Saline and silicone implants are both FDA approved. Both are considered safe. They have the same shell (outer covering) ; the difference is the fill inside the implant. They look the same. The biggest difference is in the feel.
Saline implants are filled with salt water, which is what your body is primarily made of. If they leak your body absorbs the water, and the breast implant deflates. Many of my healthy Bay Area patients prefer the idea of saline implants. Saline implants allow for size asymmetry correction more than gels, which come in prefilled sizes. The biggest downside is the feel. If you don't have much tissue covering the implant, they can feel "water baggy," and you may see wrinkles and ripples.
Silicone, also known as gel implants, were open to the breast augmentation market again in November 2006. The implants were removed from the market in the early 90s due to concerns they caused health issues, but when large studies were done, there was no statistical significant difference. Gel implants feel more like fat. The true downside is a higher incidence of capsular contracture, where the breast capsule turns hard. The current gel implants are cohesive gel, to reduce the incidence of gel bleed, to try to reduce this incidence of capsular contracture.
I use both implants. I think they are safe. If you want an implant that feels more natural, particularly if you have thin tissue cover, then gels are better. You do have a higher risk of capsular contracture with the gels. If gel implants don't sit well with you and you want something more natural inside, then saline implants are a better choice.
