Why Overfill a Saline Implant Vs Just Putting in a Bigger Size?

Question

While I have silicone implants I see a lot of the ladies who get saline have them overfilled. My question is why overfill as opposed to just putting in a bigger size. I would think overfilling would put the implant at a greater risk for rupture? Thanks!

Aldo Guerra, MD · Answer

Hello and thanks for your post. Overfilling saline implants is considered safe, while under filling can increase the risk of rupture of saline breast implants. Over filled saline look very full and often "stuck on". Best wishes, Dr. Aldo.

Ted Eisenberg, DO, FACOS, FAACS · Answer

In Aesthetic Plastic Surgery (2021) I published a paper "Does Overfilling Smooth Inflatable Saline-Filled Breast Implants Decrease the Deflation Rate? Experience with 4761 Augmentation Mammaplasty Patients" and found a significant decrease in deflation. Dr Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa. USA.

Ronald J. Edelson, MD · Answer

I think the majority of plastic surgeons overfill their saline implants in order to reduce the amount of rippling. However, I have found that using a high profile implant filled exactly to the amount on the package gives the nest overall feel with the least rippling. I used to overfill the implants but they can feel too firm and bouncy in I do. That’s my experience. Every surgeon has a different take in this.

Rady Rahban, MD, FACS · Answer

Ok....good question.  Why overfill.  The main reason to overfill is to reduce the rippling that is guaranteed with saline implants.  It isn't really meant to increase the size.  Yes as you increase the filling you definitely increase the rupture rate but no one knows how much is too much.  In addition, you increase the projection, hence making the implant like a High Profile implant.  Overall I am not a huge fan of Saline implants personally.  I like the feel of silicone better and with the new silicone implants that have increased cohesivity, the issues with rippling are much less. 

	Hope that helps

	RR

M. Scott Haydon, MD · Answer

Great question. In my opinion the saline implant is an inferior product. It does not look or feel as natural as the silicone and it has a higher reoperation rate. The saline implant must be overfilled if you want to reduce rippling. Unfortunately, this makes the implant feel more firm. It is analogous to putting more water in a balloon.

Edwin C. Pound, III, MD · Answer

The implant companies recommend overfilling their implants in order to minimize the potential for ripples/wrinkles that can be felt/seen with saline implants. Usually, the recommended amount of overfill is fairly minimal. Saline implants are basically a bag full of water and have the potential to look/feel like a bag full of water. Overfilling helps negate this problem, however, it may make the implants feel firmer than a silicone gel implant. A NICE thing about being able to overfill a saline implant is that you have more flexibility as to the final volume. You can adjust the final volume of a saline implant before removing the fill tube, something you cannot do with a silicone gel implant. Finally, as long as the saline implant is overfilled within the recommended limits, there should be no greater risk for rupture.

Kenneth Hughes, MD · Answer

Filling a saline implant with a greater volume reduces rippling and decreases the diameter of the implant allowing for more volume at a reduced diameter. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

David Shafer, MD, FACS · Answer

Saline implants have a fill range, with a maximum and a minimum recommended volume from the manufacturer.  Filling above this volume is not recommended.  In most cases our patient choose silicone implants and are leaning much more toward the cohesive/anatomic varieties.  Several patients who have had Saline implants in the past and we switched them to the newer "gummy bear" or "tear drop" breast implants have been overjoyed with their results, commenting on the improved natural shape and feel of the implant.   However, if a patient wan'ts saline implants, we do still offer those as well.

	 

	Good Luck.

Robert F. Centeno, MD, FACS · Answer

Overfilling of implants refers to filling a saline implant to the upper limit of its range. This is quite safe and decreases rippling of the implant. Thanks for your question.

David Bogue, MD · Answer

Saline implants are designed to be overfilled. When they are filled to the nominal volume, the rippling and folding in the implant can be easily visible. Overfilling helps minimize the rippling that is seen. However, by overfilling the implant it becomes firmer in its feel. Overfilling by more than the recommended amount can lead to higher rupture rates, but so can underfilling the implant.

Why Overfill a Saline Implant Vs Just Putting in a Bigger Size?

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