Should I go with Saline or Silicone!? Thin 5'5" - 32AA - before - no kids. (photos)
Doctor Answers 14
Silicone vs saline debate
First, all implants experience rippling, but to various degrees. It is just a matter of whether one can see them or feel them. It is true that saline implants are indeed more prone to ripple compared to silicone implants because saline is not cohesive like silicone.
Rippling is the appearance of wrinkling, or scalloping on the implant that may be visible through the skin. It often develops on the outer perimeter of augmented breasts: on the side, bottom, or in between the breasts. Unfortunately, rippling worsens with time as the implant puts pressure on the breast tissue and thins the overlying tissue. Rippling is common in patients who are very skinny, have very little fat to hide the implant, and have small breasts compared to the implant itself. Weight loss may worsen the situation.
To correct rippling there are solutions depending on their applicability:
- If someone has under-filled saline implants, have them over-filled moderately.
- This is more of a preventative measure. Over-filling prevents the shell from folding onto itself although, it can result in unnatural firmness.
- If someone has textured implants, have it changed for a smooth surface
- If someone has large implants, have it changed for moderate sized implants so that breasts can better conceal the implant
- If someone has saline implants, have it changed for a silicone implant
- If someone has the implant placed above the muscle (subglandularly), then have it placed behind the muscle (submuscularly)
- Saline implants ripple more over the muscle (subglandularly), but the rippling can be hidden behind the pectoralis major muscle due to a thicker layer of soft tissue that conceals 2/3rd of the top of the implant. Rippling may still appear on the outer side of the breast, just above the breast fold and this is especially true if you lean forward or bend to pick up something off the floor.
- Weight gain – weight gain will allow greater soft-tissue coverage – i.e., padding – the better the implants and rippling is concealed.
- Fat transfer to the breast soft tissue for additional support and volume to area where the implant is visible
- This is the only surgical option, but there is unpredictability in the outcome due to less than 60% fat graft take. Also note that rippling is often a problem for thin patients, and such patients have very minimal fat for fat transfer.
Saline implants – Pros and Cons:
- Saline implants appear in a non-inflated form that allows their volume to be adjusted during operation to make aesthetic looking breasts
- Their non-inflated form also allows them to be inserted without having a large incision on the skin and, consequently, results in minimal scarring.
- Saline implants can be inserted through any incision site
- Saline implants have a 1%/year chance of spontaneously deflating (10% chance after 10 years), and although no one can predict when this will happen, it will be obvious as the breast with implant deflation will reduce in size significantly. Even if the implant rupture, there is no harm. Saline is “Salt water” which is administered into veins when a person is extremely dehydrated, and thus, it is harmless when absorbed by the body.
- Saline may not make the breasts feel natural because it is not compressible – there will be a strong resistance when you squeeze your breasts making them feel firm rather than soft and squishy. However, the difference in feel compared to silicone disappears with the amount of breast tissue you have. I understand that you prefer a more ‘soft and squishy’ feel, and if that is very important for you, saline implants may not be right for you.
- Saline implants are less costly compared to silicone implants
- Silicone as a filler will make the implant feel softer resembling the feel of the natural breast tissue due to its gel-like cohesiveness. This characteristic also makes the implants less detectable even by touch or feel.
- Silicone implants are ideal for thin woman with small breasts
- Silicone implants experience minimal rippling which is barely visible and may occur mostly when patients lie down on their breasts
- Silicone’s cohesive gel allows more a greater variety of implants – i.e, shaped implants are only silicone-based and provide a natural look which is helpful in treating certain conditions related to the chest wall or breast development.
- Silicone implants have a 1%/year chance of rupturing similar to saline implants (10% chance after 10 years), however, the rupture is silent which means that you will require an MRI test to diagnose the gel leakage/rupture unlike saline implants, which cause the breasts to deflate making you aware of the problem right away. For many women this is a minor inconvenience for the superior look and feel that silicone implants offer.
- Unless they are small, silicone implants can more safely be introduced behind the breasts through the inframammary or peri-areolar approach compared to the transaxillary appraoch (scarless technique)
- Silicone implants are more costly
- Silicone implants appear in pre-filled form which means implant insertion requires a longer incision on the skin and thus the scar will be longer.
- The volume of silicone implants cannot be manipulated.
