How Do Other Patience Make the Decision Between Saline and Cohesive Gel Implants?

Hello, I am having a breast lift and would like my saline implants exchanged at the same time as I've had them for 16 years. I was attracted to the idea of cohesive gel for the way they feel but i've also had a good experience with my current saline. Either way, I will switch to high-profile as I feel they look less matronly but am unsure of what to do about the actual implant. Is one type better to choose when combining with a lift? Thank!

Doctor Answers 14

Type of Breast Implant?

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Either type of breast implant may be used in combination with breast lifting.

However, the type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some 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.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

Hope this helps.

Silicone or Saline Implants?

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The bottom line is that both can give very good results. The choice is very individual and many factors can enter into it as you can see from the other answers to your question. You should discuss the pros and cons of each with your board certified surgeon who should be willing to help you make your decision. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon

Saline or gel implants?

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In my practice, the choice between using saline or gel implants usually comes down to two things:  cost and feel.  While silicone gel implants more closely approximate the feel of real breast tissue, they are also more expensive.  I think most plastic surgeons prefer the silicone gel implants and, if it is in your budget, that is the implant that I would prefer.  Still, I think that saline implants can also give you a nice result.  I don't think that one is necessarily better to use than the other with a breast lift.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Choosing Between Saline & Silicone Implants...

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When patients are given a choice between Saline or Silicone breast implants, I see an ever increasing number opting for the new silicone gel type. Marketing and "word of mouth" have led to this shift of thinking over the past several years, after saline implants had been in that position for over a decade, under federal mandate.

In spite of this, there continues to be a small percentage of women, however, who continue to gravitate toward choosing saline implants. The arguments they offer in defense of this choice are generally one of the following:

  • It's more financially feasible to choose lower cost saline implants.
  • They know someone with a wonderful result from saline implants, and they would like the same.
  • The saline implants offer better incremental sizing for correction of subtle breast volume asymmetry.
  • Persisting concerns about silicone gel safety taints their decision making ability.
  • The shorter skin incision associated with saline implants is a deciding factor.

I always explain my opinion as to the numerous advantages of using silicone gel implants. In the end, I bow to the patient's request and, regardless of their choice, do my best to deliver a gratifying result.

Charles Gruenwald, MD (retired)
Baton Rouge Plastic Surgeon

How Do Patients Make Decision Between Saline & Gel Implants? Answer:

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I tell all of my patients that there are Psycho-Social reasons (saline is cheaper, fear of silicone, fear of deflation on a Hawaii vacation, difficulty detecting a leak, MRI’s?, etc) and there are Physical reasons (thin skin/thick skin, no breast/lotsa breast etc) in picking one implant type over the other. Discuss your comfort with your doctor BUT warning! If you feel both in your hand, you’ll pick silicone every time. It’s really not fair! In the body they can be very similar in many cases.

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Deciding between saline and silicone implants for breast lift and implant exchange

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Deciding between saline and silicone implants is a personal decision that needs to be based on multiple factors. There are too many issues to consider to present over internet communication. Some of these include feel, durability, cost, concerns about rippling, shape and its maintenance, detection of rupture, and effects on the soft tissues. Everyone weighs the various factors differently.

You need to see one or more reputable board certified plastic surgeons, feel the implants and discuss all the issues in detail. In my practice, nearly all of my patients opt for the silicone implants.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

How Do Other Patience Make the Decision Between Saline and Cohesive Gel Implants?

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It comes down to a very personal decision as to the "feel" of the implants, the look, and the costs comparison. 

How do others choose silicone or saline

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In our office we still use saline and silicone gel breast implants. For our patients many will come down to the 'hassle factor' between the two as both implants in properly selected patients can give very nice results. The silicone requires vigilance for leaks, MRI's, and at ten years the leak rate becomes significant, and the silicone is more difficult to replace after a leak and capsules occur. The saline you can wear until they leak, no 'hassle', and replacement is easier. The gel feel, perhaps better, but ultimately it comes to that comfort level.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Silicon gel implants feel and look more natural than saline implants

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When discussing the choice of breast implants with my patients I always recommend the use of cohesive gel implants over the saline filled implants. For over a decade we only had saline implants for cosmetic breast augmentation and these patients were almost all extremly please. If you want the most natural feeling and looking breast, then go with cohesive gel implants. 

Since you are having a breast lift I would plan to remove your sailine implants which I imagine are under your muscles and replace them with high profile textured cohesive gel fill breat implants under your breast. If you chose to have the saline implants  replaced with saline implants then  they need to be under your muscles. 

Over the years I find that when a patient has a breast lift with implants the breast will begin to sag a bit. If the implansts are under the muscle then there tends to be a sparation of the implants which stay higher on the chest and the breast tissue which is moving down a bit. 

All the patients that I have switched out from saline to gel are much happier with their gel implants than they were with their saline implants. The reverse is not true. In fact patients have made me swithch them back to gel. 

The advantage of saline implants is that they are less expensive and if they break or leak you will know it and can have them replaced. The new gel implants should have resolved the problem of leakage or breakage but we will have to see what the long term results are. So far the results have been superior and outstanding. 

If a patient doesn't have enough breast tissue to adequately cover the implant placed under the breast the a sub muscular placement is prefered. Even with the implant under the muscle I would recomment using silicone gel. 

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

Silicone versus Saline

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Since 2006, silicone implants have become more and more popular with our patients. The big advantage of them is that they feel more natural. The downside is the capsular contracture rate. 1 in 10 women will develop this after implantation. The breast will start to get hard and may need to be exchanged in the future. With saline, this is very rare, 1 in 100. Both implants are good and both are used throughout the world still. Every patient is different and you have to assess each patient individually. Most patients can choose either one but in some cases, one may work better than the other for you.

When combining a lift with augmentation, you can use either type of implant. I think in your situation, it is important to consult with a couple different plastic surgeons to see what would be best for you. In the end, you will be the one to ultimately decide which one to go with.

Leo Lapuerta, MD
Houston Plastic Surgeon
4.3 out of 5 stars 48 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.