I am looking into a BA to improve symmetry. In one breast I am a full 32 B, in the other a full 32 C. I am 5"5 and I'm around 122 lbs. My doctor wants to do saline because a.) I am only 19, b.) he says saline is adjustable so he can get the best symmetry. I am most concerned about looking and feeling natural. Do I have enough breast tissue that saline implants won't feel like a water balloon? Do most patients report natural-feeling results with small/moderate saline implants? I don't to be big.
Can Saline Feel Natural? (photo)
Doctor Answers (27)
Can Saline Feel Natural?
Saline implants do not feel as natural as silicone gel implants. The thicker your tissue, the less noticeable the difference. The main difference in feel is in the lower portion of the breast as the pectoralis muscle (assuming they are being placed beneath the muscle) does not cover the implant down that far. With saline you will generally feel the edges and wrinkles of the implants in the lower pole with your fingers, whereas with silicone gel implants you will not or, if so, very little in comparison. I think the "advantage" of the saline implants' "infinite adjustability" is practically speaking not very significant. The silicone implants are available in 25cc increments, and really, less than 25cc differences are not very noticeable. You would qualify for silicone gel implants because of your asymmetry despite being under 22 years of age. For a thorough discussion of all of the pros and cons of saline vs. silicone gel implants, I would suggest that you ask your surgeon or get a second opinion from another surgeon who may offer a different viewpoint.
In a patient with substantial breast tissue, submuscular saline and silicone gel implants feel similar
Be reassured that saline implants are an excellent option. The vast majority of women are extremely pleased with their results. The difference in feel characteristics is very slight, particularly when the implants are placed behind the muscle. Sometimes I will recommend silicone gel when large implants are used in a woman with little of her own body fat or breast tissue, but you are not at all such a patient - quite the opposite, you want average-sized implants and you have quite a bit of your own breast tissue. In fact, in patients like yourself, it would be unlikely that anyone could tell what type of implants you have by examining you, including plastic surgeons. It is possible to use different-size silicone implants, but with saline implants the surgeon can fine-tune the volume a little more easily, as your surgeon mentioned. You are fine going with saline. And you are correct, 22 is the minimum age for silicone (I'm not sure why). I've attached a link showing many women with saline implants. You may want to check it out and see what you think.
Saline pros and cons.
Saline implants can give a very nice result if one has sufficient breast tissue to cover the implant. In your case, that should prove to be true. The relatively minor asymmetry that you have can be minimized by overfilling the right implant to a greater degree than the left.
Silicone implants will always feel more like breast tissue than saline will but an argument can be made in your case that the advantages of saline outweigh the disadvantages. Also, your surgeon is complying with the recommendations of the FDA which is appropriate.
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I have had many very nice results with saline implants but, as you have noted, the amount of breast tissue that you have to provide coverage over the implants is very important. I suspect that avoiding excessive enlargement will also be helpful as it will not stretch and thin the tissue as much over time. In general, however, I think most women would agree that silicone gel implants provide a result that is softer, less likely to ripple and more "natural". I do not think it is a problem to use silicone implants when trying to correct volume asymmetries. It is true that we are limited to the sizes provided by the manufacturer but the incremental difference in available sizes is relatively small. If you would like silicone I would suggest waiting until you are 22.
Silicone or saline ?
Thank you for your question.
Saline implants are indeed more like a water balloon. In fact, that is really what they are. Because of this when they are filled they tend to be more firm and have more fullness in the upper portion of the implant. This looks less natural but in some cases can look sexier. Because silicone gel implants are filled with a gelatinous substance, the silicone gel, they are softer and for lack of a better word "mushier". The silicone in the implant tends to gravitate towards the bottom of the implant which gives a softer transition from the upper chest wall to the breast. This tends to look more natural.
In patients with a generous amount of natural breast tissue either implant can be well hidden if the appropriate size is chosen. In patients with less breast tissue a silicone gel implant will generally tend to look more natural.
Given your photographs and your amount of natural breast tissue if you're looking for a more natural result I would tend to favor a silicone implant. It is important that you discuss the pros, the cons, and the maintenance. with your board certified plastic surgeon before you make a final decision.
Good luck with your decision.
Saline versus silione.
The answer to the question of "feel" depends upon the amount of breast coverage over the implant and the size of the implant. A smaller saline implant with plenty of coverage will not be felt. A submuscular placement of the implant will certainly cover the upper portion of the implant. However, the implant may be palpable in the lower portion of the breast. At 19, you do not meet the FDA recommendations for silicone gel implants.
Natural feel of saline implants
Everything is Relative... Saline will never feel as "natural" as silicone gel
Saline implants can, under the right circumstances, be difficult to detect as a saline implant (this is, after all, what we mean when we say an implant feels natural- that you cannot tell by feel that it is an implant).
The problem is that it is very difficult to control the circumstances to the point where you could be very confident that the result you want is going to be achieved, especially as you are a very thin young woman.
In all patients, a silicone gel filled implant will feel more like a real breast than a saline implant will, but there are other issues to be understood with their use- especially in a 19 year old.
I do not agree that symmetry is necessarily going to suffer if you use gel however.
I would think these matters through very carefully and gather other opinions if you need to to be confident that you are doing what is best for you.
Saline BA and natural feel
Saline implants can feel natural if they are place under muscle, and a small implant is used with moderate breast tissue to cover the implants. Silicone will look and feel better but your age limits you to saline implants according to FDA guidelines. You should do just fine if you use smaller implants in a sub-pectoral pocket (under muscle.) and have the implants filled to higher end of recommended volume.
Can Saline Feel Natural?
There are many factors that will contribute to a natural feeling breast augmentation. Overall patients will say silicone feels much more natural that saline. You should have enough breast tissue coverage over the implant to allow for a more natural result and it does appear that you have enough tissue. I think an implant placed below the muscle will give you a great result. You have to be 22 years old for silicone anyway according to the FDA. You can still have a wonderful result with saline.