Saline Vs Silicone Breast Implants for a More Natural Look?

I'm getting Breast Augmentation in 2 months. I had originally decided on a 320cc silicone implant, but now feel safer going with saline.I contacted my plastic surgeon and it was clear she was trying to dissuade me from going this route. She believes I will be much happier with the look of silicone and stated that she rarely does a saline implant anymore, as almost all of her patients request silicone. Please help me make heads or tails with this decision I need to make. Can a saline implant give a comparable natural look?

Doctor Answers 27

Saline and silicone breast implants will look the same

There has been a general push toward the silicone gel breast implant and a feeling that patients will be 'happier' with the gel. The bare truth is that both work very well and I defy anyone to show a picture of a well performed breast augmentation and be able to tell if the implant is indeed gel or saline. Both will look very natural. The next issue is feel. It is true that the saline breast implant will have a greater tendency to show through a ripple, especially in thin skin, however in place in the breast the saline implant is soft and compressible and has a flow characteristic that makes it satisfactory and natural in most who seek augmentation with an under the muscle approach. The gel implant may feel softer, though it may not. The more cohesive the gel, the stiffer the implant. The extreme is the 'gummy bear' implant where the implant is form stable which flexes or compresses and then resumes its shape. It can look wonderful, though 'natural' it is not. Remember that with each implant there are trade offs, some more acceptable to a patient than others. Take your time to explore, and resist a push to one implant over another until you understand what your choice will mean in the long term.

Best of luck,


Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

The "look" of saline vs gel implants

If you looked at 10 patients with breast implants, half with gel and half saline, you would not be able to tell them apart based on the "look." Each look fine. The only difference is in the "feel." If a saline patient leans way forward, you can typically feel or sometimes even see ripples along the lower outside edge of the implant. If that wouldn't bother you and if you feel "safer" with the saline, go with them! Make sure they are under the muscle.

Saline vs. Silicone Breast Implants- Does it matter?

When dressed in clothing and looking at patient postoperative photographs, it is difficult to distinguish between saline and silicone. Patients with adequate natural breast volume and good skin quality, both implants may give natural results. The volume or size of the implant plays a greater role in the “more natural look” with smaller implants looking more natural than large implants. I believe the patient should determine the ultimate implant type- saline or silicone after reviewing the best options for them.

Silicone versus saline implants

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 72 reviews

Go for Silicone Breast Implants for a more natural look

If it is a close choice for you, go with SILICONE.

Yes, great results have been achieved with both saline and gel implants.

The advantages of saline are lower cost, ability to be placed through a smaller incision and by being able to put more or less saline in - we can correct minor asymmetries.

The advantages of gel implants are, they are lighter, they ripple less and they feel much more like the real breast tissue.

Good luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 100 reviews

Saline vs silicone implants

You should first be aware that there are no health risks of saline or silicone implants. Silicone implants have been studied extensively over the past 20 years and are FDA approved.

You can have a very natural result with either saline or silicone. Saline and silicone "look" quite similar. However, silicone breast implants "feel" more natural to the touch; this is why most patients and surgeons are now using more silicone breast implants. One potential problem with saline implants is that of rippling or wrinkling of the implant edges, which can often times be seen or felt on the side of the breast. This phenomenon of rippling rarely occurs with silicone due to its thicker, gel composition.

Please meet with your surgeon again to look at more implants and photos of patients to further assist in your decision.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 318 reviews

Results can be good for both saline and silicone breast implants

Good results can be had with both. To a large extent the decision of one versus the other depends on the patient's natural breast/chest anatomy. The thin patient with minimal tissue would often do better with the silicone implant in terms of ripples, and a natural feel. Otherwise, saline is acceptable.

Safety is not really a consideration as I feel both are "safe". Deflation is a possibility, and the saline implants go flat. The silicone implant, more involved and hence the need for MRI analysis. Not really a safety issue, but a consideration. All things being equal, go with what you are comfortable with.

Michael A. Marschall, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 9 reviews

Natural look depends on several factors

Both silicone and saline implants can achieve natural looking breasts. It all depends on the expertise of your surgeon and proper implant selection. It's important that you choose a proportionately sized implant that is the right shape to complement your overall body contour. This can be done by your surgeon, who will take several measurements.

Ronald Levine, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 19 reviews

A Natural Look with Saline or Silicone Implants

Some say #Saline implants feel a little less #natural feeling than #silicone. But, it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implants option called Ideal Implant™ was recently FDA approved was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The Ideal Implant has a unique structure allowing a similar look and feel to silicone, but, with the safety of saline.

Silicone implants are made with a silicone outer shell and are filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement.

With both implant types there are choices when it comes to size, shape, and profile.
Such will be discussed in greaterl detail at your consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 93 reviews

Gel vs. saline implants

Having been forced to use only saline filled implants from 1992 to 2006 I would say I am not a big fan. Saline implants are heavier than gel and tend to round out the bottom of the breast over time and have the additional problem of increase palpability of and rippling. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 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.