expresses a strong feeling for or against a type of implant. Individual wishes should be respected if possible as long as the pros and cons are fully discussed.