Saline or Silicone for Someone with Adequate Breast Tissue?

Getting BA done next month.My doctor usually recommends silicone because most of his patients have an A cup.After my exam, he said I could go with silicone or saline because I'm a full 34B cup. He said I have enough breast tissue so there wouldnt be a difference, and would get the same results.

It will be soft as silicone, and give me good projection. I'm a 34 full B, shooting for a 34 full D.What would you suggest? Also, 450cc or 500cc?Would like fuller, natural feel, look, and movement.

Doctor Answers 17

Saline and Silicone are both good options

Both silicone and saline implants can provide a nice result if done properly. Many surgeons prefer silicone, but there are also those who prefer saline for most patients. I have over twenty years experience using both silicone and saline implants, but for your situation, I would most likely choose a saline implant.  

There are many advantages to a saline implant which include; a smaller incision which can be hidden in the armpit leaving no breast scar, in my practice saline implants have a lower rate of scar tissue problems than silicone implants, and the leakage rate for saline implants over the last twenty years has been less than two percent.  Therefore, if your saline implant doesn't leak (98% don't) then it may not be necessary to replace it, and you won't require expensive MRI's to look for silent rupture as you would with a gel implant.  This is the recommendation of the FDA and the manufacturer of the gel implants.  I have hundreds of patients who have been extremely happy with their results from saline implants and when performed properly and with good patient selection, the implants look and feel very natural.  Ultimately, the decision is yours.  Good luck. 

Grand Rapids Plastic Surgeon
5.0 out of 5 stars 36 reviews

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Saline versus Silicone Breast Implants

Which is better, saline or silicone breast implants? There is no right answer, but there are many factors to consider:

  1. The same size saline implants weigh more than their silicone counterpart.
  2. Saline implants are firmer and more tense.
  3. Silicone implants are softer and more "lifelike".
  4. Saline implants tend to ripple, which can be felt or seen, specially at the lower outer quadrant of the breast where the implant won't be covered by muscle.
  5. Saline implants have a slightly greater chance of rupture over their lifetime.
  6. Both implant companies guarantee their silicone implants for life. Saline implants are only guaranteed for 10 years.


Are Saline or Silicone Breast Implants Better?

Dear Improvedme,

One of the most popular questions patient ask me regarding breast augmentation is "are saline or silicone breast implants better?" Unfortunately, there is no absolute answer. Both saline and silicone breast implants are good choices, each with millions of satisfied patients, but they each have their own advantages and disadvantages. In general, silicone implants are a little bit softer and more natural feeling, with less tendency to ripple, but they require a slightly larger incision to place, MRI exams after surgery to watch for leakage, and are more costly. Saline implants can be more easily placed through the axilla and require less surveillance after surgery but are slightly firmer to the touch. The less breast tissue you have to begin with, the more noticeable the implant usually is. Hence, many surgeons will recommend silicone implants for women with naturally small breasts.

Best of luck with your procedure,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 12 reviews

Saline vs Silicone Breast Implants

Your doctor is right except for one small consideration. The most obvious area of concern is superiorly if you do not have significant breast tissue to cover the implant. For people like you, this is no problem. However, because of the way the breast tissue drapes over the implant, there is one area, even in you, where there will be thin tissue coverage. That area is just above the inframammary crease. If you ballot the breast in this area, you will be able to tell the difference between a saline and silicone implant. The silicone one will feel more natural. This may not make any difference to you, but you should be aware of it.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Saline vs silicone

if you consider your implant as the frame work of a tent, if you drape a thin sheet over the framework you will see the edges of the framework.  If you drape a quilt over the framework you will lose definition due to the thickness of the quilt.  Coming in with a solid B, you are a quilt.  In your case, it probably does not matter as your tissues will camouflage your implant.  You could use saline or silicone, the saline being cheaper.  both are guaranteed for life.  One other thought I would re size you to verify what size implants you are placing 500 sounds large but, it would also depend on your height and weight.

Roger J. Friedman, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 6 reviews

Saline vs silicone

The choice of implant is yours, but in general the silicone are softer than the saline. AS for the volume, it really depends upon your exam and your specific goals. These are best addressed in the office during consultation.

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

Breast Enhancement Surgery

If you have a nice layer of coverage or adequate beast tissue you could pick either type of implant as it will be well hidden

Saline versus Silicone: Options to Consider

Patients with a good amount of breast tissue often ask me which type of implant I recommend.  The answer is that I have very happy patients with each implant type!

Generally, if a woman has a good deal of tissue, the saline implant will provide more upper chest fullness.  This is because of the shape of these implants when they are adequately filled.  The problem with saline is that they are more likely to leak than silicone, and in many patients, can produce implant palpability and wrinkling which can be felt in the lower and outer breast.   Implant wrinkling is less likely in patients with at least a full B cup of tissue and in patients who select smaller implant sizes, as these tend to thin the lower breast tissue less on average.

Silicone implants can also look great.  Smooth surface implants sit lower in the breast than textured surface implants on average.  If you prefer the feel and concept of the silicone gel implant, speak to your doctor about smooth vesus textured surfaces.  I use both of these implant types to offer patients optimal results.   Best wishes!

Stephen Bresnick, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Saline vs. Gel implants

I generally see three sets of women, I want a gel, I want a saline and what is the best implant for me.  If your breasts is going to be more implant than you then a gel will always be better.  Other than that is is all up to personal choice.  In my practice it is about 85% GEL and 15% saline.  There is nothing wrong with a saline filled implant as long as there is enough soft tissue to cover the water baggy nature of the implant. Under thin breast tissue and skin a gel will always be better and appear more natural.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 12 reviews

Sometimes deciding whether a saline implant or a silicone is best for your breast augmentation can be the

hardest decision to make, and that's because each time of implant has advantages and disadvantages.  Certainly a silicone gel implant has a more natural feel, and I agree that patients with little breast tissue of their own get a more natural look and feel with gel implants.  If you want to have the implants placed above the mscle, again silicone is better because there is more potential for visible rippling with saline implants, and you aren't hiding the implant under the muscle.  If, however, you have adequate breast tissue and just want to be bigger, and if you are having the implant placed under the muscle, then there is little difference between silicone gel and saline, and the saline costs half the price of the gel implants.  In addition, if there is a problem with the implant, it is generally easier to remove a ruptured saline implant than a gel implant.  In sum, you would be well advised to discuss the specifics of your situation with an experienced cosmetic breast surgeon. 

Michael H. Rosenberg, MD
White Plains Plastic Surgeon
5.0 out of 5 stars 2 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.