The main advantages of saline implants is that they cost less and can be placed through a somewhat shorter in decision than silicone gel implants. Another advantage of saline implants is that they do offer a greater range of sizes and fill volumes and an element of adjustability both during surgery and after surgery, should you select the Mentor spectrum implant. This can be helpful if you have a difference in breast size.
The main disadvantage of saline implants is that they do tend to wrinkle and ripple more than silicone gel implants. This will be more noticeable in a patient with a smaller breast and less body fat. In a patient with a larger breast and a greater amount of body fat the rippling may not be as much of a problem and in that case the saline implant is a very reasonable choice because it will cost less.
The main advantage of silicone gel implants is that they feel more natural than saline implants. The consistency of the silicone gel implant is more like breast tissue and so in many cases, a breast with a silicone gel implant feels very natural and it is difficult to distinguish breast tissue from the implant. Whether or not you feel the implant is determined by how larger breast is prior to the surgery and how much body fat you have. The smaller the breast and the less body fat the more likely you are to feel the implant even if you proceed with silicone.
The silicone implant is more expensive, it does require a slightly longer incision and the FDA has recommended that women have an MRI scan to evaluate the implants for leakage 3 years after the initial breast augmentation and every two years after that. Obviously, that is not a requirement; however, it is a recommendation.
I go over these advantages and disadvantages with every patient. Certainly, cost is a factor. Following that issue, I do recommend that swimmer patients with smaller breasts opt for silicone gel because they feel more natural, and have less of the chance of wrinkling and rippling. A greater amount of soft tissue coverage that is available, the more I tend to let the patient is side because the saline implant in those patients will work just fine. In most cases, you must remember that patients are very happy after breast augmentation whether they choose saline or silicone gel.
