I Can't Decide on Saline or Silicone. I Want It to Feel Natural but the Silicone Scares Me?

5-7, 145 lbs. Age 68

Doctor Answers 22

Saline versus Silicone

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My patients greatly prefer the feel of silicone implants over saline. Even patients who start out with saline implants and switch to silicone greatly prefer the way they feel. Both are FDA approved, so I generally recommend silicone. If you were my family member, I would say "get silicone".

Saline or Silicone

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Both implants are FDA approved. My preference is to use saline implants on patients with adequate breast tissue placed in subpectoral fashion and on those patients who have not had children. If a patient has no breast tissue or after their child bearing years I preferably use silicone gel. If you have a rupture with saline implants you will know, however with silicone implants you may not know for quite some time.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Saline or silicone?

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There are advantages and disadvantages of each.  Personally, I perform more saline implants  than silicone.  In most women, saline will feel some arable to silicone.  The major advantage of saline , I believe, is that they tend to more more trouble free and worry free over time.  The deflation rate is pretty low, and the implant makers warrantee them for life against deflation.  Silicone gel have a higher incidence of capsular contracture, no,matter what anyone tells you to the contrary.  I feel that silicone is very safe, but saline tend to be more worry free.  Help this helps.

I Can't Decide on #Saline or #Silicone... ANS:

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One thing to consider is at 68 years old, you may want to go with silicone. Do you really want to deal with a saline deflation and anesthesia at 78 years old. That would scare me more than silicone implants, which might end up being the only implant you ever have. But remember there is no reason you cannot get a very natural feeling breast with Saline. They can feel just as soft as a silicone implant, although the feel can be a little different.

Silicone vs. Saline #breastimplants

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Once we start discussing your breast augmentation, one of the choices you will need to make is whether to use Saline or Silicone breast implants.  There is not one correct answer to this question, but there may be a more correct choice for you depending on what your goals are, and what physical qualities of breast tissue you possess. Both styles are available in different sizes, shapes, and textures. The choice will therefore depend on other factors specific to you that will be discussed at your consultation. The following chart summarizes some of the differences and similarities between both implant types. The FDA never proved that leaking silicone in the breast pocket caused any physical harm to patients and thus were released once again for cosmetic use. Keep in mind they were never taken off of the market for breast cancer reconstruction so what does that tell you about what the FDA thought all along? They never really thought there was an issue with medical grade silicone implants harming people. Ultimately if you fear gels do not get them. Saline can be a great choice if you have the right tissue quality.


Silicone vs Saline implants.

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Both Silicone Gel and Saline implants are approved by the FDA. The outer shell is the same for both types of implants, it is the fill material that is different. 

Silicone gel does feel a little more natural, but if the implant is placed behind the muscle, this difference is very minor. 

It usually takes a larger incision to place the silicone implants as they are already inflated and the FDA currently recommends an MRI 3 years after implantation and every two years after to check for leaks. A saline implant leak is noticed within days of rupture and the saline is absorbed by the body as it is the same solution we use in your IV solution. Silicone implants also cost more than saline. This is why I prefer the saline implant. 

Natural feel of silicone implants is over-rated

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I place both silicone and saline implants through the trans-axillary sub-muscular approach. I can honestly say that I can not tell any difference in the results. A natural feeling result is entirely dependent on how the patient heals (and all heal differently). I believe post-operative massage also is important. When the two implants are compared in the office, the silicone implant feels much more natural, but this does not translate to how they feel under the muscle. Some of my most natural results have been with saline implants. I think your choice depends on your long term goals. If you were young and planning to have children in the future, I would definitely go with Saline as these are easier to remove and revise in the future when you are done child-bearing. The average life of a saline implant is under 13 years so silicone may be a better choice if you are looking for a more long term result. At 68 years old, saline will probably get you well into your 80's.

Louis R. Mandris, MD
Rancho Cucamonga Plastic Surgeon

Safety of silicone gel implants

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There is ample evidence that shows the safety of silicone breast implants.   If you are at all concerned then the saline filled implant is always available.   It is important to understand that both the outer shell of both implants is made from the rubber form of silicone.  

Silicone is safe

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Thank you for the question.  There are other women who feel the same way as you do.  All I could say is that perhaps no other medical device in the world has been studied as much as the breast implant.  It has been shown to be safe in thousands of studies.  More importantly, many of the medical devices that are used in other specialties are also either made of or contain silicone.  Lastly, silicone implants is what the majority if not all of the plastic surgeons would recommend to their loved ones.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Silicone breast implants feel more natural

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Both silicone and saline implants are safe.  Both are FDA approved.  If safety was an issue only the safest would be used by board-certified plastic surgeons.  Silicone was taken off the market by the FDA for over a decade but back in 2006 the FDA determined there was no evidence that silicone breast implants caused any health problems and allowed them to be used again.  They are popular because silicone does feel more natural than saline implants.  In someone with a large amount of breast tissue however, a saline implant will be well covered and prevent significant palpability, therefore the type of implant may not be as important.  In a thin patient with little breast tissue silicone will generally feel more natural.  Only after consultation with a board-certified plastic surgeon will you be able to get an accurate assessment about which type of implant will work best for you. 

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.