I'm 20 Years Old and Am Unsure if the Saline Implants I Get Will Be the Best Think for Me? (photo)

I'm 20 years old, Caucasian, 5ft6 and 130 pounds. I've been looking into getting saline implants as I'm not 22 yet and cannot get the silicone. I've heard alot of bad things about saline and I'm hoping y'all can put my mind at ease. How common is rippling? And how natural will it look/feel? Also, I've heard that if you have smaller breasts, that you shouldn't get a dramatic increase in bust size like say from 32A to a 32D. Is this true? Lastly, should I get it above or below the muscle? Thanks!

Doctor Answers 12

Saline implants can give a nice result

You are correct that silicone breast implants are only approved for use at age 22 and older so right now saline implants are your only option.  Saline implants can give a nice, natural result.  I prefer silicone for women who are seeking a dramatic increase in breast size (like from an A to a D) and for women with a small amount of natural breast tissue.  I love the dual plane approach where the implants (saline or silicone) are placed partially under the muscle - this also helps me achieve a more natural appearance since the implants aren't sitting right under the skin.  You should also be aware that your nipples are spaced far apart.  This cannot be corrected with breast augmentation and will probably be more noticeable.  Please also keep in mind that you have the option of having saline implants now and going up a cup size or two.  You can see how they look over the next 2 years and switch to silicone if you want at age 22.

Atlanta Plastic Surgeon
4.4 out of 5 stars 542 reviews

Under 22 only saline can be used

Your photographs show your breasts are low and your areolas are low and pointing outward.  You would benefit from a lift procedure as much as the augmentation.  You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola approach it is possible to reshape your breast tissue to increase upper pole fullness and move your breast more medial to increase cleavage.  At the same time, if you desire, implants can be placed.  At size 32 each 100 cc of implant will correspond to 1 cup size change.  If you are an A and want to be a D, you will require 300 cc implants.  The circumareola incision avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions.  Aligning the areola, breast tissue and implant high on the chest wall over the bony prominence will give you the maximum anterior projection with a minimal size implant.  The retro-pectoral position is superior in terms of look and feel.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

I'm 20 Years Old and Am Unsure if the Saline Implants I Get Will Be the Best Think for Me?

Maybe you should wait til you are 21. Than use silicones under the muscle. Please note that your posted photos demonstrate widely spaced breasts. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Saline Breast Implant Below the Muscle in 20 year old

   Saline implants placed below the muscle in a woman with your amount of breast tissue will produce a very nice result.  Rippling occurs in silicone as well.  Find the board certified plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Submuscular Saline Breast Implants Will Usually Have An Acceptable Amount Of Rippling

Saline breast implants can create the same size as that of any silicone-based implant. While there will be some rippling that may develop on the bottom and sides of the breasts, that is an issue that may be aesthetically significant if one has little to no breast tissue from the beginning. You at least have some breast tissue to act as a buffer between the implant and the overlying skin. Placing the implants under the muscle will help decrease the rippling.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

OK for Saline Implants?

I think you are allowed to have silicone implants if you prefer them but you have plenty of breast tissue to camaflage the outline of salines if you would like.  Both are good implants and each has some advantages and disadvantages.

Check with the implant companies or have your surgeon check, as I think the restriction you are talking about has been lifted.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews


I have hundreds of women with saline implants all of whom are very happy with their results. Saline implants are a great option especially if they are placed submuscularly. Despite what the manufacturers want you to think all implants have some degree of rippling

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Saline and silicone implants

You are correct, in that you ar enot allowed to get silicone until you are 22.  Saline implants are a good alternative.  Rippling happens more in very thin patients. I usually place implants under the  muscle especially in thin patients.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Most Plastic Surgeons are using Gel implants in women under the age of 22.  As you know gels offer a much more natural result.  Almost all women with saline implants will be able to detect some rippling in the lower and lateral aspect of the breast.  I place all saline implants under the muscle unless you have a lot of your own breast tissue to adequately cover the implant.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

One year doesn't make for a lifetime.

Waiting one year to be able to have the option for silicone implants is not a huge issue especially when you are looking at your entire life.  By waiting the year you are eligible for silicone and this is an elective operation.  The placement of the implant has mostly to do with the amount of soft tissue in the upper region of your breasts.  See a board certified plastic surgeon to go over all these options.

Gary A. Tuma, MD, FACS
Princeton 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.