This is THE MOST commonly asked question in Breast Augmentation. The answer is - IT DEPENDS.
For an extensive discussion of their plusses and minuses , please, refer to my website page - http://www.cosmeticsurgeryspecialists.org/breastsurgery/breastaugmentation.html
Both types of implants are made of a silicone shell; The silicone gel implants come pre-filled; the Saline implants are empty and have a fill valve at the top through which the saline will be placed ones the implant is in its position.
No breast implant is perfect - they will all suffer shell fatigue and DEFLATE / LEAK one day (from the day after surgery to as long as 30 years after surgery). But both implant producers in the USA, Allergan and Mentor, have a LIFETIME implant replacement warranty and will GIVE your surgeon a free pair for you (Even Rolls Royce does NOT have that). To delay implant leaks as long as possible the shell (envelope) cannot be too thin / weak - but the thicker it is (on either implant type), the more it is felt (palpable) from the outside, ESPECIALLY when placed in women with insufficient breast coverage.
All implants RIPPLE (More with Saline implants than with Silicone gel implants). The larger / heavier the implant, the more it will pull down with gravity and the faster the breast will sag.
So in comparison - while Saline filled implants RIPPLE more and are (cc per cc) HEAVIER than silicone gel filled implants, they cost half as much and can be placed through smaller incisions. They also obscure less breast tissue on mammogram than Silicone gel filled implants. On the other hand, the Silicone gel implants feel more "natural" and by rippling less can be placed in women who do not have sufficient breast tissue to cover the implant.
Tough choice. No Blacks or whites. You choose!
Peter A Aldea, MD
