Saline Breast Implants for a 19 Year Old?

I'm 19 and want to get Breast Implants. I am a size 32 A and I am very thin and petite with not a lot of breast tissue.

I have heard that for thin women it’s better to get silicone implants because of the rippling issue. I really do not want to wait until I am 22 to get silicone.

Is it possible to still get saline with good results with minimal rippling that is not too noticeable? Thanks!

Doctor Answers 14

Your options

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There are two great options to consider:
1. IDEAL implants - these are newly released "hybrid implants" double lumen saline implants made to feel like silicone
2. I will place silicone implants in patients under 22 yrs old but first have an informed consent and have them sign a waiver that they are aware that they are being used in "off label' FDA use.

Silicone Gel Breast Implants for a 19 Year Old?

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In my opinion, there is no good reason why there is an FDA  mandated age of 22 for patients to receive silicone breast implants. There are many patients under the age of 22 who would ( based on their body type and the advantages of silicone breast implants) benefit from the use of silicone gel breast implants. Unfortunately, the use of these implants for these younger patients will negate the breast implant manufacturer warranty.

I hope this, and the attached link, helps.

Silicone gel implants are perfectly legal in a woman under age 22!

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I'm really not sure why so many of my colleagues who will use Botox daily in crow's feet (Botox Cosmetic is FDA-approved ONLY for treatment of glabellar frown lines--use in other areas is considered "off-label" but is absolutely legal and appropriate for the informed patient who requests this) are so adamant in not using silicone gel implants in well-informed women under age 22 who request them!


Use of silicone gel implants in this age group is considered "off-label" (just as Botox in  crows feet for any age women), and not only appropriate for the woman who is well-informed and consents to and requests their use, but preferable in slim petite women with little breast tissue. The incidence of visible rippling and wrinkling is much higher with saline implants in this type of patient, and silicone greatly reduces these concerns, while also providing a softer, more natural "feel" and NO chance of leakage or deflation EVER.

So find a surgeon who is informed and willing to give you the best results possible.

Sure, waiting is always an option, but will your anatomy or wishes for larger breasts change in 3 years? Or will your ability to accept and understand the informed consent process regarding silicone gel implants suddenly be better once you're 22? That's hogwash! For more information about this whole topic, click on the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Gel vs. Saline implants for a 19 year old woman

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The FDA does not recommend gel implants for women under 22 years of age.  I believe that if a women will get a better result using a gel filled implant and this can be documented by physical examination and photographs then using a gel can be justifed in certain cases.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Breast Implants in a 19 year old

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Both saline and silicone implants can create a natural good looking result.  Implants that are selected that match a patients chest diameter, that is that are not too big,  and placed behind the muscle are less likely to ripple even in a thin patient.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 reviews

Rippling and implants

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All types of implants can ripple. The biggest factor is the native breast tissue volune and skin thickness compared to the implant volume.  If you do not have good quality skin and some breast tissue, you are more prone to have it. That is why I like to put most implants under the muscle to cover the upper pole better.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Ripples, rippling or folds, creases, lumps, bumps, knuckles in Saline breast implant augmentation surgery

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Some of the reasons for visible rippling, which tend to be higher with saline implants include:

1. thin skin and minimal breast tissue with visibility of normal folds
2. moderate profile saline implants are more likely to ripple than high profile saline
3. saline are more likely to ripple than silicone implants
4. over the muscle placement are more likely ot have visible rippling than under the muscle
5. weight loss may make rippling more noticeable
6. involutional breast atrophy after nursing may make rippling more apparent
7. breast ptosis (sag) may make rippling more pronounced
8. capsular contracture with "scrunching" of implant causing folds
9. textured surface causing folds and knuckles
10. partial deflation of implant with collapse and folding
11. underfilling of implant
12. flipping of implant

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Rippling with saline breast implants can be minimized.

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1) In New York, we have hundreds of breast augmentation patients with saline implants and no rippling (and a few with rippling, of course).

2) The trick is to OVERFILL the implants beyond the manufacturer's recommendations.

3) High profile saline implants are much less prone to rippling.

4) Also, avoid textured implants, and put the implants under the muscle.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Saline implants and rippling

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You are correct, rippling is more of a concern with saline implants; especially in a thin patient with minimal breast tissue. Since you are 19 yrs old and not yet eligible for silicone, your options are to wait 3 yrs for silicone or go with saline for now. You can have a natural result if the implant size is not too large and the implant is placed in a subpectoral (under the muscle) location.

Please consult with a board certified plastic surgeon prior to your breast augmentation procedure.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 412 reviews

Implant Rippling

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There are some general concepts when it comes to breast implant rippling.

1. The greater the size difference between the implant and the breast tissue the more likely to see and feel the implant rippling.

2. Textured implants will have more rippling

3. Incompletely filled implants will have more rippling

4. Saline implants will ripple more than gel

5. Over the muscle will show more rippling than under the muscle6. Noone can reliable assure you that you will not have visible rippling.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 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.