What is the difference between saline and silicone implants and how do I know which is best for me?

Doctor Answers (6)

What is the difference between saline and silicone implants?

+5
Thank you for your question. There are three types of implants for you to choose from:
-Saline 
-Silicone Gel
-Form Stable Silicone

Both saline and silicone implants have a shell made from a silicone elastomer, essentially a silicone plastic. The shells for silicone implants are a bit softer than those used to make saline implants.

Saline implants are packaged filled with air, and are deflated, inserted, and filled with sterile saline once implanted into the breast. If a saline implant ruptures, the saline is absorbed rather rapidly by the body. Therefore, a rupture is noticeable very quickly. Saline implants do have a higher potential to show rippling and do not feel as natural as silicone gel implants.

Silicone implants are filled and sealed by the manufacturers and are simply inserted as-is.  Silicone gel implants are more natural feeling, and have a tissue-like consistency that saline implants lack. Silicone gel implants are also less likely to ripple. If this type of implant ruptures, the gel will leak into the breast capsule (and will not migrate to other parts of the body), therefore making rupture more difficult to detect. Patients can go months or even years unaware that their implant has ruptured.

The other class of silicone implant is the form-stable, or "gummy bear" implant. These implants contain a silicone that is essentially solid so they will not leak if ruptured, and these implants have a much lower incidence of rupture than standard implants. Form-stable implants will likely last longer than saline or silicone gel implants before they have to be replaced.  These implants are not for everyone, however. The ideal candidate for this implant has a relatively small, snug breast envelope and desires a moderately sized, natural-looking breast.

I recommend meeting with a Board Certified Plastic Surgeon to discuss these implant options. He or she will help guide you to discover what implant is best for you based on your concerns and desires, taking into consideration your anatomy and frame size.


Denver Plastic Surgeon
5.0 out of 5 stars 61 reviews

Difference Between Saline and Silicone Breast Implants

+2
There are many factors that can go into recommending a saline or silicone implant for a patient, however, most of the time it’s the patient’s preference. Simply put, a saline implant is filled with a salt water solution and silicone implants are filled with “gel” or silicone.

Both implants have the same type of silicone rubber shell on the outside. The amount of your own breast tissue, the size of the implants, etc. are all considerations a board certified plastic surgeon will discuss with you at the time of consultation to help you make the best decision for your body.

The surgeon you meet with will probably have samples of both types of implants in their office for you to feel the difference.

George John Alexander, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Difference between saline and silicone breast implants

+2
Saline breast implants have a silicone rubber shell which is filled with saline which is salt water.  Saline breast implants can look perfectly natural and as good as silicone implants but there is a tendency to form ripples which in thin patients can be seen through the skin.

Silicone gel breast implants contain a viscous thick cohesive silicone gel inside the silicone shell.  They feel more like natural breast tissue and have less tendency to form ripples and visible deformities then saline implants.

Both types of implants are best placed beneath the chest muscle when possible  which provides more coverage of the implant, has less chance of capsular contracture, and ultimately can lead to better mammograms.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

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What is the difference between saline and silicone implants and how do I know which is best for me?

+2
Good question and one that is frequently asked. Without getting very technical, silicone gel implants feel more natural than their saline counter part. Not necessarily that they look more natural. I strongly feel that looking natural is a function of the basic patient's anatomy and the surgical skills of the surgeon. In addition, the incision that is required for silicone gel implants is longer than for saline. The use of the Keller funnel has really shortened the incisions required for silicone gel. All implants carry inherent risks of rupture. If the saline implants rupture then the breast will usually deflate within a few hours sometimes days. Whereas, if a silicone gel ruptures, the patient will require an MRI to make the diagnosis. For the most part, silicone gel implant are also more expensive.

When the new silicone gel was approved back in 2006, I really did not have a preference for saline or silicone. Today, I prefer the use of silicone gel implants particularly in thin, svelte patients lacking breast tissue. I feel that the use of saline implants in these patients and rippling is unacceptably high. Good luck

Jose Perez-Gurri, MD
Miami Plastic Surgeon
5.0 out of 5 stars 64 reviews

Differences between Saline and Silicone

+1
The advantages of saline implants are that they are less expensive. Silicone implants feel more natural and look more natural. If the is a hole in the shell of a silicone implant, the current silicone implants are made of silicone gel and don't leak like a liquid. Whereas with a saline implant, if there is a hole in the shell, the implant will deflate quickly. Click on the Web Reference Link below to see a more in depth discussion of the differences.

Jonathan Kaplan, MD, MPH
San Francisco Plastic Surgeon
4.5 out of 5 stars 10 reviews

What is the difference between saline and silicone implants and how do I know which is best for me?

+1
When seeing patients in consultation for breast augmentation, I individualize my recommendations when it comes to the type of breast implant that will most likely achieve the patient's goals, with the least risk of complications.  In order to provide this type of advice, the patient's physical examination  and very careful communication of her goals are necessary. In my practice, I find the use of  computer imaging and goal pictures very helpful. You will find,  that without posting your pictures and your goal pictures, that online consultants will not be able to be of much specific/meaningful help to you.
The type of implant used may  determine the final outcome achieved after breast augmentation surgery, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue.
Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately.   Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.

Other differences involve how the breast implants are filled. Saline implants are filled after they are implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
Generally speaking, patients should be aware that more important than any technical detail (such as type of implant, placement of incisions...) will be their careful selection of plastic surgeon;  I think that this selection will be the most important factor when it comes to the outcome of the procedure performed.
I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 792 reviews

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.