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Silicone Vs Saline Breast Implants for a 37 Year Old?

I'm considering Breast Implant with Breast lift since aging impact and having baby left me with flat breast with loose skin no volume on top. I hate the look of my saggy deflated breast at the age of 37 with small frame and not much breast tissue and thin skin.

I'm confused which one would be best to choose silicone or saline as far as safety, complication, price, pain, and age is considered. What is most important to keep in mind while choosing implants? Thnx for your help.

Doctor Answers (15)

Saline vs. Silicone Breast Implants?


Hi there-

First of all, it is important to realize that there is absolutely NO reason to have any health concern whatsoever with either silicone or saline implants.

The differences that are real have to do with cost, aesthetic outcome, and simplicity of follow up, if you will.

Silicone implants will give most women a superior cosmetic result, with a much more natural feel to the breasts. They are a bit more expensive, because medical grade silicone is more expensive to produce than saline solution, and because you probably will not be aware of a rupture if it were to occur, it is important for you to see your plastic surgeon each year and have an MRI of the breasts every few years to detect a problem if one should arise.

Saline implants do not require MRI's or yearly follow up (although this is a good idea) and they are less expensive, but they also don't look quite as nice, are prone to visible rippling, and tend to feel considerably less natural than silicone.

Bottom line- every year I see at least 7 women with saline implants asking for silicone, but I have never had a patient come in with silicone implants she wanted to exchange for saline because she didn't like the look or feel of the breasts.

Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

Most women choose silicone breast implants with breast lift.



You will get a fine result with either silicone or saline breast implants.  Both are extremely safe, and silicone feels a little more natural.  So most patients opt for silicone for a combination breast lift and breast augmentation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Silicone versus saline implants


Both silicone breast implants and saline breast implants have pros and cons. It’s important that the educated patient understands these differences before making an informed decision. Before delving into these differences, though, it’s important to state unequivocally that currently utilized silicone breast implants are safe. Over the past 15 years, many large and rigorous studies have been performed investigating whether silicone breast implants are associated with autoimmune diseases or any types of cancer. All studies performed reached the same conclusion; there is no conclusive data supporting any link between silicone implants and these diseases. Only after carefully considering these scientific studies did the U.S. Food and Drug Administration approve the use of silicone breast implants in all women for breast reconstruction and in women over the age of 22 years for cosmetic breast augmentation.

Some good things about silicone breast implants; breast implants filled with silicone gel look and feel more like natural breast tissue. Also, particularly in thin patients, silicone breast implants tend to have fewer problems with visible rippling than saline breast implants.

Some bad things about silicone breast implants; breast implants filled with silicone are more expensive. Silicone breast implants are approximately twice the cost of saline breast implants, which is factored into the price of surgery. Also, a breast implant rupture is easy to detect when the implant is filled with saline; the breast tends to deflate rapidly, in the span of a few days. A silicone breast implant ruptures is much more subtle to detect. For that reason, the Food and Drug Administration recommends an MRI to monitor for rupture, the first one 3 years after surgery, and then every 2 years thereafter. This test is expensive and most likely will not be covered by third-party insurers. Lastly, capsular contracture rates, or pathologic scarring around the implant, traditionally were much higher with the older generation of silicone breast implants. This does not seem to be the case with the newer generation of silicone breast implants used, which is largely attributable to a thicker implant shell and thicker, more viscous silicone gel within the implant.

So, what’s better? To repeat, silicone breast implants look and feel much more natural, but it comes at a higher financial cost, the recommendation for MRI monitoring to detect for rupture, and a larger incision.

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 33 reviews

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Silicone or Saline Breast Implants


Each implant has its positives and negatives. Generally speaking gel implants give a more consistent softer feeling and looking result. The gel implants require closer follow up. The FDA recommends an MRI scan after 3 years then every 2 years therefater. It is felt that insurance companies will not cover that expense. Also if the implant breaks and the gel leaks out some patients develop local reactions of nodules or the implant changing position or shape.

The saline implants do not need any special tests to determine if they break because they will visibly deflate. In addition the salt water is simply absorbed by the body and does not cause any problems. If the implants need to be replaced the saline is easier to replace than the gel.

You have to decide what matters most to you, the result or the potential hassle of follow up. In some patients when the implant size is not too great and there is sufficient breast tissue the difference in the final result tends not to matter as much.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 18 reviews

Silicone implants usually feel more natural when skin is thin


Given your description of thin skin and not much breast tissue, the way the implants feel will make more of a difference. When there is more tissue around the implant, you don't feel the implants as much so it isn't as important which type you choose. In your situation, most patients would go with silicone because the consistency is closer to that of breast tissue. With saline, the lower fill volumes leave them ripply, and the higher fill volumes make them firm and too round. Silicone gel implants are prefilled so that isn't an issue.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 28 reviews

Saline vs. silicone


A great but very complex question with no real answer except that there is no such thing as best. All the variables you mention are significant and need to be considered but saline and silicone implants measure up differently with each variable. You really need to prioritize the variables you accept and those you don't. While the complications might be somewhat more with silicone gel, your chance of a more natural feel and look is greater. Submuscular or subglandular placement is also a significant factor and most surgeons would suggest submuscular with your stated situation. However, a comprehensive face-to-face consultation with a plastic surgeon is the way to go.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Saline vs silicone implants in small, thin frame


If you have thin skin overlying your breast and don't have a lot of breast tissue, you may be better served with a silicone breast implant. The reason for this is the lower incidence of rippling and wrinkling which occurs with silicone compared to saline. The saline implant has about a 15-20% chance of rippling vs. 1-2% rippling with silicone. This would be my primary concern in a thin patient without much breast tissue.

Please visit a board certified plastic surgeon to discuss this issue in more detail prior to scheduling breast augmentation.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 152 reviews

Silicone vs Saline


The choices between silicone or saline is yours.  Silicone tend to feel more natural but cost more.  Saline are easier to detect a rupture.

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

Silicone vs Saline Breast Implants


You will likely get the best result with silicone gel implants. With thin skin and a scanty amount of breast tissue, you are likely to get rippling and an unnatural feel to the breast with saline implants. Gel implants are less likely to get rippling and feel softer.

The silicone gel implants do cost more, but in your case are worth it. You are going to spend a fair amount of money on this procedure anyway, so you might as well get the maximum benefit.

The implants are equally safe.

Kenneth L. Stein, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 10 reviews

Silicone vs Saline implants


One of the most important things to remember when choosing implants is that they are not forever and you may require revisionary surgery with time. Without a photo or examination, I must qualify my statements. Given your statement that the skin is very thin, it is likely that I would recommend silicone implants to enhance the palpability as well as the visibility. To some degree, most recent studies have shown tha the silicones have a lower complication rate then salines. However, there is the possiblity of "silent rupture". For this reason you may need to undergo periodic MRI evaluations to evaluate implant integrity.

The price for silicone implants is typically higher than the salines.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 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.