Saline vs "gummy bear" silicone. Which would be best for obtaining more cleavage w/ the teardrop shape? Pros & cons? (photo)

I will be having a revision to fix my 13 year old saline submuscular implant. When doing so I am opting to go slightly bigger but want to have the cleavage with a teardrop shape. What are the pros and cons of saline.

Doctor Answers 7

Cleavage and Teardrop apperance, which is better, saline or silicone?

Hi MamaKoop,Thanks for your question and photos. Depending on who you ask the opinion will likely be different. Most plastic surgeons have their own personal preferences. These vary based on the surgeons experiences and expertise. Based on your photos, for a more natural look, silicone does better. Texturing carries a possible higher risk of adult large cell lymphoma that is associated with breast implants. It is a small risk but so far has been seen mainly with textured implants. I would suggest just a simple implant exchange with smooth silicone implants in the same pocket under the muscle but that depends if you were happy with the cleavage you had before the deflation. If not then over the muscle and under the fascia! Hope this helps! Good luck and congrats!   All the best, Carlos Mata MD, MBA, FACS #breastrevision #gummybear Board Certified Plastic Surgeon

Implant choices to improve cleavage

With implants under the muscle, the space between the breasts is determined to a large degree by the muscle attachment along the sides of the sternum (breast bone.) Releasing the muscle to move them closer poses a risk of animation deformities which would not be a good trade-off; going above the muscle would allow them to be closer together but could appear unnatural. Textured implants may resist lateral displacement better than smooth implants, and these could be either teardrop or round depending on which fits your breast the best. So my suggestion is textured silicone gel implants under the muscle with very cautious release.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Saline vs "gummy bear" silicone. Which would be best for obtaining more cleavage w/ the teardrop shape? Pros & cons?

Thank you for your question and photos. It looks like you have a deflation on one side and have significant volume of breast tissue. I would recommend round smooth  cohesive silicone gel implants either in the same submuscular pocket with more muscle release medially or a pocket change to a subglandular pocket for closer cleavage. A shaped, "gummy bear" implant has an increased risk of rotation especially if capsulectomy has to be done. In multiple studies, it is difficult to impossible to tell if a woman had a round or shaped implant. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Smooth round

I also agree that smooth round is the way to go. Tear drop implants are textured increasing a potential risk for ALCL. They also rotate. I have a journal article coming out discussing how frequently tear drop implants actually rotate once inside. If you want cleavage, sticky with a smooth round implant under the muscle will get you that. Best of luck!

Saline vs "gummy bear" silicone.

Your surgeon simply needs to get a more complete release of the muscle. That incomplete release is the cause of the wide space, getting wider with arm elevation. Either implant will do but the saline is rarely used because the silicone is so much more natural in its feel.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews


I would stick with round smooth implants. Tear drop must be textured. I will not use textured implants for more than one reason, but especially anaplastic large cell lymphomo.(ALCL) Google it.

Saline versus silicone gel breast implants?

Thank you for the question. In regards to the saline versus silicone gel breast implant question: 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.

In my practice, I individualize the type of breast implant utilized based on many factors, including the patient's starting anatomy, the potential for weight gain/loss after surgery, patient concerns regarding each type of breast implant, and (probably most importantly) the patient's goals.
 I hope this, and the attached link ( dedicated to revisionary breast surgery concerns) helps.  Best wishes for an outcome that you will be pleased with long-term.

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.