Are There Times when Saline is Better Than Silicone?

aside from personal pref are there certain situations where silicone would be better than saline?1stconsult Dr STRONGLY suggested SIL and that was at 450ccSIL- he mentioned rippling was more likely for me with SAL b/c of my smaller breast a 36 small b but the Dr. I decided to go with says there is no difference in the end result of SAL and SIL im going 550ccsal. Also curious to know if there is a difference in size on the sal vs sil for example does 450sil look similar to 550sal?

Doctor Answers 11

Saline vs silicone gel filled implants

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Saline implants have been used for Plastic Surgeons for years, but this has change over the past few years, after the FDA approved the use of silicone implants in the USA. Now days is difficult to see a surgeon using it.  Cohesive gel its now the most used type of implant because it feels more natural and less chances for rippling. Saline implants feels like a sack of water after a few years (saline drops out), it usually get warm in hot weather because of the saline and they feel harder. No questions about it, go for the silicone gel, I recommend Mentor (FDA), Allergan (FDA), Silimed or Eurosilicone . Good luck.

Dominican Republic Plastic Surgeon
5.0 out of 5 stars 47 reviews

Are There Times when Saline is Better Than Silicone?

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Most surgeons (and patients) prefer silicone gel implants, largely because they feel more natural, and are less likely to have ripples, which are often palpable, and sometimes visible with saline.

For women with considerable breast tissue and small implants (going, for example, from a C to a D) there may be little difference. But when most of the the final breast size will be implant, as seems the case for you, the difference is appreciable. 

As to size, and 450 silicone should look like a 450 saline that is properly filled. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Gel vs. Saline filled implants

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I generally see three sets of women, I want a gel, I want a saline and what is the best implant for me.  If your breasts is going to be more implant than you then a gel will always be better.  Other than that is is all up to personal choice.  In my practice it is about 85% GEL and 15% saline.  There is nothing wrong with a saline filled implant as long as there is enough soft tissue to cover the water baggy nature of the implant. Under thin breast tissue and skin a gel will always be better and appear more natural. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Saline vs Silicone

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Saline always feels like a bag of water whereas silicone feels more like a breast.  In thin women, saline typically shows visible rippling whereas silicone (especially the new form-stable "gummy bear" implants do not tend to ripple.  As far as size goes, I've noticed that I typically have to go 50-75cc larger  with silicone to match the same size saline.  In other words, a 450cc saline implant will look like a 500cc silicone.  This is because saline projects more whereas silicone conforms to your chest wall better and therefore has less projection.  Hope this helps.

Saline vs. Silicone implants

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For a woman who is thin and has very little breast tissue, silicone implants may be the best option.  The main difference between saline vs. silicone is a more natural feel.  Silicone implants are more expensive and require upkeep. Currently, the FDA recommends a MRI 3 years after surgery and every other year after that to determine if there is a rupture.

Saline vs Silicone

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The implant type is a personal decision for you to make.  The look from standard round implants will typically be the same.  There might be a slightly higher chance of rippling depending on the implant size and the size of your breasts before surgery.  A high strength silicone implant may have the lowest risk of rippling.

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 182 reviews

Saline-filled vs. silicone gel-filled breast implants

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Here's how I see this apples-to-oranges question. 

If the implants have the same dimensions, the saline-filled implant is filled properly, and they are positioned properly, there should be no difference in the "look" of the result or its stability. In general, the size options for saline-filled implants are similar to the standard gel-filled implants (Mentor has a size between medium and high profile for the saline-filled implant). 

The advantages of the saline-filled implant are: Major: you don't have to wonder or worry if they're intact as they are usually obviously intact or obviously not intact and there are no issues with IV saline getting out of the implant. Minor: cost less than half of gel-filled implants, incision size (inframammary) can be nearly half of that for a gel-filled implant, allow for differential filling from one side to the other (up to 10% from rated volume)

Disadvantages of saline-filled implants are: Major: they don't feel like tissue. They feel inherently ripply even if filled properly

Advantages of silicone gel-filled implants: Major: they feel like tissue

Disadvantages of silicone gel-filled implants: Major: there is currently no simple way to know if they are no longer intact and need to be replaced. Therefore, the data regarding how long they last is suspect and there is no simple way for the plastic surgeon to tell the patient her implants are intact by look or feel. 

The patient has to decide how they feel about these issues and how important they are as they can choose either type. I also show them where the implant is going to be closest to the skin and easiest to feel (where the pec muscle doesn't cover) and how much coverage they have over that area ranging from perfect coverage to very poor coverage. 

In my area and in my practice explaining the choices this way, about 80% of patients are still choosing saline-filled breast implants for primary augmentation. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Are Saline Implants Better Than Silicone Implants Sometimes

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Silicone gel implants have a better feel, have less wrinkling and generally last longer than saline implants.  Large saline implants seem to bottom out the breast more than an equal size silicone gel implant.  Implant characteristics are more important in patients who have little breast tissue so silicone gel is best used in those patients.   However, saline implants do have the following advantages: less expensive, smaller incision required because they can be inserted prior to inflation.

Philip E. Fleming, MD
Nashville Plastic Surgeon

Is Saline better than Silicone?

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Hi! Thanks for your question- in surveys done by patients and based on my experience, silicone implants look more natural in most women. However, some patients like the rounded look of a saline implant- the best option is to discuss this with your board-certified plastic surgeon. Hope this helps!

Shankar Lakshman, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 3 reviews

Silicone gel filled implants always give more natural feeling and looking breast as compared to saline filled implants

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While the results of breast augmentation mamoplasty are alway better with silicone gel filled implants there are several reasons a patient may choose saline filled breast implants. In 1990-91 there was a great controversy about the safety of silicone gel implants. While it turned out that there was no association between silicone gel implants and auto immune diseases, some patients still feel frightened by the possibility of some systemic diseases associated with gel implants. In these patients they should be given the option of saline. The  saline implants are significantly less expensive then gel. Some patients are trying to limit their costs and may therefore chose the saline. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.