Silicone V Saline on Small Breasts? (photo)

       The information presented seems reasonable and accurate.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. 

Kenneth Hughes, MD Los Angeles, CA

There is no saying that one is necessarily better.  Silicone is more expensive but may feel nicer if you have very thin skin.  Silicone has a much greater incidence of capsular contracture requiring additional surgery.  Saline implants can ripple, but the high profile ones tend to ripple less than the moderate profile.  I believe saline implants have fewer problems over the long haul, but not all surgeons agree on that.  Taking all the pros and cons of each will allow you to make a more informed choice.

I agree with your plastic surgeon, silicone implants would be a better option for you because of the possibility of rippling.  The scar would only be slightly larger, no more noticeable.  It is hard to predict cup size without using different size implants with different bras. 

The newest biodimensional infants from Sienra and Natrelee are simply amazing,. If your goal is a natural looking breast the plastic surgeon and the placement of the implant may be your most important decision. Natural looks can be achieved with both saline and silicone with silicone feeling most natural in a woman with very title breast tissue t start with. What creates a natural look is the placenta of the implant. Are they too far apart> Too High? Too Close together> These are the giveaways someone has had breast augmentation surgery. Take a look at my gallery 

In markets like Canada and Europe (and more recently the US) where both silicone and saline implants are openly available, we tend to use predominantly silicone breast implants.  The reason is that these implants allow us many more options for size and shape and they are much less likely to ripple than saline implants.  The standard infra-mammary crease incision, depending on the size of the implant will range between 4 - 5cm, an incision not much bigger than the incision needed for saline implants.  The more you depend on the implant to give you breast shape the more important it is that the implant looks natural.  From what you have described I believe silicone sounds like the best option for you.  As we girls know, cup size varies depending on the make of the bra, the day of the week and the colour of the moon so please make sure you have an opportunity to try on an implant in a tank top or see 3D imaging like Vectra to understand what that size will look like on your body. 
I hope this helps and good luck with your surgery.

Dr K.

Every surgeon has a distinct approach to breast augmentation and that approach guides your discussion.  For some surgeons, me included, the goal is a natural appearance. The difference between the two, on appearance, shouldn't be different in most cases.  The feel and palpability of the implant, may be.  Silicone implants tend to be softer and are less likely to ripple.  There are other differences between the implants as well, which your surgeon should detail in clear terms for you. 

Regarding the size, there are some women for whom a 350cc implant is ideal, some for whom it is markedly to large and others where it is too small.  Subtle findings on your exam can guide your surgeon to help you understand how those characteristics can be made into a plan for your body.  At the end of the day, if you feel like your surgeon is listening to you and that you both have a good plan, either implant can be succesful.

Find a plastic surgeon certified by the American Board of Plastic Surgery and make sure you are 100% comfortable.  Best of Luck.

Dr. Pyle
 

Silicone and saline implants are both good choices and there are pros and cons to each. Silicone tend to feel more natural than saline and that is why they are more common.

All the reasons you wrote lead me to recommend silicone implants for you. Best to rerun to this PS for further discussions to fully understand the options. 

It is a common myth that silicone gel implants are more natural feeling than saline. I have a patient who has silicone gel implants in one breast and saline in the other. Both implants are incredibly soft and natural feeling. My patient told me that the saline implant is more natural feeling, but I can feel no difference myself.

I place all my implants completely under muscle and with this additonal layer of soft tissue coverage over the implants, rippling is not a problem even in very thin women. However, if only the top of the implant is covered with mucle as in subpectoral augmentaition, rippling can be a problem in thin womwn.

Thank you for the question. So the big dilemma of saline or silicone is such a long discussion for this forum. It sounds like your surgeon is giving you good sound advice and I agree with some of the comments. Every breast type is different, some have loose skin. some have tight skin, some have a lot of tissue to cover the implant and some have little breast tissue to cover the implant. One type of implant may be perfect for one patient but not for another patient. When I see patients with not much breast tissue and tight skin or thin skin I feel silicone is a better choice. Larger breasted women with thick tissue and good quality skin could have either type of implant. What is most important is that you feel comfortable that your surgeon is honest and giving you sound advice. It is always advised to meet with several surgeons to hear different positions on this issue.