Breast implants: silicone or saline?

I experienced a deflation of one saline implant. Rather than wait until I'm done having kids, which could be awhile, I opted to have it done in two months. I was told silicone may hold up better and provide a better look and is safe for breastfeeding, etc. I'm concerned about rupture and silicone leaking. Any suggestions on research which demonstrates safety or efficacy of either saline or silicone?

Doctor Answers 20

Saline VS silicone

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There are both pro's and con's to each implant. Both are FDA approved and safe to use. Please click the link below for a comparison on Saline VS Silicone. Best of luck. 


Toronto Plastic Surgeon
4.9 out of 5 stars 519 reviews

Breast Implants

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Thank you for your question.  

Many patients who elect to have breast augmentations are concerned with the differences between saline and silicone gel implants.  It is important that patient understand that all implants, both saline and silicone, that are used here in the United States have been approved by the FDA, which ensure the efficacy of the product as well as patient safety.  The silicone gel implants that are currently on the market are NOT a liquid based silicone as they had been in the past.  Rather, they are a compact, pre-filled and cohesive memory gel implant, and like gummy bear candy they do not leak when they are torn apart.  

Many women who have breast implants go on to successfully breast feed their children, but a patients innate ability to breast feed is not something that we can predict pre-operatively with any real certainty.  When placed in the subpectoral position, or below/under the chest muscle, silicone gel implants tend to look and feel very natural and they also do not ripple as much as saline implants do.   Additionally, silicone implants do not share the limited 8-10 year expectancy as saline implants have.  

I hope you find this helpful!

Implants Are Safer Than Ever

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All implants used by surgeons here in the United States are approved by the FDA, which means they've gone through rigorous testing to ensure both short- and long-term safety and efficacy. Today's cohesive silicone gel implants don't leak, even in the very rare case of a rupture. Instead, the filling stays in place the way a gummy bear would hold its shape when bitten in half. That being said, some patients simply feel more comfortable with the idea of saline implants rather than silicone ones. Nonetheless, there's no research supporting the idea that saline is inherently safer than silicone -- both are equally appropriate choices. Additionally, both saline and silicone implants are safe for breastfeeding and have no effect on the milk you produce. However, the general consensus is that silicone implants generally look and feel more natural. I hope this answer helps with your decision!

Saline vs Silicone

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Saline and Silicone, Safety and PerformanceWomen have so far had essentially just two breast implant fill choices: saline or silicone.
Silicone implants have distinct advantages over saline implants in terms of performance: they wrinkle less and conform to a more natural breast shape, and also have a softer feel that is more breast-like. However, silicone implants have gained a reputation—possibly undeserved—for being less safe than saline implants. Despite the fact that there is no known toxicity of silicone gel breast implants, the possibility of a “silent rupture,” undetectable except by MRI, has been enough to make many women opt for saline implants or wait for a better product to come along. The time will be here most likely within a year or so with the advent of the Ideal Implant, the name given to a new design saline hybrid implant. It has the natural feel of silicone and safety of saline.
Saline implants, though providing peace of mind by being perceived as safer than silicone, often do not create a result that seems as natural. Wrinkling, scalloping, a globular shape, and water balloon-like feel, and increased risk of capsular contracture have been the trade-off for peace of mind with breast implants. The Ideal Implant solves many if not all of these concerns.
The Ideal Implant has bothThe Ideal Implant is one of the major technological advances to come along in the past few decades in implant manufacture. Using a novel design with internal baffles, the saline implant is manufactured to achieve a similar feel and performance comparable to a silicone implant. Approximately 95% of both patients and their surgeons expressed satisfaction at the current two-year data point by the FDA. The Ideal Breast Implant is now FDA approved and soon to be released in the US market, hopefully with in the year.

Silicone vs. Saline Implants

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With both implant types there are choices when it comes to size, shape, and profile.
A #SalineImplant is made with a #silicone outer shell that is filled with saline water during the surgery and filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leak. The #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry.
Saline tends to be 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 and is now being offered here at the Pacific Center for Plastic Surgery Newport Beach. The #IdealImplant 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 unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.

A #SiliconeImplant is made with a silicone outer shell and filled with a gummy-bear-like consistency silicone. 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 with 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. However, the FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects.

The criteria best to suit you will be discussed in full detail at your breast augmentation consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Silicone > salines

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Go for silicone, they look and feel much better and there is no risk of leaking with the newest implants.

Best of luck, 

Luis Eduardo Redondo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 21 reviews

Breast Augmentation - Saline vs Silicone

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Thank you for your question. Saline and Silicone implants are the only breast implants approved by the Food and Drug Administration (FDA).

