Saline vs Silicone implants

I would like to make my choice based on a Health and Medical stand point! Not so much of how they look! I would like to know which is the healthiest and safest implant, there is so much info on the internet that in confused and torn on which to choose!

Doctor Answers 11

New Implant Coming Out in June

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Dear Anghrstn,

Since the FDA removed their restrictions on silicone implants some eight years ago, the question has always been slam-dunk. Because of the lack of rippling, natural feel, natural appearance and durability, the silicone implant has been my preferred implant. Keep in mind both implants are made of a silicone polymer shell.

There is a new option that will be released this June, which combines the perceived safety and biologic inertness of saline filling that preserves the natural feeling and appearance of silicone. It is called the Ideal Implant which will be released this June to surgeons trained and educated in its use, all of them board certified by the American Board of Plastic Surgery.
They have already received FDA approval, and the statistics on their long-term softness and resistance to capsular contracture as well as deflation has been outstanding.

I hope this has been helpful.

Robert D. Wilcox, MD

Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Health Benefits and Risk: Silicone Vs Saline: What is IDEAL

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Both Saline and Silicone have outer envelopes of silicone and silicone has been shown to be safe. There is a new hybrid implant that is now FDA approved, called the IDEAL implant which tends to have  the soft natural feel of silicone yet the peace of mind of saline implants (i.e. no chance of silent rupture).

Saline vs. Silicone Implants

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Good question. Saline and silicone implants are both safe to use in the breasts. Numerous studies have validated the safety of the silicone implants. And the saline and silicone implants each have the same outer shell of formed silicone.
The older styles of silicone implants had a thinner outer shell and a mixture of varying sizes of internal silicone molecules, some of which were in an almost liquid state that could migrate through the outer shell and in some instances cause the body to thicken the normal capsule into a capsule that deformed the implant and therefore the breast. Today's silicone implants are made of a cohesive gel and large molecules of silicone that cannot migrate through the shell. There is now, in fact, a silicone implant that has a multi year warranty against capsular contracture--which instills confidence in doctor and patient alike. There is a lot more to the comparisons that a capable, board certified surgeon with some years of experience can share with you on this topic. In many situations the saline and silicone implants may be equal in creating similar aesthetic outcomes. However, once the playing field of safety has been crossed there are some breast shapes/appearance/history/desired outcomes that will require silicone implants in order to achieve an aesthetically pleasing and lasting outcome.

H. Steve Byrd

Steve Byrd, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

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The safer implant

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Thanks for your question! There is so much information about this online it is hard to get a straight answer. Here is the short list of differences (Ignoring the cosmetic (look and feel) differences): 

- There is no difference between the implants for health or safety
- The rupture rates and durability of the implants are nearly identical
- The capsular contracture rates are slightly lower in saline (especially if above the muscle)
- If your silicone implant is ruptured, you will require a complete capsulectomy when getting new implants. This is a slightly more involved procedure than if your saline implant had ruptured. 

Saline Vs Silicone Implants

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Both implants have a silicone outer shell.  Saline implants are filled with sterile saline solution.  If they leak, your body will absorb the saline and you will likely know that you have a leaking implant that needs to be replaced.  Silicone gel filled implants are filled with cohesive silicone gel, which means they often feel softer and more like natural breast tissue.  However, it is harder to detect a leaking silicone implant.  The silicone gel implants are also more expensive.  Very nice results can be achieved with both types of implants, so it is best to have a discussion with your PS to see which is best for you. 

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 102 reviews

Saline vs Silicone implants

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Both the saline and silicone implants have the same type of outer rubbery silicone shell. The inner fill is different: sterile saline solution in the saline Implant and silicone gel in the silicone Implant. There are advantages and disadvantages of each type of implant. Both are utilized by surgeons across the country with satisfactory results. They are both safe and approved for usage by the FDA. Currently there are more silicone gel implants used in the U.S. While either implant can produce excellent cosmetic results in the appropriate patient, most patients prefer the feel of the silicone gel implant.

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that you discuss the options with your plastic surgeon who should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Saline vs Silicone implants

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Both saline and silicone implants are safe and have been validated for use in multiple peer reviewed studies. For those who say saline is safer because it has no silicone, just remember that the shell of the saline implants is made of silicone so you will still have silicone in your body if you decide to undergo augmentation with saline implants. At the end of the day, make sure you see a board certified plastic surgeon who takes the time to properly examine and evaluate you and explain ALL of your options to you. You should decide on the implant type based on what you feel comfortable with. Good luck!


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Both saline and gel implants are very safe. Saline implants are less worry because you do not need to have follow-up Xrays for the implants. If the saline implant breaks, you will know it soon. It is advised to have periodic Xrays to check the integrity of the bag for the gel implant. Some women will wind up having MRI for  gel implants. Also, the capsular contracture rate is somewhat less for the saline implant.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.8 out of 5 stars 18 reviews

Silicone vs saline

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Both are good implants.  Briefly, much of the scare concerning supposed health risks of silicone implants have been disproven in the scientific literature.  The current silicone implants have lower leak rates than the older types (0nly about 1% leakage rate per year of the implant, or less).  Hence there is, in general, less concern that silicone implants are in any way harmful to overall health.  In general, most patients make their decision on whether to have a softer and more natural feeling implant (silicone) vs the higher cost of the silicone implants.  Additionally one cannot have silicone implants until age 22.  Some use saline because they will know if a leak occurs, while with silicone, imaging tests may be necessary to detect the leaking.  Your board certified plastic surgeon can discuss all these issues with you in detail.  Good luck!

Denton Watumull, MD
Richardson Plastic Surgeon
5.0 out of 5 stars 21 reviews

Implant safety

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Hi, I have attached a link that might behelpful...

Dear anghrstn, the primary difference between the implants revolves around the event of leakage. saline is absorbed by the capsule ( scar tissue that normally forms around the implants) and it is apparent immediately. Silicone is contained by an intact capsule and may not be apparent without imaging. In either scenario, you will need another surgery to remove the failed implant and replace it. Be sure to have a conversation with your board certified Plastic surgeon so that you can understand other relevant info, like the frequency of leakage ( which is low). Good luck!

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.