Saline Vs Silicone and Which Profile? (Photo)

Ok so I chose my surgeon finally after seeing over 10 of them I found one that was compatible with me and my needs. I'm still confused on what profile type and saline or silicone . I'm obviously getting a lift as we'll . Can I have your advice on which to choose ? Saline , silicone or help with a profile?

Doctor Answers 10

Breast augmentation, saline vs silicone?

I agree with what you have planned but I would focus on the volume you want rather than the style.  If you pick the wrong size it will not matter what style of implant you have.  Silicone implants feel more natural and ripple less than saline.  Most women prefer silicone.  Good luck.

La Jolla Plastic Surgeon
5.0 out of 5 stars 13 reviews

Gel vs Saline, Implant profile, etc.

This is a decision for you to make with your operating surgeon.  These decisions depend on the thickness of your breast tissue, your chest measurements and what sort of size and look you want.  I always see my patients for a preoperative visit where all of these issues are revisited and these decisions are made a week or two before the actual surgery. 

I hope everything goes well for you.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Saline versus silicone

Hi. The recommendations here from other surgeons are all excellent and I commend my colleagues for taking their time to provide such good advise to you free of charge. I will add a few comments that you should take with a grain of salt as we all have our biases. To be as objective as possible, the newer silicone implants are the devices that all saline implants aspire to be. Saline implants have only a few advantages over silicone in my opinion and they have many tradeoffs as discussed by my colleagues: If they fail, you know it immediately and they are cheaper. In the FDA pre-market studies of the highly cohesive implant failures, there were no cases where the material migrated out of the pocket or capsule. Even in a previous generation of implants in patients that were followed for 5 years by MRI with known failed implants, the migration of material into the breast was around 10 percent. The disadvantages or tradeoffs of silicone implants are that they should be monitored for failure with the MRI as per the FDA recommendations which you should look at in your implant booklet supplied to you by your surgeon; or consider an MRI every 5 years in the first ten years and 3 years after that as has been recommended by other authoritative sources. There is a number of things to recommend silicone implants such as their softness, less rippling, (especially in the more cohesive implants), natural shape; but the most important attribute as their having less effect on thinning out the breast or migrating in the breast pocket over time. They become more one with the breast, particularly in the newer textured devices as well as providing a more natural shape to the breast in the upper pole with the shaped implants but even the round implants. I am not able to give you a recommendation on which implant without a consultation and examination, so this is an opinion. You will need a mastopexy with your implants if you choose to have an implant and this increases the complexity of the operation. Some surgeons will recommend two operations: having the mastopexy first and the augmentation after, while others, (including myself in most cases), will do the mastopexy/augmentation simultaneously. This surgery requires a revision or touchup and mastopexy correction on occasion and I tell my patients that this can be done in a year where needed. This is usually simpler than the original surgery and avoids the possibility of a third surgery that the staged mastopexy then implant surgery requires. The most important factor is how your tissue interfaces with the implant. I do not recommend high profile saline implants. They are just too distorting of the breast tissue over time. Whether you choose a different implant depends. You should consider getting a Vectra 3D analysis, which we have in our office, for a virtual image or your potential results using different implants. We have the new program that allows you to see the results of a mastopexy with the different implants. When we began using the silicone implants for cosmetic breast surgery after they were re-released, (they were always available for breast reconstruction), we did about 50/50 saline silicone implants the first year. As the public has been better educated with the issues and tradeoffs and have become more comfortable of silicone implants, we now place one saline to every nine silicone implants. There is more to the story than discussed here as these are just the highlights. 

David R. Stephens, MD
Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

Implant type and style?

You spent the time to visit 10 doctors.  I would suggest you discuss your concerns with your chosen surgeon and decide then.  If you're just gathering information to discuss with your surgeon, then you're going to get a ton of opinions here.  In my practice, the style is chosen according to your body dimensions and volume my patient selected.  As for gel or saline, both implants will make your breasts larger but there are benefits to gel that I explain to my patients but gel do cost more.  So saline is really fine as long as you are aware of the downsides.  Your lift should make your areola smaller and certainly more perky.  Best wishes to a great outcome!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Implant type and profile

Hi. Cohesive silicone implants have been around for 20 years now in countries outside the US and are very safe. Saline implants have a higher reoperation rate for deflation and problems such as rippling, unless you overfill them (in which case the implants are slightly firmer). Whatever type of implant you get nearly every study shows less problems and reoperations if the implants are placed under the muscle compared to over the muscle, and you are more likely to get a better cosmetic result if the implants are under the muscle.

There are many choices to make with breast augmenation, most of which have advantages and disadvantages. The size of the implant depends on what size you want to be after the operation, and if you chose an implant larger than your current breast there is a greater likelihood you will be able to see and feel the implants. If you chose large implants >350-400cc then you will achieve a more natural result with shaped (tear-drop) implants compared to round implants. It comes down to what shape/look you want from the operation. The best things is to ask your surgeon to show you photos with similar body frame and similar size implants to the ones you are thinking of to get a realisitic idea of what to expect.

Try to find someone with a Vectra 3D imaging machine in your area to simulate your breast augmenation result (see the link below) - in a recent article (Oct 2013) of Plastic& Reconstructive Surgery Journal (Plast. Reconstr. Surg.132: 810, 2013.), the main Plastic Surgery Journal worldwide, the 3D imaging VECTRA machine was found to be beneficial for patients considering breast augmentation surgery.

The article concluded that patients prefer a center that offers three-dimensional imaging technology; they feel that the simulation is very accurate and helps them greatly in choosing the implant; and that if they could go back in time, they would choose the same implant again.

All the best with your decision. Regards Dr Charles Cope

Charles Cope, MD
Sydney Plastic Surgeon
5.0 out of 5 stars 5 reviews

Implant Type

The type of implant you choose has important implications regarding the final result you will obtain. Computer imaging is helpful to illustrate the differences between implant shapes.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Saline Vs Silicone and Which Profile?

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 19 reviews

Saline Vs Silicone and Which Profile?

As we all say every time this question comes up, no one can recommend implant sizes without an exam. You already have a surgeon who has examined you so the recommendations and choices should have already been made. But I have a feeling if it took 10 consults for you to decide on a surgeon you are going to have a nearly impossible time making the decision re the implants.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Saline versus silicone breast implants

Thank you for your question.  The most important thing for you is your comfort level with your style of breast implant.  If you are concerned about silicone then saline is a better choice.

However today most women choose silicon gel breast implants.  The silicone implants feel more natural, and have less of a tendency to cause visible ripples than do saline breast implants.

From your photograph your base breast width is full thus a moderate profile plus breast implant may be a better choice.

Finally you need to consider a textured breast implant.  Recent studies have shown that the incidence of capsular contracture following breast augmentation is less with textured implants.

Saline Vs Silicone and Which Profile?

Generally speaking,  the type of implant used may  determine the final outcome for some patients undergoing breast augmentation/lifting surgery, especially if the patient does not have significant covering breast or adipose tissue. For example, most surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue.

Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
My best general advice for patients seeking to undergo 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're 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 which operation and/or 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 plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this, and the attached link, helps.

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