Silicone Breast Implants- The minimum recommended age for silicone implants is 22, unless for breast reconstructive purposes Silicone implants have evolved and improved dramatically over the years from a thin, oily silicone substance to the current highly cross linked silicone polymer used today. This improved gel decreases the risk that the silicone will leak out of the shell should it rupture.

Silicone implants are much more natural feeling with a smoother and softer touch. They are also less likely to wrinkle or ripple than saline implants. MRIs are recommended every 2 years to assess the implant.

Saline-filled Breast Implants-Typically, the minimum age for saline breast implants is 18, unless the implants are needed for reconstructive purposes. Saline implants are silicone shells filled with sterile saline water, (salt water). The implants may have either a smooth and textured shell and are available in round or tear dropped shapes. Saline implants are inserted into the breast and then filled with the solution to the size the patient desires.

Saline implants are slightly less expensive but there is a greater chance of rippling or wrinkling. This is often considered the greatest issue with saline implants Also, should an implant rupture, you will have one breast that appears deflated and will need immediate attention to restore a normal appearance.

In summary, there is no real consensus on which type of implant is universally considered right for everyone, The choice is essentially an individual one in consultation with your plastic surgeon.

No risk of silicone in breastmilk

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There have been studies showing that there is no risk to breastmilk with silicone implants. Rupture is self contained and scarring results around the implant; when saline implants rupture, there is deflation but no scarring. Saline implants are made with a silicone shell, so there is still silicone in the body.

Make the Switch to Silicone

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Consider the form stable, shaped or round silicone implants.  You may have had the saline implants when the silicone moratorium was in place.  The saline implants feel firmer and bottom out more than the textured silicone. Both types are considered safe.  There is an unknown incidence of silent silicone ruptures.  We don't think these ruptures will harm women.

D`Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.7 out of 5 stars 24 reviews

Saline or Silicone

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Both silicone filled and saline filled breast implants are approved for use in the US by the FDA. Both are safe. Breast implants in general have had multiple studies looking at the incidence of collagen vascular disease in patients both with and without implants. There is now definitive evidence that silicone gel implants do not increase a woman's risk for any rheumatologic condition or any set of symptoms that may represent a new disease. Interestingly, the shell of both implants is made of a rubberized silicone. Therefore, what's actually touching the patient inside the pocket is silicone, in both a saline and a silicone breast implant. There are a few differences in saline and silicone implants that one should consider before choosing each. Saline implants, because they are filled with water, if properly filled, will collapse in the upper portion of the implant is the water reaches a meniscus and lays flat. Saline implants also have a more palpable edge that looks like a wave that you can feel and sometimes see as a wrinkle. When saline implants are grossly overfilled beyond the manufacturers stated range, these wrinkles can be alleviated by the implant, however, may feel very firm. Because saline implants are two convex discs essentially glued together, as they are filled the transition from the back of the implant to its front can be very abrupt leading to a much more visible edge. This will make the breast seem very round in patients with very little overlying tissue. In my mind, there are a few advantages of saline implants. Saline implants cost less and because they come with no fluid in them, can be placed through remote access ports like the bellybutton or underarm. Silicone gel implants do not wrinkle as much, feel more breast- like, look better under the breast with less harsh of an edge and therefore less visible. Because the gel is connected all the way through to the top of the implant, even in the upright position the upper pole of the breast does not completely collapse. I believe this is better in situations where after pregnancy or weight loss, the patient needs some fullness added to the upper pole of her breast. There's also a difference in how long these implants may last. In my experience, saline implants have a 10 year break rate that somewhere in the low teens and silicone gel implants are somewhere below 5%. In today's modern cosmetic breast practice, where Vectra 3-D imaging is commonly done, I don't think it's an advantage of saline implants that you can add some saline to them intraoperatively to make better symmetry. Using the Vectra 3-D imaging platform, different sizes and shapes and volumes of implants can be placed on a 3-D image of the patient to decide which implants make for the best symmetry and therefore nothing needs to be changed in the operating room. One of the criticisms of silicone gel implants in the past was that the gel with a broken implant could escape into the breast tissue and end up causing systemic illnesses or get into the lymph nodes. Modern silicone gel implants are made with a gel diffusion barrier on the inside such that the small particles of silicone cannot leech through the shell. Also, the shell itself is highly cohesive or sticky taking on more of the consistency of a gummy bear candy than of a liquid. In fact, if the implant is cut in half the gel will only extrude from the remaining implant if squeezed and then return to the shell when the pressure is let go. Therefore, in the event of a broken silicone gel implant the gel will be contained mostly inside of the shell of the implant. In my cosmetic breast practice, for the last 10 years or so, I have used mostly silicone gel implants. Hope this information is helpful.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 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.