Silicone Vs. Saline - Which Breast Implant is Safer?

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

Doctor Answers (12)

Saline Breast Implants vs. Silicone Breast Implants

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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.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 37 reviews

Both saline and silicone implants have advantages and disadvantages

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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.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 91 reviews

BOTH Salt water(Saline) filled and Silicone gel filled Breast Implants are EQUALLY Safe

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Both Saline and silicone filled Breast Implants are equally safe. This was proven in multiple large clinical studies.

The reason for choosing one over the other is NOT over safety but instead which CHARACTERISTICS offered by the implant are MORE important to you. The list is much longer than can be discussed here and I encourage you to visit my web page below for a fuller and clear differentiation.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

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The safety studies for both implants show that both are...

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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..

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Both Silicone and Saline Implants Are Safe

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Both Silicone and Saline Implants are Safe. Please note that the outer shell of saline implants are made of silicone so it is not like you are eliminating this risk. Also realize that Saline implants have more problems with rippling and capsular contractures in many reports in the literature.

Despite three decades of safety testing and monitoring of silicone breast implants, there is still a public perception that silicone breast implants are more toxic or dangerous than saline implants. The truth is that there has no known toxicity from silicone gel breast implants. In fact, silicone is one of the most common materials used in medical devices and implants. There is no known toxicity from silicone gel breast implants. It has been studied by the FDA for more than three decades to establish its safety. Silicone is the most common material used in medical devices/implants. Examples include shunts that go from the brain to the abdomen (for hydrocephalus) which are left in for a lifetime, artificial finger joints, syringes, IVs, catheters (including ones that go next to the heart), surrounding pacemakers, and even oral anti-gas tablets.
The one possible exception may by the PIP implant made in France (generally not available in the USA). Most of the concerns about the PIP implant were about the use of non-medical silicone and manufacturing problems, and do not relate to implants used in the United States by board-certified plastic surgeons. This is not to say that breast implants, like any implant, can have problems; they may have to be removed and are not meant to last a life time. Common reasons for replacement include: capsular contracture, rupture, infection, change in breast size, and pain—but not for toxicity.
To answer the perceived toxicity of Silicone by the general public—this is quite a different matter.
Breast implants have been around since the 1960s. About 15 years ago Connie Chung ran an exposé, Face to Face with Connie Chung, claiming silicone implants were responsible for different health problems. This led to lawsuits, a huge windfall for lawyers, and the subsequent ban on silicone implants for first-time breast augmentation patients went into effect. They were always available for breast reconstruction (e.g. after mastectomy) and replacement of existing silicone breasts. Also, please note that saline implants are still covered by a silicone envelope.
Soon after, a ban on silicone implant use became worldwide. This lasted for years until more than 100 clinical studies showed that breast implants aren’t related to cancer, lupus, scleroderma, other connective tissue diseases, or the host of other problems they were accused of causing.
June 1999, The Institute of Medicine released a 400-page report prepared by an independent committee of 13 scientists. They concluded that although silicone breast implants may be responsible for localized problems such as hardening or scarring of breast tissue, implants do not cause any major diseases such as depression, chronic fatigue syndrome, lupus or rheumatoid arthritis, etc.
The Institute of Medicine is part of the National Academy of Sciences, the nation’s most prestigious scientific organization.
Eventually, a federal judge dismissed/rejected the lawsuits, declaring them junk science and ended for the most part the barrage of lawsuits. This led to the present reintroduction of silicone implants years ago and their approval by the FDA. Interestingly enough, most of the rest of the world reintroduced them many years prior to the United States.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 38 reviews

Speak to your surgeon to help weigh your options

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Both saline and silicone breast implants have been FDA-approved for breast enhancement in the United States; however, there are still ongoing studies being completed regarding the long-term effects of leaked silicone on the body.  There are many factors that drive a woman’s decision to select saline or silicone implants.  For many women, the higher viscosity of silicone gel more closely emulates the consistency of human fat or natural breast tissue.  Because there are so many components to selecting breast implants, it’s best if you speak to a board certified plastic surgeon who can help you weigh your options given your specific goals.

C. Edwin Pittman, MD
Athens Plastic Surgeon
5.0 out of 5 stars 4 reviews

Saline and Silicone implants are considered safe and FDA approved

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Both saline and silicone implants are considered safe and approved by the FDA. I use both in my practice, and there are advantages and disadvantages to each.

Some of my patients prefer saline implants because they like the idea of having less silicone in their body in case of an implant leak. The moratorium of the use of silicone implants a few years back regarding a possible link to lupus or auto-immune disorders, although not substantiated by the evidence, left some patients nervous. The saline implants do have a silicone shell. An advantage of saline implants for my patients is that I use a transaxillary approach for insertion of the implant. A very small incision is made under the armpit so that the patient has no scarring on the breast, and this appeals to many women. With the proper amount of fill for the implant, and proper placement, the look and feel of saline implants is very natural.

Silicone gel implants can also give patients a very nice, natural result. With silicone implants the incision is made very close to the nipple or hidden under the breast in the fold. Some of the available implants offer a higher or lower profile, and there are varying degrees of firmness associated with each. The choice is really up to the patient and she should discuss advantages and disadvantages of each approach with her doctor. Communication and education are the key in getting the best result. Perhaps selecting a board certified plastic surgeon who offers both choices would give you the most unbiased answers to your question about which implant is right for you.

There will undoubtedly be discussion in the near future about recent news regarding a concern about textured implants and a rare form of Non-Hodgkins Lymphoma. Although no direct causal relationship has been established between textured implants and this very rare form of lymphoma, this may be one reason the FDA has held up approval of any new textured implants. There are several national studies in progress evaluating this important issue.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 26 reviews

Silicone and saline implant safety

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According to the FDA, both types of implants are safe. In the U.S., we have good lont-term data on the safety of saline implants, as we've been using them much longer than silicone. It appears that silicone implants are also very safe. In the U.S., though, we've only gotten about 2.5 years of followu-up data on patients that have had silicone implants due to the previous moratorium on silicone implants by the FDA.

Thus, a final determination on the long-term safety of silicone implants in the U.S. will not be available for another 5-7 years. That being said, silicone implants have been used widely throughout Europe with no issues for many years—much longer than we've used them here in the U.S. Silicone implants have also been extensively studied and repeatedly determined to be safe. Most of my patients choose silicone implants. In the end, it is best for you to go with what you feel most comfortable and safe with. A consultation with your surgeon can help you out with this.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Silicone versus Saline.

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There are different risks to each and clearly the newer style of breast implants which are probably one of the most studied devices by the FDA which have been brought to market have actually been shown to generally have a lower risk of comparable side effects when compared to saline implants. Clearly, this is partially attrubutable to the increased cohesivenss of these implants (see video below). However, the risks are different and you should not proceed until you understand these risks. Your board certified plastic surgeon will provide you with abdundant materials discussing these risks. Feel free to ask questions.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Safety of saline or silicone breast implants

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Both implants are safe. Silicone breast implants have been studied to death. And finally, the truth of science prevailed and the silicone breast implant was found SAFE.
There are pros and cons about each one of them.
Discuss these issues with your PS and decide for yourself, and what you are comfortable with.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.