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Breast Augmentation

What it is: a plastic surgery procedure to enlarge breast size by inserting breast implants

What it addresses:

- Dissatisfaction with small breast size- Changes in breasts post-pregnancy- Breast asymmetry- Post-mastectomy breast reconstruction

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Question

Silicone vs. Saline - Which type of breast implant is healthier?

Which type of breast implants are healthier - silicone or saline?


Asked by: Anonymous

Answers (4)

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1
September 20, 2008

Saline Breast Implants vs. Silicone Breast Implants

Michael Law, MD
Michael Law, MD
Board Certified
Plastic Surgeon
Answer by Michael Law, MD

In November of 2006 the FDA lifted the moratorium on the use of silicone gel implants for primary aesthetic breast augmentation. Women seeking breast augmentation may now choose between saline-filled and silicone gel-filled breast implants, and thus it is extremely important for prospective patients to understand a number of differences between the two kinds of implants.

Currently in my practice about half of patients choose saline implants and about half choose silicone gel implants. Beautiful and natural-appearing results can be obtained with both styles of implants, and a patient’s decision regarding saline vs. silicone gel implants usually comes down to individual preferences regarding the pros and cons of each.

I think it is important for patients to understand, in advance of choosing a type of implant, that both types of implants are safe and that claims which have been made about silicone gel implants have not held up under scientific scrutiny. A small number of women with silicone breast implants reported symptoms similar to those of known diseases of the immune system, such as systemic lupus erythematosis, rheumatoid arthritis, scleroderma, and other arthritis-like conditions; this eventually led to the FDA moratorium on their use for cosmetic patients only (during which time the FDA still allowed their use for patients undergoing breast reconstruction following mastectomy for breast cancer).

To date there is no scientific evidence that women with either silicone gel-filled or saline-filled breast implants have an increased risk of these diseases. These inflammatory and autoimmune diseases appear to be no more common in women with breast implants than they are in women who do not have breast implants.

2
September 10, 2008
Richard P. Rand, MD
Richard P. Rand, MD
Board Certified
Plastic Surgeon

Both implants are considered safe by the FDA. The patients choose between them on the basis of "feel" vs the perception of some that the saline implants are "safer" even though the data doesn't support that. They both look about the same but the gels feel more natural.

3
August 31, 2008

Both silicone and saline are very safe

Steven Wallach, MD
Steven Wallach, MD
Board Certified
Plastic Surgeon

The safety studies for both implants show that both are very safe, in fact some reports suggest that the safety risk is better for silicone gel implants.  However, I think that further studies will show both equally safe in terms of capsular contracture rate, rupture rate, etc..

4
August 28, 2008

Both saline and silicone implants have advantages and disadvantages

Shahram Salemy, MD
Shahram Salemy, MD
Board Certified
Plastic Surgeon

The choice of which type of breast implant to use is a very common one.  There are advantages and disadvantages with both, so it's very important for you to sit down with your plastic surgeon and discuss everything in detail.

The short answer is they are both safe options.  Silicone implants have a silicone shell and are filled with a cohesive silicone gel.  Saline implants ALSO have a silicone shell, but are filled with saline. 

In my view, the advantage of a saline implant is that you need a smaller incision during surgery (about 3 cm or just over an inch) and if it does leak, you will know (the breast will flatten as your body absorbs the saline) and so you will be able to have it replaced.  The disdvantage to saline implants is that in some patients, especially very thin ones or if they are placed above your pectoralis muscle, they can show some rippling or folds of the implant wall.

Silicone implants have the advantage of a much more natural look and feel, even in thin patients and even in cases where we place the implant above the muscle.  The disadvantage is that you need a slightly longer incision to introduce the implant (4- 4.5 cm in most cases) and you often will not know if it leaks or ruptures.  This is why the implant companies recommend an MRI of the breast every couple of years to view the implant to rule out a leak.  For many women this is a minor inconvenience for the superior look and feel that silicone implants offer.

In the end, for most patients we can achieve a very nice, safe result with either option, so the choice is truly yours.

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