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

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.

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.

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..