Which to choose, silicone or saline? What size implant is best for me? (Photo)

I had 550cc saline implants and about 5 years ago my right one ruptured so the PS replaced them with 700cc silicone. I wear a DDD in a bra and I hate it. I spoke with a PS and he said he could remove these implants and do a mastopexy and put in smaller saline implants. I have thin breast skin and I'm not sure if I would be happy with saline. I tend to ripple. What do you suggest? Also what size implants should I consider? I was thinking about 500cc do you think it would make a big difference?

Doctor Answers 6


Thank you for your question and picture.  If you decrease from 700 to 500 you will probably drop about 1 cup size but will likely need a lift because of the extra skin.  I would recommend that you stay away from the saline implants as they may likely ripple more so than the silicone implants and probably cause more droopiness. 

Pembroke Pines Plastic Surgeon
4.6 out of 5 stars 28 reviews

Implant revision

You would have to be seen in person to determine what is appropriate.  If you have thin tissues then under the  muscle may be better and you may need an ADM to camouflage the lower pole.

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

Planning a breast implant revision

Thank you for asking about your breast implant revision.

  • You have very large implants now - you are right to have smaller ones.
  • If your skin is thin, gel implants are less likely to show through.
  • Are you happy with the gel? Do they show less than the saline ones you had before?
  • If so, gel implants of no more than 500 cc seems fine - look at your photos when you had implants this size to remind yourself of the difference.
  • You will see a significant change.
  • Depending on your age, height, weight and the look you want, you might want to consider even smaller ones.

Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Why not stick with silicone/gel

if you have thin skin and don't want the rippling. Downsize and do the lift, saline vs silicone is a personal choice. Going back down to 500-550 you will clearly notice a difference and you know roughly what that looks like on your body as you used to have 500cc implants. 

Which to choose, silicone or saline? What size implant is best for me?

Thank you for the question and pictures. Given your anatomy and concerns regarding rippling with breast implants, it is likely that you will be best off sticking with the use of silicone gel breast implants.  Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.  Sometimes,  when downsizing) additional "maneuvers" such as breast lifting may be necessary (depending on the patient's physical examination).

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps.  You will find a separate page, on the same website, dedicated specifically to downsizing breast implant surgery concerns.  Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Breast Revision to Include Smaller Implants

It is certainly possible to #exchange for smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome. Typically, it's best to wait 6 to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. It's best to consult with a board-certified plastic surgeons who has specialized in cosmetic breast surgeries. They are most suitable to perform your revision. You will then greatly improve your chances of getting the result you desire, and, without the need for additional revision surgery.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 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.