Saline vs. silicone on petite women. Which implant type is right for me?

Thank you for your question.  Although I have not evaluated you in person, silicone implants give a more natural-looking and -feeling result in general compared to saline implants.  Saline implants can give patients with little breast tissue ripping which can be noticeable.All the best,Dr. ResultsMiami, FL 

Hello,We have no such recommendation in Canada where the new generation, silicone cohesive gel implants have been on the market longer. I will typically recommend my patient get an MRI done if they have trauma to the breast or concerning changes which is quite rare. Silicone certainly tends to feel and look more natural especially when the patient has very little of their own breast tissue. I recommend that you discuss the options, the FDA recommendations and pros/cons with your surgeon and then make the choice that you are most comfortable with.All the best

Hello, as you've pointed out, each implant type has unique advantages and disadvantages.  The majority of my patients with smaller breasts do choose silicone implants since they tend to be less prone to rippling.  However, I have also had petite patients who have been satisfied with their outcome with saline implants.  Best to book a followup appointment with your surgeon because they will take into account your anatomy and goals when helping you make a final decision.

In the larger patient or patient with fair amount of breast tissue, there is much less difference in appearance of saline vs silicone implants. However, most breast augmentation patients do not have a lot of breast tissue which is exactly why they are having the surgery to begin with. Most of these patients choose silicone. 95% or more of my patients choose silicone. The FDA did recommend  regular MRIs in silicone patients but I have found most patients have chosen not to have regular MRIs but have them when they have had a problem, which fortunately in my patients has been rare. Saline implants in thin or small breasted patients have a high incidence of wrinkles and being able to feel the implant edges. Does not seem natural to me. Good luck.

Both implants are equally safe, but will differ significantly in how they feel. In general, thinner patients with minimal breast tissue have more palpability, wrinkling, and rippling with saline than with silicone. Both implant types can make your breast look the same, the issue is mainly feel.I advise patients that are thin to choose silicone if they are going to be bothered by feeling wrinkling or rippling. MRI exams are recommended by the FDA every two years beginning in year 3, but it is the patient's decision as to whether or not to follow this recommendation. Due to the high cost of MRI's and the lack of insurance coverage, most patients do not get regular MRI's.

Thank you for your excellent question.  The decision on which implant type to select is based on patient preference. Both types of implants are comprised of a silicone shell, but filled with different material: saline implants contain a salt-water solution, while silicone implants contain a silicone gel. Silicone implants tend to look, and feel, more natural in the body, and are lighter in weight than their saline counterparts; however, they do require a longer incision and are more costly.   MRIs are recommended for silicone implants every two years to detect possible ruptures of the implant, but many patients decide to forego this exam if they have not had any issues in the interim.  Speak to a board certified plastic surgeon about your concerns.  They are in the best position to help you make the right decision. 

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

Silicone implants are used by an overwhelming majority of women today because these implants tend to feel more natural and are less likely to show rippling through the skin.For a petite woman like yourself with little breast tissue, silicone implants are your best option. Ultimately, of course, the decision is yours. The FDA does recommend a breast MRI three years after silicone implants are placed, and then every two years after, to look for an undetected leak of the implants.However, the decision of whether or not to get an MRI is yours.  Many plastic surgeons and other physicians recommend having a yearly physical exam, and if anything seems different with your breast implants, then an imaging study can be obtained. As far as health is concerned, leaking silicone implants do not cause any systemic health issues. Therefore, you don't need to worry about that. Definitely meet with a board certified plastic surgeon to find out more!

Hello dear, thanks for post,The choice of which type of breast
implant to use is a very common one. There are advantages and
disadvantages with both, so it's very important for you to sit down with
your plastic surgeon and discuss everything in detail.The short
answer is they are both safe options. Silicone implants have a silicone
shell and are filled with a cohesive silicone gel. Saline implants also
have a silicone shell, but are filled with saline. In my view,
the advantage of a saline implant is that you need a smaller incision
during surgery (about 3 cm or just over an inch) and if it does leak,
you will know (the breast will flatten as your body absorbs the saline)
and so you will be able to have it replaced. The disdvantage to saline
implants is that in some patients, especially very thin ones or if they
are placed above your pectoralis muscle, they can show some rippling or
folds of the implant wall.Silicone implants have the advantage
of a much more natural look and feel, even in thin patients and even in
cases where we place the implant above the muscle. The disadvantage is
that you need a slightly longer incision to introduce the implant (4-
4.5 cm in most cases) and you often will not know if it leaks or
ruptures. This is why the implant companies recommend an MRI of the
breast every couple of years to view the implant to rule out a leak. For
many women this is a minor inconvenience for the superior look and feel
that silicone implants offer.In the end, for most patients we can achieve a very nice, safe result with either option, so the choice is truly yours.Good luck :)

Silicone implants feel more natural than saline implants. They also cost more.Saline implants are safer and cheaper.  In the end it is buyer's decision.