I Am Considering Getting my Boobs Done. Which is Better: Saline or Silicone?

I have heard silicone feel more natural, but I am afraid because they have had a bad reputation. If they rupture, will I get sick? My friend has saline and they are as hard as a rock. Will mine be like this?

Doctor Answers 13

Great Candidate for Saline or Silicone Breast Augmentation

First off, you provided a great photo which shows your breast tissue and shape clearly and your proportions. Makes our job easier here. So, based on your photo, you can go with either. There are advantages and disadvantages to either one for your breast type. in patients such as yourself, with very little to no breast tissue and relatvely think looking skin, you may want to stretch your breasts out with sub-muscular saline breast implants first in order to get more projection. The downside is that saline tends to not "hide" or camouflage itself as well as silicone. Saline implants tend to be more easily felt under the skin and are associated with more visible rippling. Silicone implants for you may not give as much projection unless you go real large, and you do not want to go huge because your breast tightness and shape does not indicate too large an implant.  However, the right sized silicone implant will look more natural and feel more like natural breast tissue.  You apper to be a good candidate for a "flash recovery breast augmentation."  With this technique, your recovery will be quick and you can get back to your life in less than 24 hours.  Good luck.  Do your research and always choose a plastic surgeon that is board certifed by the American Board of Plastic Surgery.

Beverly Hills Plastic Surgeon
4.0 out of 5 stars 68 reviews

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Saline or Silicone

Both silicone and saline breast implants are safe. There are distinctions between the two breast implants. However, the distinctions are best explained in the context of a consultation process. Surgeon will weigh these distinctions differently based on their preferences, experience and expertise. Consult with 3 board certified plastic surgeons to understand your options and choose the surgeon/surgical plan that best meets your needs/objectives.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 21 reviews

Silicone versus saline breast implants for augmentation surgery

Saline Breast Implants
Saline breast implants are filled with salt water. They come from the manufacturer unfilled and will be filled during the augmentation procedure, which makes them more flexible during surgery, and in fact there are some incision types that can only be done with saline breast implants. Also, because they come unfilled, they can be adjusted to meet your individual aesthetic goals, and even to adjust for asymmetrical amounts of natural breast tissue. The advantages of Saline breast implants are:

•Fill level adjustability
•Surgical flexibility
•Ruptures noticed quickly because saline is absorbed by body
•Slightly safer
Silicone Breast Implants
The FDA has determined that the lawsuits surrounding silicone breast implants were largely a product of fear and had little basis in medical evidence, and therefore re-approved them for use in November 2006. Silicone breast implants are considered aesthetically superior, both visually and tactilely, to saline implants. They are unlikely to show rippling, and silicone gel is far more like natural breast tissue than saline solution. Because the implants come pre-filled to an optimum level, the implants never have fill-related aesthetic defects. The advantages of silicone breast implants are:

•Aesthetic superiority
•Factory-determine optimum fill level
There are some disadvantages of silicone implants, however. Because silicone is not readily absorbed by the body, the implants do not deflate visually after rupture, since the silicone stays in the breast implant capsule. This means that women with silicone breast implants should have regular MRIs to make sure that the implant is intact. Research has shown that the MRIs are successful at detecting ruptures whether the implant is placed subglandularly or submuscularly.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 54 reviews

Candidates for saline implants vs. silicone gel

Based on your photo and information you provided, you are an ideal candidate for saline or silicone gel. Based on the look you would like to achieve and your body type, it is your choice whether you would like saline or silicone gel. Both implants are safe and offer a lifetime warranty, if in case of a malfunction, defect, or rupture of the implants. Silicone gel is the more natural feeling of the two and there is less chances of rippling or palpation of the implant. However, if you are starting with enough breast tissue and coverage, saline can be used. Board certified plastic surgeons would not suggest saline implants for patients with very little breast tissue or a low percentage of body fat because it would not provide enough coverage of the implants causing rippling and palpation of the implants. It is best to place the implants under the muscle to provide a more natural look and support. Submuscular placement also prevents encapsulation (scar tissue), which may be the cause of your friend having firm breast with her saline implants. I recommend consulting with a board certified plastic surgeon to examine you and discuss the best and safest possible options for you. Good luck.

The truth about Saline and Silicone

To answer the question, "Will Silicone implants get me sick?", I refer you to the FDA (link provided) and the myriad of silicone implant studies. In brief, the answer is that silicone gel ruptures may lead to local problems such as breast pain, granulomas or scarring, and distortion of the breast. Body-wide or systemic diseases such as lupus, RA, fibromyalgia, and cancer have not been linked to ruptured silicone implants.

