What size? Saline vs Silicone

Currently 5'2" and 108lbs. 26 to 27 inch rib cage.

Doctor Answers 7

Breast augmentation

Thank you for your questionDuring your consultation I like to find out your goals(i.e. What cup size you would like to be).It's important to measure the width of your breast to determine which implant you need . There are 4 different profile implants.
They are moderate ,moderate classic, high and ultra high profiles.
 There are three profiles for round saline breast implants .
 Low ,moderate and high profile implants .
 I use the bloodless breast enlargement technique  ,bleeding is minimal, typically there is no bruising after surgery and recovery is quicker versus traditional technique.
I hope you find this useful. Please see enclosed video.

Tampa Plastic Surgeon
4.8 out of 5 stars 63 reviews

Saline vs Silicone, some advices:

Thank you very much for this interesting question.Breast Augmentation with Saline or Silicone It is a very common question.
In my practice i recommend using - Cohesive Gel - Silicone Breast Implants with textured cover.
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

What size? Saline vs Silicone

It's hard to determine your best size without specific breast measurements and an in person exam. Remember to choose a board certified plastic surgeon who actually takes the time to measure you and examine your breast pocket. The goal of breast augmentation is to optimally fill your breast pocket, not to overstuff or understuff it. At my practice, we utilize a series of 5 breast measurements that help me determine the implant size, which in turn helps me deliver a 24 hour recovery. Do your research and choose a surgeon who takes the time to sit down with you and discuss your goals/expectations to determine the best size for you. Remember that sizers will only give you a rough estimate. Good luck!!

Farah Naz Khan, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 100 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question. The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.   Silicone will give you a fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion. Anatomic gummy bear implants might be a good choice to give you volume. These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak. During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Best size

The best size for you depends not only on your body dimensions but also on your desires. A face to face consultation with full physical examination followed by a detailed discussion of your options and ending with a sizing session will allow you to help in the decision making process in selecting the implants best for you, both in size and in type (saline or silicone)

William A. Wallace, MD, FACS
Jacksonville Plastic Surgeon
4.8 out of 5 stars 45 reviews

What size implants

Both silicone filled and saline filled breast implants are approved for use in the US by the FDA. Both are safe. Breast implants in general have had multiple studies looking at the incidence of collagen vascular disease in patients both with and without implants. There is now definitive evidence that silicone gel implants do not increase a woman's risk for any rheumatologic condition or any set of symptoms that may represent a new disease. Interestingly, the shell of both implants is made of a rubberized silicone. Therefore, what's actually touching the patient inside the pocket is silicone in both a saline and silicone breast implant. There are a few differences in saline and silicone implants that one should consider before choosing each. Saline implants, because they are filled with water, if properly filled, will collapse in the upper portion of the implant as the water reaches a meniscus and lays flat. Saline implants also have a more palpable edge that looks like a wave that you can feel and sometimes see as a wrinkle. When saline implants are grossly overfilled, beyond the manufacturers stated range, these wrinkles can be alleviated by the overfilled implant. These implants may then feel very firm. Because saline implants are two convex discs essentially glued together, as they are filled, the transition from the back of the implant to its front can be very abrupt leading to a much more visible edge. This will make the breast seem very round in patients with very little overlying tissue. In my mind, there are a few advantages of saline implants. Saline implants cost less and because they come with no fluid in them, can be placed through remote access ports like the bellybutton or underarm. Silicone gel implants do not wrinkle as much, feel more breast- like, look better under the breast with less harsh of an edge and therefore less visible than saline implants. Because the gel is connected all the way through to the top of the implant, even in the upright position the upper pole of the breast does not completely collapse. I believe this is better in situations where after pregnancy or weight loss, the patient needs some fullness added to the upper pole of her breast. There's also a difference in how long these implants may last. In my experience, saline implants have a 10 year break rate that somewhere in the low teens and silicone gel implants are somewhere below 5%. In today's modern cosmetic breast practice, where Vectra 3-D imaging is commonly done, I don't think it's an advantage of saline implants that you can add some saline to them intraoperatively to make better symmetry. Using the Vectra 3-D imaging platform, different sizes and shapes and volumes of implants can be placed on a 3-D image of the patient to decide which implants make for the best symmetry and therefore nothing needs to be changed in the operating room. One of the criticisms of silicone gel implants in the past was that the gel with a broken implant could escape into the breast tissue and end up causing systemic illnesses or get into the lymph nodes. Modern silicone gel implants are made with a gel diffusion barrier on the inside such that the small particles of silicone cannot leech through the shell. Also, the gel itself is highly cohesive or sticky taking on more of the consistency of a gummy bear candy than of a liquid. In fact, if the implant is cut in half, the gel will only extrude from the remaining implant if squeezed and then return to the shell when the pressure is let go. Therefore, in the event of a broken silicone gel implant, the gel will be contained mostly inside of the shell of the implant. In my cosmetic breast practice, for the last 13 years or so, I have used mostly silicone gel implants. Hope this information is helpful.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

What size? Saline vs Silicone

  • Good questions. Much of the final look and feel achieved after breast augmentation surgery depends on several factors:
  • 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal. 
  • 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's  responsibilities.
  • I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
  • 3. 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. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
  • 4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. 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.
  • Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.


  • I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 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.