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Saline Vs Silicone Breast Implants for a More Natural Look?

I'm getting Breast Augmentation in 2 months. I had originally decided on a 320cc silicone implant, but now feel safer going with saline.I contacted my plastic surgeon and it was clear she was trying to dissuade me from going this route. She believes I will be much happier with the look of silicone and stated that she rarely does a saline implant anymore, as almost all of her patients request silicone. Please help me make heads or tails with this decision I need to make. Can a saline implant give a comparable natural look?

Doctor Answers 23

Saline and silicone breast implants will look the same

There has been a general push toward the silicone gel breast implant and a feeling that patients will be 'happier' with the gel. The bare truth is that both work very well and I defy anyone to show a picture of a well performed breast augmentation and be able to tell if the implant is indeed gel or saline. Both will look very natural. The next issue is feel. It is true that the saline breast implant will have a greater tendency to show through a ripple, especially in thin skin, however in place in the breast the saline implant is soft and compressible and has a flow characteristic that makes it satisfactory and natural in most who seek augmentation with an under the muscle approach. The gel implant may feel softer, though it may not. The more cohesive the gel, the stiffer the implant. The extreme is the 'gummy bear' implant where the implant is form stable which flexes or compresses and then resumes its shape. It can look wonderful, though 'natural' it is not. Remember that with each implant there are trade offs, some more acceptable to a patient than others. Take your time to explore, and resist a push to one implant over another until you understand what your choice will mean in the long term.

Best of luck,


Chicago Plastic Surgeon
4.0 out of 5 stars 36 reviews

The "look" of saline vs gel implants

If you looked at 10 patients with breast implants, half with gel and half saline, you would not be able to tell them apart based on the "look." Each look fine. The only difference is in the "feel." If a saline patient leans way forward, you can typically feel or sometimes even see ripples along the lower outside edge of the implant. If that wouldn't bother you and if you feel "safer" with the saline, go with them! Make sure they are under the muscle.

Silicone versus saline implants

Some of the reasons for visible rippling, which tend to be higher with saline implants include:

1. thin skin and minimal breast tissue with visibility of normal folds
2. moderate profile saline implants are more likely to ripple than high profile saline
3. saline are more likely to ripple than silicone implants
4. over the muscle placement are more likely ot have visible rippling than under the muscle
5. weight loss may make rippling more noticeable
6. involutional breast atrophy after nursing may make rippling more apparent
7. breast ptosis (sag) may make rippling more pronounced
8. capsular contracture with "scrunching" of implant causing folds
9. textured surface causing folds and knuckles
10. partial deflation of implant with collapse and folding
11. underfilling of implant
12. flipping of implant

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Go for Silicone Breast Implants for a more natural look

If it is a close choice for you, go with SILICONE.

Yes, great results have been achieved with both saline and gel implants.

The advantages of saline are lower cost, ability to be placed through a smaller incision and by being able to put more or less saline in - we can correct minor asymmetries.

The advantages of gel implants are, they are lighter, they ripple less and they feel much more like the real breast tissue.

Good luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 83 reviews

Saline vs silicone implants

You should first be aware that there are no health risks of saline or silicone implants. Silicone implants have been studied extensively over the past 20 years and are FDA approved.

You can have a very natural result with either saline or silicone. Saline and silicone "look" quite similar. However, silicone breast implants "feel" more natural to the touch; this is why most patients and surgeons are now using more silicone breast implants. One potential problem with saline implants is that of rippling or wrinkling of the implant edges, which can often times be seen or felt on the side of the breast. This phenomenon of rippling rarely occurs with silicone due to its thicker, gel composition.

Please meet with your surgeon again to look at more implants and photos of patients to further assist in your decision.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 239 reviews

Results can be good for both saline and silicone breast implants

Good results can be had with both. To a large extent the decision of one versus the other depends on the patient's natural breast/chest anatomy. The thin patient with minimal tissue would often do better with the silicone implant in terms of ripples, and a natural feel. Otherwise, saline is acceptable.

Safety is not really a consideration as I feel both are "safe". Deflation is a possibility, and the saline implants go flat. The silicone implant, more involved and hence the need for MRI analysis. Not really a safety issue, but a consideration. All things being equal, go with what you are comfortable with.

Michael A. Marschall, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 9 reviews

BA- Saline VS Silicone

When choosing a breast implant, it’s important to keep in mind the “look” the patient is trying to attain. Both types of implants are safe and effective. Saline has a rippling effect due to the fact that it’s water based, while silicone has a harder texture, making it feel more natural to some patients. We suggest for the patient to bring us a picture of what they want to achieve and together we can make a proper decision of what’s best for the patient.

Both Implants Offer Benefits

The type of breast implant used is one of the most important decisions facing patients undergoing breast augmentation.Silicone and saline implants both offer significant advantages for breast augmentation and are both associated with high satisfaction rates.
Although it’s hard to tell the difference between saline and silicone when looking at patients, there’s a significant difference in how they feel.This difference is especially noticeable in women who have minimal amounts of breast tissue.
Silicone implants offer several advantages over saline implants.The most important advantage is how they feel.There’s no doubt that they feel more natural than saline implants, especially when there’s minimal breast tissue present.In addition, silicone implants are less likely to cause rippling than saline implants.
Saline breast implants also offer several advantages.They can be placed through smaller incisions, because they’re not filled when inserted.The volume can be adjusted and, in patients with asymmetry, this offers a significant advantage.In addition, patients don’t have to worry about the lingering silicone controversy when saline implants are used.
Finally, saline implants are less expensive than silicone implants.For many patients, affordability is extremely important.
It’s extremely important that patients be educated about the advantages and disadvantages of each type of implant.For some patients, having a natural feel is their primary concern and silicone is the best choice.Other patients worry about safety and the silicone controversy and saline is the obvious choice for them.It’s essential that the patient be involved in the decision.Ultimately, high satisfaction rates are associated with both types of implants.

Natural looking results

Factors such as technique, placement and implant type all contribute to how real implants look and feel, and these factors are all determined by a patient's unique physiology and expectations. However, in general, when it comes to implants cohesive silicone gel are considered to look and feel more natural.

More natural look

Benefits of Cohesive Gel Silicone Breast Implants:
  • Feels much more natural, like a real breast
  • Much less rippling, wrinkling than saline
  • For the same size, silicone weighs slightly less than saline
  • Limitations of Cohesive Gel Silicone Breast Implants:
  • A larger incision is necessary, usually placed under the breast because the implants are pre-filled. Smaller sizes can be placed via a trans-axillary incision
  • Although it is a cohesive gel, there is a very small possibility the silicone could leak into the breast tissue, although long term population studies have shown this does not cause any heath risks. Incidence of leakage is approximately 1% per year or less
  • Slightly higher risk of Capsular Contracture than with saline
Benefits of Saline Implants:
  • Can be inserted through smaller incisions, and incisions away from the breasts such as Transumbilically (belly button) or Transaxillary (armpit)
  • If it leaks, your body absorbs the saline. Incidence of leakage is approximately 1% per year or less
  • Can make adjustments for asymmetry by adding more fluid to one implant
You should talk to your surgeon to figure out which one is better for you.  Both can achieve a natural look - it just depends on the skill of your surgeon!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.