Saline Versus Silicone? (Barely 34A)

I am very small, barely a 34A, and am considering implants. I'm 5'5 and 125lbs. For someone my size, I've read it is best to get implants under the muscle because it will keep the breasts looking more "natural". But which is better for someone like me, saline or silicone?

Doctor Answers (9)

Saline or silicone breast implants for thin person with little breast tissue

+1

Thank you for your question. Both types of implant can give you a nice result.

However in patients who are thin with little breast tissuethe concern is that saline implants can cause visible rippling.

Silicone gel breast implants placed beneath your chest muscle may reduce the risk of visiblerippling or implant.


Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

Breast Implants - Saline Versus Silicone? (Barely 34A)

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As always, there are no absolute answers (or else there wouldn't be choices!).  What is right for one person may not be for another, and that's part of what you have to do in your research - figure out which issues are most important to you.

In general, I find that smooth silicone gel implants under the muscle produce the softest and most natural results, so that's normally what I recommend.  Of course, in order to be "natural" you can't go too large - regardless of what the implant is made of - or else it will not look "natural."  That, too, is part of what you have to try to decide.

There is no shortage of places to do research online include this site, and others, and books, and doctor's website, etc.  Once you've done your research you can go visit a few surgeons in your area or reasonably convenient to you, and then see what they recommend.  All of that will help you make the best decision you can for you.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 148 reviews

Silicone over saline for patients with minimal breast tissue

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Thank you for your question. The decision of silicone vs saline is truly up to you.  I prefer silicone for patients who have very little breast tissue to cover up the implants as they tend to feel more natural and have a lower risk of rippling. Saline implants are better for patients who have a lot of breast tissue to cover up the implant and their natural tissue will hide the 'sloshy' saline feel. Definitely get your implants under the muscle.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Saline vs silicone

+1

It is a personal choice slaine vs silicone. The silicone usually feels mroe natural.  My patients prefer silicon and the majority get them under the muscle.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Which is better... Saline or Silicone??

+1

This is a common question. Most surgeons would agree that silicone implants have a more natural feel, but either option can lead to a great result. At my plastic surgery practice about 80% of the breast implants I place are made from highly cohesive silicone. Silicone implants tend to have less rippling which can be seen in women like yourself with only a small amount of breast tissue. They require a slightly larger incision but otherwise surgery is similar to place them. Since silicone implants come pre filled from the factory you have 25cc size differences versus saline which have more variability. You must also be older than 22 to have a silicone implant placed. I recommend going on a consult with a board certified plastic surgeon so you can feel and see the differences for yourself. Best of luck, Dr. Kerr

Mahlon Kerr, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 74 reviews

Breast augmentation choices

+1

Thank you for your question.  There are a number of options for placement of your implant.  The choices include sub muscular, sub glandular, dual plane (part sub muscular and part sub glandular, and subfascial.  There are distinct advantages and disadvantages to each of these choices.  A consultation with a board certified plastic surgeon can help you determine what is best in your case.  In regards to implant choice, most of my patients choose the silicone gel implants because of their look and feel.  They believe that they feel more natural than the saline implants.  I hope that this helps.

Bill Kortesis, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 49 reviews

Natural Looking Breast Augmentation

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One very important issue to consider is implant palpability, i.e. whether you can feel the implant or not when you - or someone else - feels your breast. Both silicone gel and saline implants are soft and generally breast-like. Most surgeons and patients agree, however, that silicone gel breast implants tend to feel more natural than saline breast implants. Because saline is non-viscous, it tends to allow the edges of the implant to collapse and this makes the implant edges more easily palpable. This will be quite obvious to you when you examine samples of saline and silicone gel implants during your consultation.


The degree to which this difference is significant varies a great deal with regard to two factors: the amount of breast tissue that exists prior to augmentation, and the size of the implant that is used. A silicone gel implant's more natural feel will be much more important to patients who are slender and who fit in an A cup bra preoperatively, as they have less subcutaneous soft tissue and breast tissue to conceal the implant. In such a patient a saline implant is usually very easy to feel through the skin, and may even be visible externally - especially in the lateral aspect of the augmented breast where the tissue covering the implants is the thinnest. The difference in feel between saline and gel implants will be less noticeable to a patient who is more full-figured and whose pre-operative bra size is a full B or especially a C cup, and in some fuller-figured patients saline implants may be undetectable by palpation (meaning they feel completely natural). Saline implant palpability is primarily a matter, therefore, of how much natural tissue there is to disguise the implant.

When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is this: Am I seeking a natural-appearing result? If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have (and appropriate training and experience). And insist on seeing `before and after' photos. A lot of them.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 38 reviews

Saline Vs. Silicone

+1

This is a very common question. Size matters little. It is important to understand what is most important to you. If you have a fear of silicone (which is actually a very safe inert substance), then go with saline. If a natural look and feel is most important, go with saline. There are other reasons that your BOARD CERTIFIED PLASTIC SURGEON can discuss with you but those are usually the main reasons people choose one or the other.

Jacob Freiman, MD, FACS
Miami Beach Plastic Surgeon
5.0 out of 5 stars 83 reviews

Saline versus Silicone Breast Implants?

+1

Thank you for the question.

It is difficult to give you precise advice without direct examination. However, for patients with your body type I often recommend dual plane ( partially sub muscular),  silicone breast augmentations for the most “natural” results.

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.


2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.


3. The type of implant used may  determine the final outcome, 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. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  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’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.



4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. 

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.


By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 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.