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

I have had a consultation a while ago ..I am petite 34A about 5 5 108lbs .. it was mentioned that I have little breast tissue ... I'm really debating between silicone & saline ... Both cost and health .. I was told with silicone a MRI is needed yearly .. I want saline but of course I want would look the most natural & best

Doctor Answers 16

Silicone or Saline

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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

Saline vs silicone

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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.

Silicone or saline

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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 :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 441 reviews


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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. Results
Miami, FL 

Saline vs silicone implants

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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.

Silicone implants look more natural

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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.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

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

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Thank you for your question.  In general, petite patients with little breast tissue will have less wrinkling and rippling with use of silicone implants.  Most patients agree the silicone implants feel and look the most natural. Regarding silicone implants-the FDA recommends an MRI every 2 years, starting at the 3rd year from surgery, to help determine if there is any break in the implant.  Since these tests can be costly, many patients elect not to get the MRI routinely.  I encourage my patients to have a yearly physical  exam.  If there are any problems that develop, then a test can be done. Hope this helps.  Best wishes.

Jeanette Padgett, MD, FACS
Oklahoma City Plastic Surgeon
4.6 out of 5 stars 11 reviews

Saline vs. silicone on petite women

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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.

Saline vs. silicone

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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.

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

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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. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 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.