Silicone gel implants have a much more "natural" feel than saline implants. In women with smaller breasts, the implant often makes up the majority of breast volume after an augmentation. In these cases, the "feel" of the implant is more important and silicone is typically recommended. Saline devices have the one advantage in that a rupture is obvious as the saline becomes absorbed and the breast "deflates."

My recommendation is for you to consult with a board certified plastic surgeon and review the provided information on silicone implants. This will allow you to make an informed decision as to which implant you feel comfortable with. Again, I encourage you to visit the link provided for the FDA's consumer information regarding silicone breast implants.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Silicone implant safety

First, most of the problems previously attributed to silicone implants were due to how they were used. All the studies done over the last 18 years have proven them safe. The hardness of your friend’s saline implants has nothing to do with the type of implant. All implants can feel hard if the body creates a tight scar around them. As thin as you are, and as little breast tissue as you have, I would use nothing but silicone implants. Placement would depend on your physical examination and your activities. Wherever I place them, I would probably recommend a textured implant to reduce the risk of scar capsular contracture (that which causes implants to feel hard) to a minimum.

Getting my Boobs Done. Better: Saline or Silicone

Very difficult question to answer. Yes silicones on average feel more natural. But salines are the standard here in USA. I bet if the fee was exactly the same for either salines vs silicones than the most used would be the silicones. All in all it is a very personal decision that you need to be seen in person by at least 3 boarded plastic surgeons in your area. Best of luck from MIAMI DR. Darryl J. Blinski, 305 598 0091

Silicone vs. Saline

The choice is yours.  I believe there are several things to consider with each in your particular case.

1.  You do not have a well defined crease.  silicone implants are place through a crease incision.  The final position of the crease can be tricky and end up higher than desired if it is not planned appropriately.

2.  Since you do not have a well defined crease, saline implants placed through a periareolar incision can be performed (smaller incision).  The downside is that there is a higher chance of numbness of the nipple, decrease ability to breast feed and a slighter higher chance of infection.

Dr. ES

Implant choices

Saline vs silicone is a personal choice made by the patient after a thorough discussion with the doctor during consultation. Both are good choices.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Gel-filled vs. saline-filled breast implants

The first answer is that there is no evidence to support the fear that a silicone gel-filled breast implant will affect your health if it fails while in place. The problem with gel-filled implants is that there is still no simple way to know if a gel-filled implant has failed. It has a lifetime guarantee for replacement but the best test for whether it needs replacement is an MRI which is not a simple or inexpensive test. 

The second answer is that your friend's breasts are non rock hard because the implant is saline-filled. There seems to be no consistent benefit of saline or gel implants in regard to what sounds like capsule contracture. 

Here's how to understand the advantages and disadvantages of gel-filled breast implants compared to saline-filled breast implants. Silicone gel-filled breast implants have only one advantage over saline-filled but it's a big one. Silicone gel-filled implants feel like natural tissue regardless of the tissue coverage over them. Saline-filled implants don't. If you have good tissue coverage over the implants then this wouldn't be an important factor. If you have thin or poor coverage over the implants then it's a very important issue for you to consider. Based on your picture it would appear that you have good skin and fat layer coverage but little breast tissue so you are a 2 out of 3 on coverage. If the implant is smooth surfaced, sized and positioned properly under the pectoralis muscle (and filled properly if it's saline-filled), you will be able to feel it on the side and underside of your breasts but not too much and it shouldn't be visible in terms of ripples or apparent to someone else. 

Another way to look at it is that saline-filled breast implants have all the advantages but one big disadvantage and that is that they feel inherently ripply because of the saltwater fill. Their major advantage is that there are no health concerns if they were to fail and no tests are necessary because it's obvious when a saline-filled implant fails. Their other minor advantages are that they cost less than half of what gel-filled implants cost, you can put them in through a 2 cm incision (compared to about twice that for gel) and you can also adjust the fill volume up to 10% over the rated volume (but not with gels). 

So it depends on how important these various factors are to you and how good your tissue coverage is. Volume and width/profile options are very similar for gel vs. saline (aside from the 10% fill variation for saline). I think this choice should be up to the patient rather than the surgeon. The sizing is based on dimensions and profile choices. The technical details for how to carry out the procedure based on experience is best left up to the surgeon. 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

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.