Is silicone better than saline?

Doctor Answers 20

Silicone better than Saline?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a question I hear on an almost daily basis.  I have been performing breast augmentation for 30 years. My current preference is to use only silicone implants  The reasons for this are: Silicone implants feel more natural and move better with the body  They also look more natural because saline implants to avoid wrinkling have to be overfilled creating a round globular look  The downside of  saline implants  is much more wrinkling rippling  and ptosis. They cause thinning of the skin and migration of the implant  100% of the patients that I have had who switched from saline implants to silicone implants preferred the silicone  The  FDA has approved silicone implants and multiple studies have set to rest the idea of silicone implants causing disease.  In my practice over the years I have only seen a handful of patients who could possibly have had a reaction to the silicone  and those were with the much older style of implant that is no longer on the market . 

Sacramento Plastic Surgeon

Silicone better than saline?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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 I preffer to use silicone cohesive gel implants (gummy bear implants) for the vast majority of our patients.  The technology is simply excellent and gives a natural look and feel.  

The merits of silicone implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your inquiry and the word better is subjective.  Rather we should explain the merits of silicone implants.  I have attached a link to my website with content and a video describing silicone implants. Hope that helps.  

Silicone vs Saline

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That depends on the individual making the choice.  Generally speaking, if a soft, natural feeling breast is the most important consideration, then a silicone implant is clearly your best choice.  The downside is that these implants are more difficult to manage when they leak and they cost more.  If cost and/or worry about silicone leakage are important factors, then a saline implant may be the better choice.  The downside to saline implants is their tendency to ripple, causing visible wrinkling on the breast.  This is a question that merits a comprehensive discussion with your plastic surgeon prior to breast augmentation surgery.

Robert C. Bledsoe, Jr., MD
Grapevine Plastic Surgeon

Choice of saline or silicone implants?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The vast majority of patients these days select cohesive silicone gel implants due to their more natural feel in those patients who have healed well (i.e. free of capsule contracture).  Rarely patients seek the security of having saline implants since they are simply water-filled and easily detectable if they rupture.  Equally important in my judgment is the fact that in my 30 years of experience I have rarely seen silicone implants rupture in the first 10 to 20 years whereas I have had moderate numbers of saline deflations between years two and eight.  If you have reasonably thick breast tissue and elastic skin saline may be a consideration for you.  Good luck with your decision and you might enjoy the video that have linked above for more information.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Saline versus silicone

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. It depends what your desired effect is as there are several key differences between the implants and a few of them are here. My patients and many patients will tell you that silicone implants feel and look more natural and have less rippling in those patients with thin breast tissue. If an implant does leak, it will be detected more easily if there are saline implants in place as the saline will simply leak out. A saline implant still has a silicone shell around it, and it is inflated to the desired volume after the appropriate pocket is developed. Smaller incisions can be used to place saline implants because they are inserted as a flat, deflated disk which is small and then gradually filled with saline. The silicone implants come fully filled. Hope this helps.


Benjamin J. Cousins MD Board Certified Plastic Surgeon

Benjamin J. Cousins, MD
Miami Beach Plastic Surgeon
5.0 out of 5 stars 10 reviews

Is silicone better than saline?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That is a good question without a good answer. Both implants are good devices but have different qualities. In my practice 95%+ of patients choose silicone because in most slender patients (the usual physique of a patient seeking breast enhancement) the silicone feels more human in that it mimics the feel of fat as opposed to the saline which is water filled. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

#siliconeimplant #salineimplant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are certain advantages and disadvantages of each. Talk to a board certified plastic surgeon to help you decide what implant meets your expectations.

For most patients in our practice, the gel implant will be a superior implant because it will look more natural, drape more like a natural breast and will feel more natural.

If you are interested in saline, see a surgeon with experience in saline, as gel (I am guessing) now represents the vast majority of implants being placed in the US. Additionally, check on warranty as companies are modifying the saline warranty.

Jack Peterson, MD
Topeka Plastic Surgeon
4.6 out of 5 stars 47 reviews

Is silicone better than saline?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question.  Both are good options and have their pros and cons.  It really depends on your goals and preference.  Generally, silicone implants feel more natural and tend to ripple less.  However, some women want the reassurance of knowing that their implant is filled with saline in case of a rupture.  Also, there are newer saline implants like the Ideal implant which feels more natural than the old "water balloon" saline implants.  Bottom line, there are many good options.  During your consultation, it's important that you get an opportunity to feel the different implants and learn more about them.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Is silicone better than saline?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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  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

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.