Silicon VS Saline. Which is better in the long run?

I'm scheduled for my BA June 6th. I'm 5'8 140lbs with roughly a 32A. My goal is at least a C. I originally wanted 375cc Saline. I'm really leaning more toward 400cc but wanted some different opinions on silicone. Is it more dangerous if it were to rupture? I was in such a daze at my consultation my husband asked most of the questions.

Doctor Answers 17

MRI Scans Forever

Saline and silicone implants have both risks and benefits.  The problem with silicone implants is that in the future if you ever have any question about the integrity of the implant shell, for any reason, you have to have an MRI scan to evaluate the implant shell.  That can cost anywhere between $1,200 to $1,600.  It is true that the silicone "fill" is not as fluid as it was in the past and stays cohesive, but the point is if the shell is ruptured, you body is expose to internal gel, not just the silicone elastomer shell.  It's still a ruptured implant.

If a saline implant leaks, you go flat because your body absorbs the saline,  But you know what happened and you have to replace it.  MRI scan is not necessary.

The FDA still recommends routine MRI surveillance of silicone implants.  You can make your own decision about that recommendation and ask your surgeon.

I only use saline implants, so I guess I am very conservative regarding the long term durability of silicone implants.  You have to think about these things lasting 20, 30 40 plus years?

Gordon Telepun, MD
Decatur Alabama Plastic Surgeon

Saline versus Silicone

This is one of the most common questions that I get on a daily basis.

Silicone is a superior product, a more natural feel, and equally safe to saline. Cons are that it is more expensive and a "leak" is not detectable without an MRI. Although, the newer gummy bear implants don't leak like the older implants.

Saline was used from 1993 to the early 2000s as the only option for primary breast augmentation. It is a good option. Less expensive. A leak is visibly detected.

I hope this helps. Be sure to consult with a board certified plastic surgeon.

Both silicone and saline implants can be a good choice.`

Ultimately, this decision comes down to your personal preference. Both silicone and saline implants have their own advantages, and each can offer excellent results. And according to the FDA, they both carry about the same risk for complications. Although silent ruptures can sometimes happen with silicone implants and an MRI is necessary to detect the rupture, the silicone gel inside the outer shell is cohesive enough that it shouldn’t leak into the body. If you want to combine the benefits of saline and silicone, you may want to visit a board certified plastic surgeon who offers the IDEAL IMPLANT®, a new type of saline implant that feels as natural as silicone. Good luck!

Jeremy Pyle, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 66 reviews

Both Have Certain Advantages

Kudos to your husband for joining you at the consultation and being prepared with questions. Choosing between saline and silicone gel implants is a very personal decision that's based on a number of factors. Both are very safe and have unique benefits and risks. Many patients gravitate toward the latest generations of cohesive silicone gel implants, saying they look and feel more like natural breast tissue. But they aren't for everyone. Saline implants can be inserted with very small incisions, because your surgeon fills them after they are already in place. Saline implants do tend to feel a bit harder and are subject to visible rippling or wrinkling, so I recommend having them placed under the chest muscle.

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 16 reviews

Saline vs Silicone and the Ideal Implant

The FDA studies have been exhaustive and the data is pretty clear that there is no difference in the safety between saline and silicone implants. There are, however, other important differences to be aware of.

Silicone implants -  usually a little more expensive than saline, softer than saline offering a more natural feel and more natural breast movement and to a certain extent more natural breast shape. They can also commonly be placed above the chest wall muscle and can more easily be used in small breasted women. The downside is that when they leak/rupture/fail it may be more difficult to detect that this has happened. One may go for an extended period of time with a "silent" rupture. This is in and of itself not a health hazard. The FDA recommends routine MRIs with silicone implants to check to see if there is a silent rupture but the reality is that probably relatively few woman actually do this since the test is somewhat expensive.

Saline implants - usually less expensive, usually feel a little like a water balloon, tend to have an 'inflated' feel and look to them. They more commonly ripple i.e. develop waves in the shell that are visible through the breast. Their main advantage is that when they leak, they tend to deflate over the course of a few days leaving no question that a rupture has occurred. The saline in the implant is harmlessly absorbed by the body. Depending upon how much natural breast tissue is covering the implant, one can however achieve a very pretty result.

Ideal Implant - a newer design of the saline implant with an inner shell and an outer shell with a series of baffles in between. This implant is soft like a silicone implant yet is actually filled with saline and thus there is no concern about 'silent' ruptures. This is an outstanding choice for women who want a soft natural feeling breast implant that has all the benefits of a saline implant as well.

For more information about these options please see the web link below.

Best Wishes -hope this helps!

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon
4.4 out of 5 stars 25 reviews

Saline vs Silicone, some advices:

Thank you very much for this interesting question.
Breast Augmentation with Saline or Silicone It is a very common question.
In my practice i recommend using - Cohesive Gel - Silicone Breast Implants with textured cover.
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Silicon VS Saline implants

Thank you for your question. Mentor, Allergan, and Sientra are the three US companies that make FDA approved silicone and saline implants. All implants have some silicone as even the saline implants have a silicone shell. These breast implants have undergone some of the most rigorous testing in FDA history, and they are all perfectly safe to use in breast surgery. No matter what breast implant is used, there are possibilities of contracture rippling, and rupture rates for all devices. We have noted especially excellent results with the newer cohesive gel (gummy bear) implants and are using these almost exclusively in our practice. 

Implant choice

Silicone and saline can give nice results.  However, since the new silicone implants came out in 2007 98% of my patients have picked silicone. It has a superior look and feel. Also, every old saline patient that has come in for a leak or for a change in size has switched to silicone. Discuss again with your surgeon and try on and feel both types so you will feel fully informed on what you chose. Good luck.

Silicone vs Saline Implants

The choice between silicone vs saline filled implants is completely up to the patient. In my office, 99.9% of patients go with silicone implants. They have a much more natural feel and look to them compared to saline implants which are basically a bag of water. Saline implants must always go under the muscle in order to try and prevent rippling or a crinkling feeling due to their makeup. Silicone implants can go wither on top of or under the muscle, depending on a persons amount of breast tissue. If down the road you have a rupture or some kind of leakage from the valve, you will immediately have a deflation in the saline implant. Silicone implants do not do this. If some type of trauma was caused to a silicone implant, the gel is cohesive and would just stay stuck to itself inside the breast pocket. It would not leak out throughout your body. Saline implants are much cheaper vs silicone. The decision is up to you. Either one will give a nice result. Choose whichever makes you more comfortable.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

Silicon vs saline. Which is better.

Both are very good implants and there are trade offs with each. Saline implants will tend to ripple more, especially if the size is very large and adequate breast tissue to cover is important to consider. Many choose saline because of the difficulty of detecting a leak in a silicone gel implant and the expense of future replacement. You should sit down with your surgeon again and ask your own questions to understand your choice and comfort level with either implant.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 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.