- There is often a concern over safety and monitoring, but silicone implants have a similar complication rate compared to saline implants, and several clinical trials have shown the safety and longevity of silicone implants that allowed them to be approved by the FDA since 2006. The concern over silicone implant safety originated in 1990s when it was speculated that silicone was associated with connective tissue diseases such as cancer, systemic lupus erythematosis, rheumatoid arthritis, scleroderma. This soon led to the ban of silicone implants worldwide. After over 100 clinical trials showed that silicone implants are not associated with connective tissue diseases, it was not until 1999 that an independent committee of 13 research scientists affiliated with National Academy of Science concluded that silicone breast implants do not cause any major diseases such as depression, lupus, or rheumatoid arthritis, etc. However, silicone was said to be responsible for localized problems such as hardening or scarring of breast tissue. After structural re-engineering of silicone implants, FDA approved them in 2006.
- That being said, the biggest difference between saline and silicone implants is that the incision is slightly larger with a silicone implant and silicone provides a more natural feel and the current FDA recommendation is to have an MRI 3 years after implantation, and subsequently every 2 years. Please note that today's 5th generation silicone cohesive gel implants have been proven to be very durable and safe. In fact, they have lower rates of capsular contracture and silicone gel diffusion. Silicone gel diffusion which can lead to an inflammatory response was a major concern with previous silicone implants along with capsular contracture. This was the case in the 1970s, and this problem cannot be applied in the contemporary context because the more cohesive silicone gel and the higher number of shells prevent silicone’s movement, diffusion, leakage, and exposure to the surrounding breast tissue. In fact, even in the case of an implant rupture, the silicone gel remains restricted inside the shell because of its thickness – this is referred to as “gummy bear silicone”. The new silicone implants have thicker shells, wider variety of surface textures, and implant shapes, giving patients more options to meet their desired looks.
Silicone or Saline
Thank you for your question. My patients do not report Silicone weighing more than saline but many of them do switch from Saline- to silicone for the more natural look and feel. I recommend that you meet with a board certified Plastic Surgeon in person and discuss your goals/options. They will cover pros and cons for either choice with you.
All the best
Breast Augmentation/ Breast Implants / Anatomic Gummy Bear Implants/ Silicone Implants/ Breast Implant Revision Surgery
The best way to determine implant size is based on chest wall measurements that fit your body. Once we determine that we can choose the profile based on what you want or need to achieve.
Implants under the muscle, there is less risk of capsular contracture. Anatomic implants tend to give a more natural shape with more nipple projection.
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!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
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Saline vs. silicone
Feels more natural and less risk of rippling. I'm not aware of any significant weight difference between saline and silicone implants.
Saline or silicone
Paul Wigoda MD
Should I go with Saline or Silicone!?
- Good questions. You will find that the answers to these questions are best obtained during the consultation process.
- Generally speaking, 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. The weight of the breast implants are almost identical; silicone is actually a slightly lighter weight breast implant.
- 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.
Saline vs Silicone, some advices:
Breast lift with 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.
Dr. Emmanuel Mallol Cotes.-
Wish Photos and Saline or Silicone
The most useful way to utilize pictures of other woman is to review our extensive before and after breast augmentation gallery and look for patients who started with a similar breast size and shape to yours now.
Saline Vs. Silicone. Both saline and silicone implants are FDA approved for cosmetic breast augmentation in the United States. Clinical trials demonstrate similar infection, failure and re-operation rates. Neither type of implant causes breast cancer. Despite lawsuits, and internet horror stories, medical studies do not link silicone implants to autoimmune disease like lupus, scleroderma or rheumatoid arthritis.
The major difference between saline and silicone implants is how the implants look and feel. In general silicone implants are softer, lighter and will feel more "natural." Saline implants are firmer, rounder and gives a more augmented or fake look. These can be positives or negatives depending upon your goals. The main downside to saline is increased scalloping and rippling, meaning a higher likelihood of seeing (visibility) or feeling (palpability) the implant in thin patients. The only two things that control implant visibility and palpability are the device itself and the amount, and quality, of tissue above the implant hiding it. Therefore, the type of implant selected plays a large role in your result in terms of both look and feel. The vast majority of my patients select silicone implants.
Interestingly, when we refer to silicone or saline, we are talking about the inner fill material. Both saline and silicone implants have the same silicone shell, so the body is exposed to the exact same material for the majority of woman who never experience a failure. Only if the shell was to fail would the breast pocket and capsule be exposed to the fill material. Saline is absorbed and urinated out, silicone gel remains inert, and except in extraordinary cases, stays within the breast pocket.
One factor that should not be considered when considering the difference between saline and silicone breast implants is price. A few hundred dollars is a small difference upfront, for a device you may have for decades. Additionally, both implants carry a lifetime warranty against device failure, but the silicone implant includes a 10-year warranty to help pay some of the surgery fees (up to $3500) should the device fail. To put it simply, both have a lifetime “parts” warranty and silicone includes a 10 year “labor” warranty while that “labor” portion of the warranty is an additional $200 for saline, thereby negating most of the price savings.