Do You Have More Women Come Back with Problems from Saline or Silicone? (photo)

This may not be accurate to ask since almost ALL women had saline 10 years ago, so of course the women coming back are going to most likely have issues with saline, not silicone since they were not available. I am trying to make an educated decision regarding what implant to get and every study says something different and I do not know who to trust. Please give me honest opinions, based on patient satisfaction and long term results.

Doctor Answers 13

Which type of implant saline or silicone?

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Hi Karen. Instead of discussing whether saline or silicone implants are better generically, lets discuss which implant is best in a woman with your breast condition. I recommend you to the FDA publications for statistics about saline and silicone implants. 

You need a full mastopexy with or without implants. One of the things that I have not seen documented in studies, but has been my observation, is that saline implants will thin the breast tissue out over time more than silicone and have higher risk of implant displacement in the implant pocket. Saline implants have significantly increased rippling and don't feel as natural. In my view, silicone implants are far superior in most mastopexy patients as they have much superior interaction with the breast tissue. If you are using a small implant with good breast tissue coverage the issues with saline are less of a problem and can be a second option but silicone are still superior in my view. Saline implants are at best a less than ideal device. Some surgeons recommend textured surface due to their potential to adhere to the tissue and not migrate as much but in my experience, they sometimes don't adhere and can risk a higher incidence of seroma. The form stable implant is the newest device and can be an option in some patients and might be a consideration. Realize that all implants have trade offs. The shaped form stable implants can rotate and are firmer. I am concerned about the long term interaction with the breast tissue as in the saline. There is a saline implant called the "Ideal Implant" that is undergoing clinical trials that has the softness and lack of rippling similar to the silicone implant.  If you are silicone phobic you might see if you can participate in the trials. With your degree of breast ptosis, you might need a mastopexy prior to the implant. I say this while performing mostly combined mastopexy/augmentation procedures. So it is more about why you need a mastopexy, which is because your breast tissue has no firmness to it anymore and your skin has thinned out. An implant that does not "push on the breast" over the years and is soft is definitely the best device. 

More problems, saline or siicone?

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We use both implants on a regular basis. There is no one choice for all, and some will indeed do better with a silicone implant. All women did have saline 10 years ago, and we had very few problems and few complaints. When the implant is worn out it lets you know, and replacement is quite easy. Most who wore saline actually have saline replaced (if the choice is still right). As we approach year 10 with gel implants, we don't know exactly how women will react. Will they be proactive and replace implants? Will they get MRI's? Will they wait for firmness and capsular contracture? All implants require some maintainence. Look carefully at your tissue and specific needs, and what your expectations are, and then make an informed choice.

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

More options for women considering breast implants

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I generally see three sets of women, I want a gel, I want a saline and what is the best implant for me.  If your breasts is going to be more implant than you then a gel will always be better.  Other than that is is all up to personal choice.  In my practice it is about 85% GEL and 15% saline.  There is nothing wrong with a saline filled implant as long as there is enough soft tissue to cover the water baggy nature of the implant. Under thin breast tissue and skin a gel will always be better and appear more natural.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Are There More Problems with Saline or Silicone Gel Breast Implants?

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Thank you for your question.

First, you will need a Breast Lift in addition to a Breast Implant.

Choose the type of implant you are comfortable with. Modern cohesive Gel Breast Implants have not, in my experience, had more problems than Saline. Long term, deflation and rippling can occur with Saline. See link below:

Saline vs silicone implants

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I think that in general, the saline and silicone implants are both safe, and they both have similar complication rates. It is really your choice which implant to go with.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


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Both saline and silicone implants are safe and the decision is purely a personal one. The manufacturers would like you to believe that the silicone implants are far superior but they really are not.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Saline or Silicone breast implants ?

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This is maybe another take on your question: 

Before 1991 about 70 % of the implants placed in the USA were Silicone implants, then all Saline implants and now since 2006 the rate approaches again 60 - 70 % of the implants used being Silicone. Another observation: Most women who had both type of implants prefer  Silicone implants. 

Find out in a consultation what implant is the best for your looks, confidence in the implant and the surgeon placing them.

Guido P. Gutter, MD
Evansville Plastic Surgeon
4.9 out of 5 stars 18 reviews

Do You Have More Women Come Back with Problems from Saline or Silicone? (photo)

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Thanks for the question. Most boarded PSs offer either saline and or silicone choices. The choice is dependent on many factors. Some financial, others preference oriented, while others medically determined. Without in person examinations and discussions with the patient, it is very hard to recommend what to chose on such little data about yourself. Seek a few in person evaluations. 

Saline vs. Silicone - the debate continues, but I've made up my mind

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There are a variety of reasons why an individual patient may choose a saline vs. silicone implant. I think the overriding concern - at least for me - is implant durability. Its pretty clear that our current generation of cohesive silicone implants are more durable and robust medical devices compared to their saline counterparts. They also fell more 'breast like' than saline implants. 

Based on your photos, I would recommend a vertical breast lift with a silicone implant of a size to be determined based on your preferences and what's safe for your tissues.

Which is better saline or silicone #breastimplants?

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There is no question that silicone implants give a better cosmetic result. However, most of the information indicates that they are both safe and a reasonable choice. That being said, over the muscle saline implants are likely to be the worst combination and a silicone under the muscle likely the best. For you, I assume you are considering a lift in combination with your proposed plan as you will likely not have a favorable aesthetics outcome without a full lift.

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 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.